Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?

Background: This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations. Methods: The study used sequential mixed methods drawing on data collected from surveys and key informant interviews, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022. Results: Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises. Conclusion: This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.

Diverse and competing interests around tobacco: qualitative analysis of two decades of parliamentary questions in India.

INTRODUCTION: India continues to enhance tobacco control regulations protecting the public health while housing a widespread tobacco industry. This implies complexities in regulating tobacco. As part of a broader inquiry on the political economy of tobacco, we aimed to understand the concerns of Indian parliamentarians around tobacco. METHODS: We sourced transcripts of tobacco-related questions asked by parliamentarians between the years 1999 and 2019 from the electronic archives of both the houses of Indian parliament. We analysed the frequency of questions during different regimens, segregated by the states and the political parties that parliamentarians belonged to, as well as by the government ministries to which these questions were posed. We also conducted thematic content analysis of these questions, identifying specific themes defining parliamentarians' concerns. RESULTS: 729 unique parliamentarians asked 1315 questions about tobacco, conveying varied concerns related to health, commerce, labour and agriculture sectors. Over time, the focus of the questions shifted from majorly trade to majorly health-related concerns. We show how the tobacco regulations in India are multi-institutional and are a result of negotiations of several legitimate and competing, interests. We found important state-level differences in the number and nature of these questions. CONCLUSION: Parliamentary questions constitute a useful resource in studying tobacco politics. Tobacco regulations are a product of complex negotiation of varied and competing concerns. We identify core arguments in favour and against tobacco control that would help tobacco control advocates and agencies to better prepare and engage with diverse political voices around tobacco.