Written by:
Mukdarut Bangpan, University College London
Tanja Kuchenmüller, World Health Organisation
Can evidence truly shape policy in every country?
At the recent World Health Assembly side event, this question sparked lively debate - and our research across three continents offers some answers. The event on evidence-informed decision-making (EIDM) highlighted both opportunities and challenges in embedding this approach across diverse settings. Our reflections, based on a research project applying the WHO Institutionalisation Checklist in Thailand, Trinidad and Tobago, and Tajikistan, suggest that a one-size-fits-all solution won't work. To truly embed evidence in policy, we must first understand the unique context, build awareness, and foster long-term partnerships.
As part of the Geneva Science-Policy Interface's ICP project - Supporting the routine use of evidence during the health policy-making process: a pilot project of World Health Organization checklist, WHO and the team at the Evidence for Policy and Practice Information Centre started our journey with a situation analysis of EIDM in each country. The three countries we worked in have distinct political and economic environments - from a parliamentary democracy in Trinidad and Tobago to a presidential republic in Tajikistan and a constitutional monarchy in Thailand. Similarly, their health systems vary significantly in structure, funding, and accessibility.
Conducting a situation analysis was crucial for identifying key actors and understanding how evidence is used and influenced by each country’s political and economic systems. This initial step proved essential for tailoring our approach.
In Thailand, recognising the co-production model known as "Triangle that Moves the Mountain" (Tangchaleronsathein et al., 2021, Wasi P. 2000), we leveraged strong partnerships between scientists, civil society, and policymakers to engage in our research process. A key takeaway is that a participatory approach, supported by a shared vision, is more effective than individual efforts.
In Trinidad and Tobago, we saw how a collaboration between the Ministry of Health and a research institution created a conducive environment for strengthening EIDM capacity. Knowledge-sharing activities like workshops and rapid response briefs fostered dialogue and built trust, demonstrating that small, sustained efforts can enhance existing policymaking processes. As one health official in Trinidad and Tobago put it, “We don’t just need data—we need dialogue.” This quote captures the essence of what makes EIDM work: not just information, but meaningful exchange.
In Tajikistan, a low-resourced setting, the Ministry of Health and Social Protection plays a central role in health policymaking. Their close working relationships with international partners like the WHO, the World Bank and UNICEF are critical. This model illustrates how external expertise can help navigate a complex political landscape, guiding research teams and supporting EIDM discussions where internal capacity may be limited.
These varied pathways show that understanding a country's existing systems and relationships is the foundation for successful EIDM institutionalisation.
A key lesson from our work is the critical role of Science-Policy Organisations (SPOs). These agencies – whether affiliated with the government or with a non-governmental organisation - act as essential bridges between science and policy (Wagner et al., 2023). We collaborated closely with SPOs in all three countries - including Chulalongkorn University in Thailand, the new Health Analysis Unit in Tajikistan, and the Caribbean Centre for Health Systems Research and Development (CCHSRD) in Trinidad and Tobago. Our experience highlighted that building long-term relationships with these organisations is essential as they provide access to key actors and EIDM champions, and they help sustain momentum for institutionalising evidence use beyond a single project.
A significant challenge we encountered was the varying perceptions of what constitutes "evidence". For some, evidence might be routine administrative data from a hospital; for others, it's primary research findings or a complex evidence synthesis. This lack of a shared conceptualisation of evidence complicates how it's used, when it's used, and by whom.
To address this, we found that capacity-building initiatives and workshops are incredibly effective. By bringing different interest-holders together, these activities help ensure that everyone shares a mutual understanding of EIDM principles. This alignment is necessary for newly built mechanisms to work effectively. Over the past decade, The WHO Evidence-Informed Policy Network (EVIPNet) has built capacity in Tajikistan to promote and assess EIDM processes. Similarly, the Caribbean Centre for Health Systems Research and Development (CCHSRD), a member of EVIPNet Americas, and its capacity-building activities in Trinidad and Tobago, has partnered with ministries to strengthening EIDM capacity. More recently, In Thailand, the Southeast Asia Evidence for Policy and Partnership has designed and delivered workshops that bring together with researchers and policy-makers to co-produced research evidence in education. These efforts are leading the way in fostering shared understanding and collaboration. They provide a platform where stakeholders can learn not only technical aspects and conceptualisation of EIDM but also principle and values of EIDM.
The WHO Institutionalisation Checklist provides a valuable framework to understand key challenges and opportunities for EIDM. Our experience reconfirms that institutionalisation of EIDM is not a linear process. It requires iteration, adaptability, and a tailored approach that prioritises local context, shared vision, and strong relationships.
To make evidence truly work for policy, we must invest in the people and partnerships that turn EIDM principles into actions—and actions into impact. If you would like to hear more about our Community of Practice of EIDM institutionalisation, please contact:
Tanja Kuchenmüller, Unit Head, Evidence to Policy and Impact, Science Division at the WHO: kuchenmullert@who.int
Mukdarut Bangpan, Professor, the Evidence for Policy and Practice Information and Coordinating Centre (EPPI-Centre), Co-Director of Social Science Research Unit, UCL: m.bangpan@ucl.ac.uk
This blog reflects insights from a joint initiative between the EPPI Centre and WHO, drawing on fieldwork conducted in Thailand, Trinidad and Tobago, and Tajikistan as part of the WHO Institutionalisation Checklist project, financially supported by the Geneva Science Policy Interface and the Special Programme for Research and Training in Tropical Diseases (TDR). The pilot project in Thailand is financially supported by Chulalongkorn University.
Tangcharoensathien V, Sirilak S, Sritara P, Patcharanarumol W, Lekagul A, Isaranuwatchai W et al. Co-production of evidence for policies in Thailand: from concept to action BMJ 2021; 372 :m4669
Wasi P. Triangle that moves the mountain and health systems reform movement in Thailand. Hum Resour Heal Dev J2000;4:106-10
Wagner, N., Velander, S., Biber-Freudenberger, L., & Dietz, T. (2023). Effectiveness factors and impacts on policymaking of science-policy interfaces in the environmental sustainability context. Environmental Science & Policy, 140, 56-67.