The International Health Regulations were adopted in 2005 in response to the risks of health crises. This article shows how the concept of health security underlying this instrument, initially intended to protect economic liberalization, was promoted by actors in the North to the detriment of a concept based on the universal right to healthcare. It explains how the inequalities generated by the covid-19 crisis subsequently led countries in the South to join forces to negotiate, through the Pandemic Agreement, a compromise between these two approaches. The case study of Senegal illustrates these tensions in a national context and argues for the need to mobilize the “One Health” approach in support of a concept based on cooperation and solidarity.

Introduction: Reducing social health inequalities requires bridging the gap between knowledge and its implementation. Knowledge brokering facilitates exchanges between researchers and practitioners but remains underexplored in the French public health system. Methods: This study evaluates a knowledge brokering intervention within the Ile-de-France Regional Health Agency (ARS). The intervention aimed to strengthen staff capacities through knowledge translation activities, including training sessions and thematic groups. A qualitative evaluation was conducted based on participant observations and 16 semi-structured interviews. Data were analyzed both inductively and deductively using a coding framework focused on effectiveness, implementation, and influencing factors. Results: The intervention was well received, supported by strong institutional leadership and motivated stakeholders. However, participation remained limited due to time constraints, a lack of clarity regarding the role of brokers, and difficulties integrating the intervention into existing mechanisms. While thematic groups and the MOOC helped strengthen staff knowledge and skills, their impact on decision-making was modest, and dissemination across the different departments of the Regional Health Agency was limited. Discussion: The evaluation prompted adjustments in the intervention and highlighted the need to redefine the knowledge brok-ering function to better fit this context-for example, by estab-lishing brokering as a dedicated unit.

Background Breast cancer is an increasing public health concern in many low- and middle-income countries, yet prevention and care decisions do not consistently rely on evidence. In Mali, patient associations are increasingly visible in cancer advocacy, but their potential role in mediating research and experiential knowledge within decision-making remains poorly understood. This study adopts a systemic perspective on knowledge transfer to examine the conditions under which a patient association–led knowledge intermediation mechanism could plausibly emerge and be embedded within breast cancer governance. Methods We conducted a qualitative pre-implementation study based on 29 semi-structured interviews, one focus group, and participant observation involving patient association members and leaders, health professionals, researchers, decision-makers, international partners, and media representatives. Data were analysed using an adapted version of the Consolidated Framework for Implementation Research to guide construct-based coding, followed by cross-domain analysis to identify clusters of interacting determinants synthesised into broader analytical configurations. Results Analysis identified three configurations shaping the plausibility of patient association–led knowledge intermediation in breast cancer governance, across institutional, organisational, and epistemic dimensions. First, fragmented institutional arrangements, project-based financing, and discontinuous coordination limit the stabilisation of interfaces and continuity of interactions, thereby constraining the emergence of sustained knowledge transfer processes. Second, patient associations hold strong experiential legitimacy and mobilisation capacity, but their ability to assume intermediation roles is constrained by stigma, limited confidence in engaging with scientific and policy-relevant knowledge, restricted access to data and analytical resources, and weak integration into institutional decision-making spaces. These constraints are also shaped by gendered illness trajectories and social expectations that affect women’s ability to engage publicly and the recognition of experiential knowledge as policy-relevant evidence. Third, competing framings of cancer problems, combined with institutional norms privileging biomedical and quantitative evidence, narrow the range of knowledge considered actionable, limiting the integration of experiential and contextual knowledge into decision-making. Together, these configurations identify the interdependent conditions shaping the emergence, functioning, and durability of association-led knowledge intermediation mechanism. Without simultaneous alignment of institutional, organisational, and epistemic conditions, intermediation is likely to remain partial, episodic, and weakly sustained. Conclusion These findings suggest that association-led KT cannot rely on patient associations alone, nor on capacity-building alone. It requires implementation strategies that build structured interfaces enabling patient associations, researchers, clinicians, and decision-makers to jointly interpret and translate heterogeneous forms of knowledge into actionable inputs, while addressing the gendered conditions of women’s engagement and the uneven recognition of experiential knowledge in institutional evidence use. Further research is needed to test how such relational configurations can be operationalised and sustained in constrained health systems. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The SENOVIE study is supported by the Institut National du Cancer (INCa) – DA N°2022-135 SCHANTZ, the French Collaborative Institute on Migration, coordinated by the CNRS under the reference ANR-17- CONV-0001, Médecins Sans Frontières (MSF), the ministère de l’Europe et des Affaires Etrangères (MEAE – Ambassade de France au Cambodge), the Agence Universitaire de la Francophonie (AUF), the Global Research Institute of Paris – GRIP IdEx "Université Paris 2019" : ANR-18-IDEX-0001, La Ligue contre le Cancer, the Institut de Recherche pour le Développement (IRD), the Ceped UMR 196, the GIS Institut du Genre and La Cité du Genre, IdEx University of Paris, ANR-18-IDEX-0001. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The SENOVIE Mali study protocol was submitted to, evaluated and approved by the ethics committee of the Institut National de Santé Publique (Bamako, Mali) on 26 October 2021 under No. 17/2021 /CE-INSP. All participants gave their written consent to take part in the study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The qualitative data generated and analysed during this study are not publicly available due to confidentiality and the risk of participant re-identification. De-identified excerpts supporting the findings are included in the article and supplementary materials. Additional information may be available from the corresponding author upon reasonable request and subject to ethical approval.

