Institutional capacity to acquire, assess, adapt and apply evidence in Brazil: a mixed-methods study, 2024

To evaluate the institutional capacity of the Health Ministry's Health Science, Technology and Innovation and Economic-Industrial Complex Secretariat (Secretaria de Ciência, Tecnologia e Inovação e do Complexo Econômico-Industrial da Saúde - SECTICS/MS) in using scientific evidence in decision-making.

This was a two-phase mixed-methods study conducted between August and September 2024 in the five SECTICS/MS departments. Data were collected through questionnaires, based on the Brazilian version of the "4A Tool", which assesses four dimensions: Acquiring, Assessing, Adapting and Applying evidence, and were quantified using SPSS software (version 30).

Of the 15 representatives invited, 12 participated in the quantitative phase (phase 1). Of these, 4 agreed to participate in the qualitative phase (phase 2). The majority held a doctorate (67%), were civil servants (75%) and had worked for five years or more at the Ministry of Health (67%). All reported being familiar with evidence-informed policies. The "acquire" (82%) and "assess" (72%) dimensions showed high agreement, indicating consolidated institutional capacity. The "apply" dimension had (63.0%) agreement, while the "adapt" dimension had the lowest (47%), highlighting weaknesses. Participants stressed the importance of evidence for process optimization but pointed to inequalities between departments and structural limitations, such as lack of time, barriers to accessing articles and absence of knowledge translation tools.

This study showed progress in institutional capacities to acquire and assess evidence. However, there remains a need to strengthen the adaptation and application of evidence, especially through investments in knowledge translation that bring evidence, managers and the public closer together.