Abstract
Evidence-informed decision-making (EIDM) is a transparent, systematic approach with structured, repeatable techniques to locate, assess, and apply evidence in a variety of decision-making processes and practices. Making informed decisions about health systems and policies that contribute to Sustainable Development Goals, such as universal health care, excellent health, and well-being, requires timely access to solid credible evidence. While there is sufficient evidence on the crucial role of rapid evidence synthesis platforms in health policy and health systems decision-making, there is still a gap regarding their integration into institutional frameworks particularly when it comes to the increasingly contested nature of knowledge and its generation and use in developing countries that are usually viewed as low resource settings. Through key informant interviews and document analysis, the thesis examined key factors influencing EIDM institutionalisation, the viability of the rapid evidence synthesis platform approach, and strategies for sustaining the institutionalisation process. The findings of the thesis offer valuable insights into dynamics of EIDM institutionalisation that include evidence making practices linked to institutional frameworks and skills, incentives, high-level support, networks, stakeholder involvement, the systemic environment, and related political and other interests at play. Capacity development also emerged as an important cross-cutting element. The findings of the thesis further point to intricacies of the interconnections between diverse practices and processes during EIDM institutionalisation, which is marked by an equally complicated and politically charged decision-making process. The thesis also highlighted that, given the complexities involved in the institutionalisation of EIDM, the rapid evidence synthesis platform approach emerges as having enormous potential as a sustainable strategy for institutionalising EIDM in health systems in low-resource settings. This is, however the case, provided that it is interpreted and conceptualised in a standardised, demand-driven, locally contextualised, and integrated manner. The thesis concluded that, rather than narrowly concentrating on classical aspects such as skills, processes, and procedures, equal emphasis needs to be given to "softer" factors such as leadership, political dynamics, interpersonal relationships, and social networks when institutionalising EIDM. By establishing a connection between institutional theory and practical knowledge translation variables, the thesis thus offers a more nuanced understanding of the institutionalisation, effectiveness, and sustainability of rapid evidence synthesis platforms in institutionalising EIDM. The thesis recommends that targeted research be done in specific parts of the process to have a better grasp of how the distinct factors interact with one another.
Keywords: Evidence-informed decision-making, Institutionalisation, health, policy, evidence, synthesis