To effectively implement the stages of the framework and strengthen the interconnections between them, two cross-cutting activities are of vital importance.
In order for research findings to be integrated into policy-making and implementation, a minimum level of capacity is needed at the individual, organizational and institutional/system level.
Individual capacity: there is a need to strengthen the capacity of evidence users to understand EIDM, obtain evidence, interrogate evidence, use and apply evidence in policy-making, engage with stakeholders in formulating evidence-informed policy, and monitor and evaluate the success of EIDM [125]. Likewise, evidence producers should strengthen their skills in understanding policy and science, synthesizing research, managing expert communities, communicating scientific knowledge, advising policy-makers, engaging with citizens and stakeholders, and in M&E [126]. Some strategies to increase capacity at the individual level include tailored interactive workshops supported by goal-focused mentoring and activities promoting cross-sector collaboration [127].
Organizational capacity: a number of factors at the organizational level have been identified as critical for building capacity for EIDM [128]. Organizations should start with a self-assessment of their capacity (using validated tools such as the one developed by the Canadian Health Services Research Foundation [CHSRF] [129] followed by the design of strategies aimed at strengthening organizational enablers and overcoming barriers. An example of a strategy at this level is fostering an organizational culture that supports research and learning, training and mentoring for EIDM, and creating interdisciplinary working groups to promote the integration and application of research and research evidence in decision-making and practice [128].
Institutional/systems capacity: at this level, strengthening capacity is more complex, as it usually entails long-term initiatives that go beyond any specific organization. However, initiatives can be based on experiences from countries already engaged in building capacity for promoting better use of evidence in policy-making [52]. Examples of strategies at this level include the establishment of new organizational mechanisms to support the use of evidence, such as the experience of the National Institute for Health and Care Excellence (NICE) in the UK or the REACH Initiative in East Africa [130].
Communication, interactions and collaboration between the different stakeholders involved in the process of EIDM is one of the factors that has been repeatedly mentioned as a facilitator of the use of evidence [48]. Therefore, it is important to strengthen continuous, strategic communication throughout the EIDM process, not only to keep stakeholders informed but also to build relationships, trust and mutual respect among them, as well as promote a culture more favourable to EIDM. Although the role of informal, unplanned contact should be recognized, the establishment of regular virtual meetings and efficient communication channels such as email or personal communication can be useful to keep all the relevant stakeholders connected [131].
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