How are mathematical models and results from mathematical models of vaccine-preventable diseases used, or not, by global health organizations?

Abstract

While epidemiological and economic evidence has the potential to provide answers to questions, guide complex programs and inform allocation decisions, how this evidence is used by global health organizations who commission it and what organizational actions are generated from the evidence remains unclear. This study applies analytical tools from organizational science to understand how evidence produced by infectious disease epidemiologists and health economists is used by global health organizations. A conceptual framework that embraces evidence use typologies and relates findings to the organizational process of action generation informs and structures the research. Between March and September 2020, we conducted in-depth interviews with mathematical modellers (evidence producers) and employees at global health organizations, who are involved in decision-making processes (evidence consumers). We found that commissioned epidemiological and economic evidence is used to track progress and provides a measure of success, both, in terms of health outcomes and the organisations’ mission. Global health organizations predominantly use this evidence to demonstrate accountability and solicit funding from external partners. We find common understanding and awareness across consumers and producers about the purposes and uses of these commissioned pieces of work and how they are distinct from more academic explorative research outputs. Conceptual evidence use best describes this process. Evidence is slowly integrated into organizational processes and is one of many influences on global health organizations’ actions. Relationships developed over time and trust guide the process, which may lead to quite a concentrated cluster of those producing and commissioning models. These findings raise several insights relevant to the literature of research utilization in organizations and evidence-based management. The study extends our understanding of how evidence is used and which organizational actions are generated as a result of commissioning epidemiological and economic evidence.