Table 3.
Comparing mean differences in factors influencing the health policymaking process and use of evidence in the policymaking across the study countries (* indicates p-values <0.05, ** indicates p-values <0.001)
| |
Overall |
Lebanon |
Pakistan |
Palestine |
Jordan |
Bahrain |
Sudan |
Yemen |
Oman |
Algeria |
Tunisia |
|---|---|---|---|---|---|---|---|---|---|---|---|
| |
N = 237 |
N = 20 |
N = 42 |
N = 28 |
N = 27 |
N = 10 |
N = 29 |
N = 27 |
N = 23 |
N = 22 |
N = 9 |
| Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | |
|
Factors influencing the health policymaking process | |||||||||||
| 1-Lack of coordination in governmental/ministerial relations across different ministries (such as the Ministry of Health, Ministry of Finance, etc.) hindered the health policymaking process. |
3.86 (1.02) |
4.20 (0.70) |
3.93 (0.95) |
3.79 (0.92) |
4.04 (0.90) |
3.2 (1.62) |
4.24 (0.87)* |
4.27 (0.78)* |
3.09 (1.24)* |
3.5 (0.96) |
3.56 (1.01) |
| 2-Lack of coordination in government/ health provider relations hindered the health policymaking process. |
3.62 (1.01) |
3.55 (0.83) |
3.76 (0.97) |
3.82 (0.86) |
4.04 (0.82)* |
3.20 (1.40) |
3.62 (1.12) |
3.85 (0.78) |
3.04 (1.19)* |
3.45 (1.06) |
3.00 (1.00) |
| 3-Physician associations exerted a strong influence on the health policymaking process. |
2.6 (1.17) |
3.35 (1.14) |
2.88 (1.10) |
2.29 (0.94) |
3 (1.07) |
2.78 (0.97) |
2.48 (1.30) |
1.63 (0.79)** |
2.14 (1.11) |
2.68 (1.25) |
3.33 (0.87)* |
| 4-Nursing associations exerted a strong influence on the health policymaking process. |
2.22 (0.91) |
2.25 (0.79) |
2.26 (0.83) |
2.18 (0.82) |
2.56 (0.85)* |
2.67 (0.71) |
2.14 (0.95) |
1.46 (0.71)** |
2.15 (1.09) |
2.43 (0.98) |
2.88 (0.84) |
| 5-Other types of health professional associations exerted a strong influence on the health policymaking process (e.g., Syndicate of hospitals). |
2.59 (1.07) |
3.70 (0.80)** |
2.67 (0.85) |
2.11 (0.88)** |
3 (1.18) |
2.60 (0.70) |
2.34 (0.90) |
1.65 (0.85)** |
2.19 (1.03) |
3.14 (1.08)* |
3.11 (0.93) |
| 6-Private health providers exerted a strong influence on the health policymaking process. |
2.87 (1.08) |
3.60 (1.10)** |
2.67 (1.03) |
2.96 (1.14) |
3.3 (1.03)* |
3.30 (0.82) |
2.96 (1.02) |
2.37 (1.04)* |
2.3 (0.88)* |
2.71 (1.01) |
3.00 (1.00) |
| 7-Private insurers exerted a strong influence on the health policymaking process. |
2.42 (1.06) |
2.80 (0.95) |
2.45 (0.92) |
2.32 (0.91) |
2.44 (1.03) |
2.56 (0.88) |
3.1 (1.29)* |
1.92 (1.02)* |
1.96 (0.98)* |
2.09 (1.14) |
2.33 (0.87) |
| 8-Values of governing parties exerted a strong influence on the health policymaking process. |
3.36 (1.22) |
3.65 (1.39) |
3.15 (1.04) |
3.36 (1.22) |
2.67 (1.8)* |
3.70 (0.82) |
4.00 (1.10)* |
3.69 (1.09) |
2.43 (1.29)* |
3.5 (1.10) |
4.22 (0.67)* |
| 9-Public opinion exerted a strong influence on the health policymaking process. |
3.04 (1.09) |
2.80 (1.20) |
2.67 (1.00)** |
2.71 (1.08) |
3.33 (1.11) |
3.7 (0.82)* |
3.34 (1.11) |
2.81 (0.98) |
3.43 (0.99) |
3.00 (1.16) |
3.44 (0.88) |
| 10-Media exerted a strong influence on the health policymaking process. |