Despite the unprecedented speed of COVID-19 vaccine development, vaccination coverage in Mali was low. Research has primarily focused on individual vaccine hesitancy, overlooking systemic issues related to the implementation of vaccination in health facilities. This article analyses the implementation of Mali’s national vaccination strategy in 2021 and 2022 to understand the challenges associated with COVID-19 vaccination coverage and the lessons learned. The study employed a qualitative approach. Data collection involved field observations (n = 15 days) and semi-structured interviews (n = 57) conducted at two Primary Health Centres ( Centres de Sante Communautaire , or CSComs) in Bamako, Mali. The analysis utilised a conceptual quality implementation framework to identify factors that influenced the successes or limitations of the campaign. Vaccination campaigns intensified gradually between 2021 and 2023. The implementation used a top-down approach controlled mainly by the staff of the Health District. The limited involvement of CSComs in key vaccination activities (planning, capacity building, supervision) prompted them to develop adaptation strategies to meet their assigned objectives. The analyses showed that the implementation of the national vaccination strategy did not have the same intensity depending on the quality phases of implementation. The CSComs conducted very few evaluation activities. We cannot fully understand vaccine coverage without a thorough analysis of implementation mechanisms. This study highlights the importance of building local capacity, customising strategies to fit community realities, and enhancing documentation of field practices for future public health interventions.

In recent years, the evaluation of global health interventions has seen the concept of ‘configuration’ re-emerging through an approach rooted in critical realism. However, thanks to the work of Norbert Elias, this concept is longstanding and has been widely utilized in sociology. This methodological and reflective text aims to demonstrate how this concept is beneficial for examining global health interventions. After analyzing how the configuration is approached in health sociology, organizational sociology, and realist evaluation, we show its heuristic contribution through three empirical examples in global health. The text highlights the diverse uses and challenges of the configurational approach in the ongoing debate on generalization and causality in evaluating interventions.

Introduction : Reducing social health inequalities requires bridging the gap between knowledge and its implementation. Knowledge brokering facilitates exchanges between researchers and practitioners but remains underexplored in the French public health system. Methods : This study evaluates a knowledge brokering intervention within the Île-de-France Regional Health Agency (ARS). The intervention aimed to strengthen staff capacities through knowledge translation activities, including training sessions and thematic groups. A qualitative evaluation was conducted based on participant observations and 16 semi-structured interviews. Data were analyzed both inductively and deductively using a coding framework focused on effectiveness, implementation, and influencing factors. Results : The intervention was well received, supported by strong institutional leadership and motivated stakeholders. However, participation remained limited due to time constraints, a lack of clarity regarding the role of brokers, and difficulties integrating the intervention into existing mechanisms. While thematic groups and the MOOC helped strengthen staff knowledge and skills, their impact on decision-making was modest, and dissemination across the different departments of the Regional Health Agency was limited. Discussion : The evaluation prompted adjustments in the intervention and highlighted the need to redefine the knowledge brokering function to better fit this context—for example, by establishing brokering as a dedicated unit.

