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Evidence-based management of Caribbean health systems: barriers and opportunities

Damian Eisenghower Greaves (Department of Humanities and Social Sciences, St George’s University, St George’s, Grenada)

International Journal of Health Governance

ISSN: 2059-4631

Article publication date: 5 June 2017




The purpose of this paper is to explore and assess barriers and opportunities for evidence-based management (EBMgt) and decision-making in healthcare systems of the small island developing states (SIDSs) of English-speaking Caribbean.


The study utilized grounded theory to collect and analyze data on experiences and perceptions of 20 senior managers/leaders from seven Ministries of health in the region. It used semi-structured, in-depth interviews comprising open-ended questions. Data analysis comprised open, focused and theoretical coding.


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. Notwithstanding, there are opportunities for meaningful application of this management/leadership strategy.


To the author’s knowledge, this is the first assessment of the application of EBMgt to health systems of SIDSs of the Caribbean. This paper is concerned with the approach to decision-making in health systems across island states and lends support to the use of evidence in decision-making and policy development. It provides useful direction for policy makers, and senior managers/leaders of these systems.



Greaves, D.E. (2017), "Evidence-based management of Caribbean health systems: barriers and opportunities", International Journal of Health Governance, Vol. 22 No. 2, pp. 104-117.



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Copyright © 2017, Emerald Publishing Limited

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