Healthcare Evidence-Based Management: Towards Overcoming its Barriers in Uganda’s Local Government Healthcare System
This article identifies local barriers and potential promoters
of healthcare evidence-based management decision-making in Uganda’s local government
context. It puts to local context feasible measures for increasing research evidence
utilization by healthcare decision-makers, as part of the efforts to make research
more beneficial to intended users, and ultimate recipients of the services. The
findings were a result of a cross- sectional semi-structured questionnaire survey
of 225 clustered healthcare authorities in Arua District Local
Government, West Nile Sub-region of Uganda. The survey data were triangulated with
nine key informant interviews (KIIs). Analysis reveals existence of multiple barriers
at individual, organizational and system’s levels of the local government healthcare
management. Standing out prominently were barriers related to attitude, perceptions
and beliefs of healthcare managers, dissemination, accessibility, communication,
participation, engagement, capacity, knowledge, skills, cost, time, staffing, workload,
leadership, policy enforcement, and culture. Other barriers related to researchers
were their competence, authority and level of mutual trust. Fortunately, most of
these barriers are consistent with those reported previously by other studies in
developing countries. Through a critical logical analysis, recommended strategies
for increasing utilization of research evidence were combined into five broad categories;
stakeholders’ engagement and participation, contextualized dissemination, capacity
building, local leadership and democracy, and knowledge marketing, awareness and
visibility. Again, these are not naïve, but important is the manner and details
in which they have been contextualized. Hence, this article adds to existing knowledge
about multifactorial contextual nature of barriers and promoters of research evidence
utilization, and the importance of action research in providing evidence for improving
quality of healthcare service delivery.
Keywords: barriers, promoters, research evidence, healthcare authorities.
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