3.21 (0.99) |
3.40 (0.94) |
2.95 (0.99) |
2.79 (0.83) |
3.67 (0.96)* |
3.5 (1.18) |
3.57 (1.10) |
3.11 (0.93) |
3.13 (1.14) |
3.14 (0.77) |
3.22 (0.67) |
| 11-Research about problems related to healthcare or health systems exerted a strong influence on the health policymaking process. |
3.17 (1.13) |
3.30 (0.92) |
3.12 (1.13) |
2.79 (1.20) |
2.96 (1.13) |
3.5 (0.97) |
3.54 (1.04) |
2.81 (1.15) |
3.78 (1.09)* |
2.82 (1.18) |
3.78 (0.83) |
| 12-Limited public funding for the health sector exerted a strong influence on the health policymaking process. |
4.05 (1.10) |
4.25 (0.91) |
3.81 (1.38) |
4.21 (0.79) |
3.63 (1.25) |
4.3 (1.25) |
4.52 (0.68)* |
4.3 (0.95) |
3.78 (1.20) |
3.86 (1.13) |
4.00 (0.87) |
| 13-Other countries’ health policies exerted a strong influence on the health policymaking process. |
3.14 (1.00) |
2.85 (0.99) |
2.76 (0.87)** |
3.54 (0.92) |
3.37 (0.74) |
3.2 (1.03) |
3.21 (1.15) |
2.96 (0.96) |
3.61 (0.94)* |
2.95 (1.24) |
3.00 (0.87) |
| 14-Donor organizations (e.g., United States Agency for International Development (USAID), United Nations, World Bank, World Health Organization (WHO)) exerted a strong influence on the health policymaking process. |
3.83 (1.01) |
4.00 (0.97) |
3.86 (0.84) |
4.32 (0.82) |
4.00 (1.04) |
3.2 (0.92) |
4.07 (0.84) |
4.04 (0.90) |
3.43 (1.16) |
3.14 (1.17)* |
3.22 (1.09) |
|
Use of evidence in the health policymaking process | |||||||||||
| 1-I generally look and/or ask for scientific evidence to support my work in formulating and implementing health policies. |
4.28 (0.80) |
4.70 (0.47)* |
4.2 (0.93) |
4.36 (0.68) |
4.04 (0.76) |
4.5 (0.53) |
4.52 (0.51)* |
3.96 (1.02) |
4.48 (0.67) |
3.95 (0.95) |
4.33 (0.71) |
| 2-I have access to health research through an internet connection at my organization. |
3.94 (1.06) |
3.75 (1.21) |
3.98 (1.28) |
4.18 (0.77) |
3.81 (1.04) |
4.4 (0.70) |
4.21 (0.86) |
3.63 (1.15) |
3.74 (1.14) |
3.68 (1.08) |
4.44 (0.53)* |
| 3-There are contact and collaborative relations between researchers and health policymakers/ decision makers in my organization. |
3.15 (1.07) |
3.45 (1.15) |
3.17 (1.14) |
3.39 (0.99) |
2.74 (0.98)* |
3.8 (0.63)* |
3.14 (0.89) |
2.63 (1.15)* |
3.3 (1.11) |
3.1 (1.07) |
3.44 (1.13) |
| 4-I participated in meetings with researchers to identify high-priority policy issues for which research is needed to inform how to address these issues. |
3.71 (1.06) |
4.15 (0.49)* |
3.63 (1.22) |
3.82 (0.86) |
3.37 (1.18) |
4 (0.82) |
4.07 (0.96) |
3.31 (1.16) |
3.65 (1.23) |
3.41 (0.96) |
4.44 (0.53)* |
| 5-Health policymakers request scientific evidence in the policymaking process. |
3.26 (1.09) |
3.75 (1.07) |
3.22 (1.13) |
3.07 (1.09) |
2.81 (1.11)* |
4.2 (0.63)* |
3.07 (1.00) |
2.93 (1.21) |
3.35 (0.89) |
3.50 (1.01) |
4.00 (0.87)* |
| 6-The scientific evidence is delivered at the right time. |
2.77 (1.01) |
2.7 (0.92) |
2.9 (1.06) |
2.75 (0.80) |
2.56 (0.89) |
3.6 (0.52)* |
2.48 (0.98) |
1.85 (0.77)** |
3.00 (0.91) |
3.52 (1.03)* |
3.33 (1.00) |
| 7-There are summaries of evidence with messages that specify possible actions about health policies issues I confronted in my organization. |
