How do decision-makers use evidence in community health policy and financing decisions? A qualitative study and conceptual framework in four African countries.

Authors: Meghan Bruce Kumar, Miriam Taegtmeyer, Jason Madan, Sozinho Ndmia, Kinglsey Chikaphupha, Aschenaki Kea, and Edwine Barasa

Decisions about whether and how to finance and support close-to-community community health programming are best driven by evidence about what “works,” but a recent study by Meghan Bruce Kumar and her team suggests that the evidence base is limited. The researchers took a look at financing decisions in Ethiopia, Kenya, Malawai, and Mozambique to model their decision making processes. They found that decisions are often guided by limited resources, little pressure to evaluate existing strategies, and political opposition to evidence-driven changes.