Use of evidence for decision making: a qualitative exploratory study on MNCH program, Pakistan

ABSTRACT

Research and evidence are getting more important for organizing and delivering the health services. Quality research has an important part to play in strengthening the health systems. There is a concern that evidence is not utilized to the extent it should be. The purpose of this study was to find out whether the Maternal, Neonatal and Child Health [MNCH] Program is an evidence based initiative in Pakistan. A qualitative exploratory study was conducted in June toAugust 2011 in Islamabad, with key stakeholders of health system, using a semi-structured in-depth interview. The study participants feel that the basis of decision-making in Pakistan's health sector including national MNCH program is indeed evidence based; however other factors such as personal interest, donor interest and political factors have influenced as well. They quote national surveys, research studies and HMIS as credible sources of evidence. There is consensus on the importance and use of local, regional and global evidence. National as well as international best practices have been considered at the conceptualization, designing and planning phases of MNCH program; while execution and M and E stages have not benefitted at all from the available evidence. Lack of funding for research, time limitations and absence of culture of evidence utilization are some of the challenges. Astrong linkage between researches, policy makers and managers is most emphasized strategy for ensuring evidence based decision-making. This study has informed the stakeholders about the extent, type and scope of evidence utilization for decision-making of national MNCH program. Moreover, an improved use of evidence in future country wide programs will help in resource saving, ensuring better performance, ownership and sustainability of the program