Abstract Background Waterlogging, a form of chronic, stagnant flooding, is increasing in the Ganges-Brahmaputra delta in Bangladesh due to the compounding effects of land-use change, including the expansion of brackish shrimp farming, poor water management, and changing rainfall regimes. Its effects are negatively impacting livelihoods and health; its association with mental wellbeing is less known. Methods We hypothesised that 1-recent waterlogging, 2-social disadvantage (women, older individuals, the poorest, the least educated, those with chronic illness, and religious minorities) would be associated with lower wellbeing, and 3-chronic illness would modify the association between waterlogging and mental wellbeing. 1260 respondents from 595 households in Tala upazila, southwest Bangladesh, were interviewed about their mental wellbeing, chronic illness, and exposure to waterlogging in the 12 months prior to data collection, in August and September 2022. Associations between WHO-5 wellbeing scores and waterlogging and covariates were assessed using multi-level linear mixed-effects models with household random effects and cluster fixed effects. Results Our results confirm our hypotheses: wellbeing was lower among disadvantaged groups and chronic health vulnerability modifies the association between waterlogging and wellbeing: waterlogging exposure was associated with 18.31-point lower WHO-5 scores among individuals with chronic illness (95% CI -26.45 to -10.17), an association markedly attenuated among those without chronic illness (interaction β=14.21, 95% CI 5.48 to 22.95, p=0.001). Conclusion These results suggest that chronic illness may increase vulnerability to the mental health burden associated with waterlogging. As waterlogging is increasing, policies addressing both its environmental drivers and the needs of vulnerable populations should be considered. Competing interests None declared This study is funded by the French National Research Agency (ANR) as part of the French presidential call “Make Our Planet Great Again” (MOPGA), ANR-18-MPGA-0010. The funders had no role in study design, data collection and analysis, publication decision, or manuscript preparation. The Grant recipient was VR.

Equitable access to health services remains a major challenge to achieving universal health coverage (UHC). In Senegal, the National Family Safety Net Program (PNBSF) aims to reduce vulnerability among poor households through cash transfers and free enrolment in community-based health insurance. However, barriers to effective healthcare access persist. This study examines determinants of healthcare utilization among PNBSF beneficiaries in rural Senegal. A mixed-methods study was conducted in the departments of Koungheul and Foundiougne. The quantitative component was based on a cross-sectional survey of 254 PNBSF beneficiaries who reported a health problem in the four weeks prior to the survey and were eligible for the analysis of healthcare utilization. Determinants of healthcare utilization were analyzed using the Andersen behavioral model, including predisposing, enabling, and need factors, and multivariate logistic regression. The qualitative component included 41 semi-structured interviews exploring healthcare experiences and access barriers. Findings were integrated using an explanatory mixed-methods approach. Overall, 69.7

BACKGROUND:Integrated Management of Childhood Illness (IMCI) guidelines, used alone, fail to reliably identify severe hypoxaemia (SpO2<90%), a predictor of mortality in children under five. The AIRE (Améliorer l'Identification des Détresses Respiratoires chez l'Enfant; in English, Improving Identification of Respiratory Distress in Children) operational research project introduced routine use of pulse oximetry (PO) within IMCI consultations in Burkina Faso, Guinea, Mali and Niger. We estimated the added value of incorporating PO within IMCI (IMCI+PO) for improving the diagnosis and subsequent management of severe hypoxaemia in primary healthcare centres (PHCs). METHODS:All children aged 0-59 months attending IMCI consultations were eligible for SpO2 measurement, except those 2-59 months classified as simple non-respiratory cases using IMCI. Monthly aggregated data were collected from 202 AIRE PHC's through a cross-sectional study to estimate the added value of PO within IMCI in diagnosing severe cases (SCs) which should be referred. The added value was defined as the number of additional IMCI SCs with severe hypoxaemia, diagnosed using IMCI+PO, divided by the number of SCs diagnosed using IMCI alone. In a subset of 16 PHCs, we conducted a 14-day cohort follow-up for SCs. We analysed their management and mortality according to hypoxaemia status. RESULTS:Of the 514 901 IMCI consultations between June 2021 and December 2022, 74.2% were eligible for PO use. Of those, 5.4% were SCs diagnosed using IMCI+PO. The added value of PO was +4.9% (+962 SCs; 95% CI 4.6% to 5.2%). This was similar for all countries except Guinea (+0.9%). Healthcare workers' referral decisions were significantly higher for SCs with severe hypoxaemia (74.5%) than for those without (22.2%), p value <0.0001. In the research PHCs, the 142 SCs with severe hypoxaemia were significantly more likely to be referred and admitted to hospital, although their survival rates were similar. However, oxygen therapy remained suboptimal. CONCLUSION:At PHC level, PO improves the diagnosis of SCs with severe hypoxaemia and is associated with improved management. However, subsequent care in these settings remains challenging. TRIAL REGISTRATION NUMBER:PanAfrican Clinical Trial Registry (PACTR202206525204526).

