BACKGROUND Among the many barriers to evidence use in decision-making, weak capacity for evidence use has attracted a lot of focus in the last decade. The study aims to inform and enrich ongoing and future efforts to strengthen capacity for evidence use by presenting and discussing the experiences and lessons of a project implemented in Kenya and Malawi to strengthen individual and institutional capacity for evidence use within the ministries of health (MoHs). METHODS This paper draws on the internal and external evaluations of a 3-year project funded by the United Kingdom's Department for International Development, the Strengthening Capacity to Use Research Evidence in Health Policy (SECURE Health). To strengthen individual capacity, the project implemented a training and mentorship programme for 60 mid-level policy-makers in the two MoHs. To strengthen institutional capacity, the project conducted sustained advocacy with top leaders to strengthen structures that enable evidence-informed decision-making (EIDM), supported Kenya to develop research-for-health policies and priorities, supported Malawi to review the implementation of its health research agenda, developed EIDM guidelines for both MoHs, and supported bi-annual evidence dialogues to improve interactions and raise the profile of evidence. Internal evaluation included baseline and endline surveys (93 baseline and 92 endline interviews), 60 in-depth interviews, and intervention-specific evaluations (pre-post tests for training workshops, feedback forms for policy dialogues and tracking effects of advocacy efforts). The external evaluation was implemented alongside project implementation, conducting three annual evaluations. RESULTS The results show that training and mentorship programmes in EIDM were effective in improving competencies of civil servants. However, such programmes need to train a critical mass to be effective in enhancing EIDM practice at the MoHs. On strengthening institutional capacity for EIDM, while the project achieved some success, it did not realise long-lasting effects because of its limited time of implementation and limited focus on sustained political economy analysis, which meant that the intervention was negatively affected by frequently changing interests within the MoHs. CONCLUSIONS Although training and mentorship are effective in improving EIDM competencies, they need to be incorporated in existing pre-service and in-service training programmes for sustainability. Strengthening institutional capacity for evidence use is complex and needs sustained political commitment and long-term investments.

中文翻译：

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加强在卫生部门决策中使用研究证据的能力：肯尼亚和马拉维的经验。

背景技术在决策中使用证据的众多障碍中，过去十年来，证据使用能力薄弱引起了很多关注。该研究旨在通过介绍和讨论在肯尼亚和马拉维实施的旨在增强卫生部（MoHs）的个人和机构证据使用能力的项目的经验教训，来丰富当前和未来的努力，以增强证据使用能力。方法本文采用了一项由英国国际发展部资助的为期3年的项目的内部和外部评估，即在卫生政策中使用研究证据的能力（SECURE Health）。为了增强个人能力，该项目在两个卫生部为60名中层决策者实施了培训和指导计划。为了加强机构能力，该项目与高层领导人进行了持续性倡导，以加强结构，使循证决策成为可能（EIDM），支持肯尼亚制定卫生研究政策和优先事项，支持马拉维审查其卫生执行情况研究议程，为两个卫生部制定EIDM指南，并支持两年一次的证据对话，以改善互动并提高证据的知名度。内部评估包括基线和最终调查（93次基线和92次最终访谈），60次深度访谈以及针对干预措施的评估（培训研讨会的岗前测试，政策对话的反馈表和跟踪倡导工作的效果）。外部评估与项目实施同时进行，进行了三项年度评估。结果结果表明，EIDM中的培训和指导计划对提高公务员的能力是有效的。但是，此类计划需要培训一定数量的人员，以有效提高卫生部的EIDM实践。关于加强EIDM的机构能力，尽管该项目取得了一些成功，但由于实施时间有限且对持续的政治经济分析的关注有限，因此并未产生长期的影响，这意味着干预措施受到利益变化频繁的负面影响在卫生部内。结论尽管培训和指导有效地提高了EIDM的能力，但仍需要将其纳入现有的职前和在职培训计划中以实现可持续性。