Assessment of research systems in universal health coverage-related organizations

Background: Universal health coverage (UHC) is the desired goal of achieving universal access to health services without having to endure pain and financial difficulties. Multiple factors can help steer countries toward UHC. One of the most important factors is the production of valid quality evidence that can be achieved through research. The present study aimed at outlining the status of research systems in UHC–related organizations and identifying the barriers faced by research. Methods: The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews. Thematic analysis was used to analyze the interviews. Categories and subcategories were deductively extracted from the text based on research system performance as follows: resource provision, production and utilization of knowledge, existing resources, and stewardship. Then, the themes were inductively extracted from the interviews. Results: Many barriers existed for performing research in UHC–related organizations. The stewardship barrier seemed to play a key role such that structural changes in organizations affected the production & utilization of evidence. Limited financial and human resources were evident in most of the organizations. Research questions were not comprehensively identified. The conducted studies either were not designed to answer the relevant questions and/or were not appropriately reported to policy makers. As a result, their implementation in decision- making did not reach the ideal status. Conclusion: Research utilization aimed at achieving UHC will come to realize only when and if research is conducted to produce evidence required for decision–making and implementation. Therefore, in addition to the interventions recommended by the World Health Organization, we should design and implement interventions tailored to the local barriers and needs of UHC–related organizations.