A review of the functionality of Technical Working Groups (TWGs) in enabling Evidence Informed Decision Making (EIDM) within Malawi's Ministry of Health and Population: A cross-sectional qualitative study

Abstract BackgroundThe roles and functionality of Technical Working Groups (TWGs) in the health sectors varies across countries, but they generally aim to support government and ministries in formulating evidence informed recommendations for policies and facilitate dialogue and alignment of activities among stakeholders within the health sector. Thus, TWG’s have a core role to enhance functionality and effectiveness of the health system structure. However, in Malawi the functionality of TWGs and how they utilise research evidence to contribute to decision making is not monitored. This study sought to understand the TWGs performance and functionality in enabling Evidence Informed Decision Making (EIDM) in Malawi's health sector.MethodsA cross-sectional descriptive qualitative study employing qualitative methods. Data was collected through interviews; documents review and observation of three TWG meetings. Qualitative data was analysed using a framework analysis approach. ResultsTWG functionality varied in the Ministry of Health in Malawi. The reasons for those perceived to be functioning well included meeting frequently; diverse representation of members; and the membership consisted of highly technical people; and their recommendations to MoH were usually taken into consideration when decisions were made. For the TWGs that were perceived as not functioning well, the main reasons included lack of funding, irregular meetings and discussions that did not provide clear decisions on the actions to be taken. In addition, evidence was recognized as important in decision-making and research was valued by decision makers within the MoH. However, some of the TWGs lacked reliable mechanisms for generating, accessing, and synthesizing research. They also had limited capacity to review and use the research to inform the decisions they made. ConclusionsTWGs are a key decision-making structure within the MoH in Malawi. However, TWGs functionality will need reliable interventions for evidence informed decision making and sustainable funding to facilitate performance of TWGs.