Understanding and Bridging Gaps in the Use of Evidence from Modeling for Evidence-Based Policy Making in Nigeria's Health System.

Background. Modeled evidence is a proven useful tool for decision makers in making evidence-based policies and plans that will ensure the best possible health system outcomes. Thus, we sought to understand constraints to the use of models in making decisions in Nigeria's health system and how such constraints can be addressed. Method. We adopted a mixed-methods study for the research and relied on the evidence to policy and Knowledge-to-Action (KTA) frameworks to guide the conceptualization of the study. An online survey was administered to 34 key individuals in health organizations that recognize modeling, which was followed by in-depth interviews with 24 of the 34 key informants. Analysis was done using descriptive analytic methods and thematic arrangements of narratives. Results. Overall, the data revealed poor use of modeled evidence in decision making within the health sector, despite reporting that modeled evidence and modelers are available in Nigeria. However, the disease control agency in Nigeria was reported to be an exception. The complexity of models was a top concern. Thus, suggestions were made to improve communication of models in ways that are easily comprehensible and to improve overall research culture within Nigeria's health sector. Conclusion. Modeled evidence plays a crucial role in evidence-based health decisions. Therefore, it is imperative to strengthen and sustain in-country capacity to value, produce, interpret, and use modeled evidence for decision making in health. To overcome limitations in the usage of modeled evidence, decision makers, modelers/researchers, and knowledge brokers should forge viable relationships that regard and promote evidence translation.

Highlights: Despite the use of modeling by Nigeria's disease control agency in containing the COVID-19 pandemic, modeling remains poorly used in the country's overall health sector.Although policy makers recognize the importance of evidence in making decisions, there are still pertinent concerns about the poor research culture of policy-making institutions and communication gaps that exist between researchers/modelers and policy makers.Nigeria's health system can be strengthened by improving the value and usage of scientific evidence generation through conscious efforts to institutionalize research culture in the health sector and bridge gaps between researchers/modelers and decision makers.