For policymakers and stakeholders the challenge in using research evidence has shifted from making the best possible use of local studies to: (1) finding systematic reviews that address their many questions related to the policy issue at hand; (2) deriving insights from the reviews for a particular context (which may differ from where the studies included in the review were conducted); and (3) combining these insights with the insights from local data and studies and from local tacit (‘‘how to’’) knowledge and other forms of knowledge.
Policymakers and stakeholders then need many types of systematic reviews, for these reviews to be packaged in different ways in order to facilitate their use in policymaking, and more generally for their use of the reviews to be supported in multiple complementary ways. The same holds true for health system managers, including those working in hospitals, nongovernmental organizations, and many others settings. In some countries these managers are counted as policymakers, and in others they are counted as stakeholders. In all countries they are decision makers in their own right. Much of what follows applies to health system managers as well.