Introduction: Sub-Saharan Africa is increasingly impacted by rising temperatures and extreme heat events. Insufficient attention has been given to the environmental factors, particularly extreme heat and household water insecurity, that may affect exclusive breastfeeding practices in climatically vulnerable regions, despite growing evidence of their relevance to maternal and child health. Objective: This review aims to explore the determinants of exclusive breastfeeding (EBF), specifically focusing on environmental factors, and to assess the methods used to measure EBF prevalence in Sub-Saharan Africa. Inclusion criteria: To be eligible, studies must be peer-reviewed empirical research or relevant grey literature (theses, WHO/UNICEF reports, national health surveys), published in English or French. Studies whose objectives, primary outcomes or main theme are related to exclusive breastfeeding in Sub-Saharan Africa will be included. Methods: The review will follow the JBI methodology for scoping reviews. We will search four databases (PubMed, Web of Science, Embase, CINAHL) and grey literature for studies published from 2015 to present. Study selection and data extraction will be performed by two independent reviewers using Covidence. Dissemination: The results will inform the SPRINT-Sen research project and will be submitted for publication. The protocol will be registered and the findings will be submitted for publication in a peer-reviewed journal. Additionally, a research brief will be produced to inform the stakeholders and decision-makers.

In 2024, the Lancet Commission on Investing in Health proposed targeting investment in 15 priority conditions through 19 modular interventions to improve global health by 2050. While pragmatic, this approach may not fully capture the complex-adaptive nature of health and health systems, nor their social, economic and political determinants. In an iterative, interpretive analysis, proposed global health investment frameworks were mapped against complexity, systems thinking and health epistemology frameworks; five thematic areas were identified for further development: (i) health as emergent from interdependent, social-biological systems; (ii) the non-biomedical determinants driving inequities; (iii) health systems' adaptive requirements; (iv) epistemic injustices that marginalize non-Western perspectives; and (v) the need for context-sensitive, community-led implementation of health measures. Recent major disruptions to international aid financing, while challenging, present a unique opportunity to redesign health investment on more sustainable and locally grounded foundations, where national governments deliberately invest in the social determinants of health as direct health improvement strategies rather than merely as adjacent social policy. To seize this opportunity, we propose five guiding principles for policy-makers: (i) community co-production of interventions; (ii) adaptive governance structures; (iii) complex systems literacy in workforce training to navigate interdependencies and uncertainty; (iv) cross-sectoral partnerships to address determinants of health; and (v) context-sensitive metrics that incorporate community engagement to support learning within health systems. These are not optional enhancements to existing approaches; they are the foundations without which any health investment strategy will continue to treat the symptoms of inequity rather than its causes.

