... are the key philosophies, drivers and goals for future health system and service improvement; intention to reality, however, remains a challenge with knowledge about how to effectively sustain changes to service provision elusive (MacLeod et al., 2020 ; Khan Ai et al., 2022). Conversely...

... in Western Europe, with high healthcare expenditures per capita, such as Germany, Denmark, Austria, and the Netherlands, they had resilient health systems to face pandemic crisis and lower COVID-19 fatality rates. Practical implications These findings suggest strategies of systematic and continuous...

... and theoretical coding. Findings EBMgt and decision-making is not a prominent approach taken by top officials of health systems because of internal and external barriers to its use. Indeed the absence of a culture of decision-making based on evidence pervades the public services of Caribbean island states...