2.96 (1.08) |
3.1 (1.07) |
3 (1.13) |
3.14 (1.01) |
2.7 (0.91) |
3.1 (0.99) |
2.93 (1.00) |
2.41 (1.19)* |
3.09 (1.20) |
3.41 (1.01)* |
2.89 (1.05) |
| 8-The available scientific evidence provides sufficient information on the impacts, costs and concrete benefits of the studied or soon-to-implement health policies. |
3.04 (1.05) |
3.15 (1.04) |
2.83 (1.16) |
3.00 (1.05) |
2.69 (0.88) |
3.6 (0.70)* |
3.07 (1.10) |
2.67 (1.07) |
3 (1.02) |
3.64 (0.79)* |
3.89 (0.60)* |
| 9-The available scientific evidence is delivered with information about its quality and local applicability. |
2.87 (1.05) |
3.2 (1.06.) |
2.83 (1.05) |
2.96 (1.11) |
2.62 (0.94) |
3.5 (0.71)* |
2.69 (1.11) |
2.22 (0.97)* |
2.95 (0.95) |
3.23 (0.92) |
3.63 (0.92) |
| 10-There is a sufficient quantity of health research that may contribute to inform the health policymaking/decision making process. |
3.02 (1.14) |
3.25 (1.12) |
3.05 (1.16) |
3.04 (1.09) |
2.58 (1.14) |
3.1 (1.10) |
3.1 (1.08) |
2.68 (1.25) |
2.78 (1.04) |
3.5 (0.96)* |
3.56 (1.33) |
| 11-There are clearly identified places to find or to ask for scientific evidence that may inform the health policymaking/decision making process. |
3.15 (1.09) |
3.7 (0.92)* |
3.24 (1.14) |
3.21 (0.92) |
2.69 (1.16) |
3.9 (0.74)* |
3.07 (1.03) |
2.56 (0.89)* |
2.7 (1.19) |
3.64 (1.00)* |
3.78 (0.67)* |
| 12-Health policymakers use scientific evidence in the policymaking process whenever it is available and supplied to them. |
3.29 (1.02) |
3.3 (1.17) |
3.17 (1.18) |
2.86 (1.08)* |
3.00 (0.98) |
3.9 (0.32)** |
3.59 (0.83) |
3.11 (1.05) |
3.96 (0.64)** |
3.23 (0.81) |
3.44 (1.01) |
| 13-I have received training to acquire, assess the quality and local applicability of scientific evidence, and apply scientific evidence in health policymaking/decision making. |
3.26 (1.28) |
3.45 (1.40) |
3.22 (1.17) |
3.50 (1.00) |
2.96 (1.37) |
3.6 (1.43) |
3.54 (1.32) |
2.81 (1.42) |
3 (1.35) |
3.64 (1.09) |
3 (1.32) |
| 14-There is explicit budget or funding for both research and evidence- informed health policymaking within my organization. |
2.54 (1.13) |
2.55 (1.19) |
2.61 (1.16) |
2.43 (1.17) |
2.15 (0.86)* |
2.9 (0.99) |
2.34 (0.94) |
2.44 (1.42) |
2.7 (1.02) |
3.05 (1.17) |
2.67 (1.12) |
| 15-There is an administrative structure suitable to support an evidence- informed health policymaking process (for example; a policy analysis department or a decision support unit, or the availability of resources, incentives and time for the use of scientific evidence in health policymaking). |
2.62 (1.18) |
2.45 (1.00) |
3.18 (1.26)* |
2.54 (1.11) |
2 (0.83)* |
3.3 (1.06) |
2.66 (1.05) |
2.33 (1.24) |
2.26 (1.25) |
2.86 (1.28) |
2.89 (0.93) |
| 16-The political actors related with health (political parties, ministers, parliament, other ministries, etc.) value the use of scientific evidence in the policymaking process. | 2.81 (1.11) | 2.5 (1.15) | 2.78 (1.39) | 2.82 (1.25) | 2.85 (0.99) | 3.1 (0.57) | 2.76 (1.15) | 2.56 (0.97) | 3.14 (0.94) | 2.73 (0.93) | 3.56 (0.73)* |