OBJECTIVE:Road traffic injuries are a leading cause of death among children in Africa, especially in urban areas with inadequate infrastructure. Despite this, few scientifically taught educational initiatives to address this issue at the school level have been implemented in West Africa. METHODS:This quasi-experimental study evaluated a road safety education program conducted in 11 primary schools in Bouaké, Côte d'Ivoire. The initiative targeted 509 students in Grade 4 (CM1) and was implemented in three formats: (1) printed textbooks, (2) animated videos, and (3) a combined textbook and video approach. Data were collected before and after the intervention using a 59-item questionnaire measuring knowledge, behaviors, and self-efficacy related to road safety. A difference-in-differences analysis using generalized linear models targeting the program's effectiveness. RESULTS:During the 7 month study period, a decrease in the number of crashes involving students was observed near the intervention schools. The combined textbook and video group achieved the greatest improvement across most outcomes, including road sign knowledge (+200%) and safe crossing behaviors. The textbook-only group also generated significant gains. The video-only group had limited impact. No significant change was found in self-efficacy. CONCLUSION:A hybrid educational intervention using printed and audio-visual materials improved road safety knowledge and behaviors among primary school children in an urban African setting. These results support the integration of context-adapted, multimodal road safety programs into national education strategies.

Introduction: Extreme heat has always been a public health challenge in the Sahel, with growing evidence of its adverse effects on maternal, newborn, and child health (MNCH), including mental health. In Senegal’s Matam region, high seasonal temperatures may affect exclusive breastfeeding (EBF) practices and maternal mental health through direct effects of heat perceptions and knowledge. SPRINT-Sen aims to co-design, implement, and evaluate a community-based, population health intervention to improve EBF and maternal mental health under a hot and arid climate. Methods: SPRINT-Sen is a population health intervention research (PHIR) study using a quasi-experimental longitudinal design with four independent cross-sectional surveys in an open cohort. The impact evaluation follows a pre–post design using a mixed-method approach for acceptability and process evaluation. Eligible participants are pregnant women and mothers of infants aged 0–12 months. The co-designed intervention will combine (1) EBF promotion adapted to extreme heat conditions; (2) maternal mental health support through promotion and psychosocial activities; and (3) continuous temperature monitoring to inform a heat warning system. The primary outcome is EBF at six months. Secondary outcomes include maternal mental health impacts such as anxiety, stress, and interpersonal conflict. Meteorological and thermal mapping will assess environmental exposure. Results: The study will generate evidence on the mechanisms and implementation of heat-EBF interventions and heat-related mental health impacts among MNCH. Findings will inform efforts to strengthen a heat-resilient health system through community-based solutions. Knowledge transfer will be supported through co-dissemination with stakeholders and integration into maternal health and climate adaptation policies. Conclusions: SPRINT-Sen will provide novel and context-specific evidence on the feasibility, implementation and effectiveness of an integrated intervention addressing both maternal mental health and EBF in the context of extreme heat. The findings will inform adaptation strategies for MNCH programmes and contribute to global discussions on PHIR in Sahelian contexts.

Current health systems, particularly in Senegal, are struggling to ensure that the indigent population has access to health care. Although the recent situation has been well-studied, there remains a lack of historical research on the subject. When Senegal gained independence in 1960, did the country inherit a health care system that did not adequately meet the needs of indigent people and their access to care? This article shows that from 1852 to 1960, access to health care for the indigents was not a political and financial priority, that the colonial administration often confused the Indigenous people with the indigent people, and that the latter faced discrimination in accessing health care. The analysis shows that the current challenges in accessing health care for indigent people are a continuation of colonial history. There is an urgent need for change to achieve greater equity.

Health coverage for informal workers in Sub-Saharan Africa remains a major challenge. This study evaluates an alternative approach: bundling health insurance with microcredit. We conducted a randomized controlled trial in Ouagadougou, Burkina Faso, to assess the impact of mandatory health insurance linked to microcredit. The study covered 88 microcredit groups (44 treated, 44 control), analyzing outcomes for 1,095 individuals who reported illness episodes in the six months preceding the final survey in January-February 2022. Results show that the insurance requirement did not lead to program dropout, with loan renewal rates remaining stable between groups. Health insurance had a significant positive impact on financial protection: out-of-pocket expenses decreased by over 50% and payment difficulties by 36%. The study also reveals changes in health-seeking behaviors. Use of modern healthcare facilities increased by 7%, while reliance on traditional medicine decreased by 61%. Insured individuals also sought care more quickly, with 23% more seeking care on the same day symptoms appeared. However, no significant impact was observed on physical or psychological health outcomes. These findings suggest that bundling health insurance with other services like microcredit can be a viable solution for deploying mandatory health coverage to populations working in the informal sector. This approach provides significant financial protection against health risks and improves access to healthcare.

