Mapping health evidence ecosystem in Brazil: a mixed-methods study protocol for developing a framework

Evidence ecosystems play a vital role in informing and shaping policy; however, little is known about how these systems function, particularly in diverse national contexts. This article presents a mixed-methods study designed to be the first to systematically map and characterize Brazil's health evidence ecosystem, focusing on key institutions, actors, and practices across the country. We aim to map, describe and analyse the ecosystem of production, use and dissemination of policy evidence in Brazil's five regions.

We will adopt a five-step mixed-method approach to understand Brazil's health evidence ecosystem comprehensively. Five steps will be undertaken: (a) cultural adaptation of two published situation analysis tools, (b) digital ethnography to identify and categorize organizations that are evidence producers, users, or intermediaries as well the types of evidence demanded, (c) autoethnography workshops with selected organizations, (d) interviews to apply an evidence institutionalization and (e) focus groups to produce a situation analysis of institutional practices, governance and the overall environment for evidence use in policy in each of the five Brazilian regions.

This study combines diverse tools to understand how evidence is produced, disseminated and utilized in Brazil. The study of regional differences and institutional practices can help to identify barriers and facilitators to the effective use of evidence in policy. Furthermore, it may inform the development of strategies to strengthen the evidence ecosystem in Brazil and serve as a roadmap for other countries that aiming to conduct a comprehensive evidence ecosystem analysis.