During the COVID-19 pandemic, the global population was particularly vulnerable to psychological distress. However, the impacts of pandemics on the state of psychosocial well-being in Africa remain insufficiently studied, particularly in Senegal. Our study aimed to fill this gap by exploring these determinants. This was a cross-sectional, descriptive and analytical study representative of the population of Senegalese people aged 18 and over . 813 individuals were collected by telephone call based on the random dialing method after a marginal quota survey stratified by sex, age and region during the period from June 11 to July 10, 2020. The state of well-being was assessed using the WHO well-being index. The determinants were assessed using cumulative ordinal regression well-being modeling with R software version 4.1.0. About half of our population had a moderate level of well-being (48.2%) and about a tenth had a low level (6.6%) including 4 2.6% with a low economic level. The analysis revealed that poor knowledge about the cause of the disease (OR = 1.31; 95% CI [1.09-1.58]), reduced time spent in public places (OR = 1.53; 95% CI [ 1.15-2.04 ]); trust in institutional sources of information (OR = 1.26; 95% CI [ 1.06-1.49 ]) and cancellation or postponement of a social event (OR = 1.34; 95% CI [ 0.96-1.89 ]) are factors related to the decline in psychosocial well-being towards the low level. The study highlights the importance of implementing appropriate communication strategies to strengthen the knowledge of populations at all levels, but also the need to pay particular attention to vulnerable groups and to provide psychosocial support throughout pandemics. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research is part of the support program for the African Response to the Epidemic of COVID-19 (ARIACOV) Funded by the French Development Agency (AFD). The did not play any role in the design of the study, the collection and analysis of the decision to publish or the preparation of the manuscript ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The research received approval from the National Health Research Ethics Committee of Senegal (SEN/20/23). All individuals were informed of the ethical issues and the possibility of withdrawing from the study at any time. They all consented to participate. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Les données ont été collectées via ODK collecte puis généré sous format de tableur (Microsoft Excel) Les données démographiques enquêtes, leurs habitude de vie, leurs perceptions, leur acceptabilité par rapport aux mesures restrictives de lutte la pandémie et leurs connaissances sur la maladie sont fournis dans le fichier Excel. L’analyse des données a été faite avec le logiciel R version 4.1.0 disponible uniquement en ligne sur ce lien https://figshare.com/s/75a21943c9a06e9a28eb

BackgroundThe COVID-19 pandemic necessitated the rapid availability of evidence to respond in a timely manner to the needs of practice settings and decision-makers in health and social services. Now that the pandemic is over, it is time to put in place actions to improve the capacity of systems to meet knowledge needs in a situation of crisis. The main objective of this project was thus to develop an action plan for the rapid syntheses of evidence in times of health crisis in Quebec (Canada).MethodsWe conducted a three-phase collaborative research project. First, we carried out a survey with producers and users of rapid evidence syntheses (n = 40) and a group interview with three patient partners to prioritize courses of action. In parallel, we performed a systematic mapping of the literature to identify rapid evidence synthesis initiatives developed during the pandemic. The results of these two phases were used in a third phase, in which we organized a deliberative workshop with 26 producers and users of rapid evidence syntheses to identifying strategies to operationalize priorities. The data collected at each phase were compared to identify common courses of action and integrated to develop an action plan.ResultsA total of 14 specific actions structured into four main axes were identified over the three phases. In axis 1, actions on raising awareness of the importance of evidence-informed decision-making among stakeholders in the health and social services network are presented. Axis 2 includes actions to promote optimal collaboration of key stakeholders in the production of rapid evidence synthesis to support decision-making. Actions advocating the use of a variety of rapid evidence synthesis methodologies known to be effective in supporting decision-making are presented in axis 3. Finally, axis 4 is about actions on the use of effective knowledge translation strategies to promote the use of rapid evidence synthesis products to support decision-making.ConclusionsThis project led to the development of a collective action plan aimed at preparing the Quebec ecosystem and other similar jurisdictions to meet knowledge needs more effectively in times of health emergency. The implementation of this plan and its evaluation will enable us to continue to fine-tune it.