Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study
Background Uncertainty is defined as limited knowledge or lack of predictability about past, present or future events. The COVID-19 pandemic management was significantly impacted by uncertainty, as the gaps between existing information and the necessary knowledge hindered decision-making. Current un...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-02-01
|
| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/2/e018124.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825206933160722432 |
|---|---|
| author | Clare Wenham Alexandra L Phelan Winifred Ukponu Sumegha Asthana Tahmina Shirin Claire J Standley Adachioma Chinonso Ihueze Sanjana Mukherjee Ibrahim B Gobir Mohannad Al Nsour JJ Woo Mohammad Mushtuq Husain Nevashan Govender Roujia Lin Sumit Asthana Renee Vongai Mutare |
| author_facet | Clare Wenham Alexandra L Phelan Winifred Ukponu Sumegha Asthana Tahmina Shirin Claire J Standley Adachioma Chinonso Ihueze Sanjana Mukherjee Ibrahim B Gobir Mohannad Al Nsour JJ Woo Mohammad Mushtuq Husain Nevashan Govender Roujia Lin Sumit Asthana Renee Vongai Mutare |
| author_sort | Clare Wenham |
| collection | DOAJ |
| description | Background Uncertainty is defined as limited knowledge or lack of predictability about past, present or future events. The COVID-19 pandemic management was significantly impacted by uncertainty, as the gaps between existing information and the necessary knowledge hindered decision-making. Current uncertainty literature primarily focuses on natural disasters, leaving a gap in understanding decision-making under uncertainty in times of public health emergencies. Analysing strategies for making decisions under uncertainty during the pandemic is crucial for future pandemic preparedness.Methods Using a comparative research design, we study the strategies governments used to make decisions under uncertainty during the COVID-19 pandemic. We collected data through desk reviews, stakeholder interviews and focus group discussions with stakeholders from government, academia and civil society from six purposefully selected countries: Nigeria, Singapore, South Africa, Bangladesh, Jordan and the UK.Results Regardless of political, geographic and economic context, all six countries adopted common strategies to make decisions under three types of uncertainties. Decision-making under epistemic uncertainty involved seeking expert advice and collecting evidence from other countries and international organisations. Decision-making under strategic uncertainty involved coordination, collaboration and communication. Decision-making under institutional uncertainty involved using or adapting pre-existing experiences, structures and relationships and establishing new institutions and processes.Conclusions We contribute to the theory and practice of public health crisis decision-making by presenting a unified national-level applied decision-making framework for events involving uncertainty. We provide practical guidance for approaches to enhance decision-making in future health crises that could also be used for other emergencies. |
| format | Article |
| id | doaj-art-2ee440e0d65449069c1c7c90ffb6250f |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-2ee440e0d65449069c1c7c90ffb6250f2025-02-07T02:55:09ZengBMJ Publishing GroupBMJ Global Health2059-79082025-02-0110210.1136/bmjgh-2024-018124Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical studyClare Wenham0Alexandra L Phelan1Winifred Ukponu2Sumegha Asthana3Tahmina Shirin4Claire J Standley5Adachioma Chinonso Ihueze6Sanjana Mukherjee7Ibrahim B Gobir8Mohannad Al Nsour9JJ Woo10Mohammad Mushtuq Husain11Nevashan Govender12Roujia Lin13Sumit Asthana14Renee Vongai Mutare15Department of Health Policy, The London School of Economics and Political Science, London, UKDepartment of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USAGeorgetown Global Health LTD/GTE Nigeria, Abuja, NigeriaCenter for Global Health Science and Security, Georgetown University, Washington, DC, USAInstitute of Epidemiology Disease Control and Research, Dhaka, BangladeshCenter for Global Health Science and Security, Georgetown University, Washington, DC, USAIndependent consultant, Cambridge, Ontario, CanadaO’Neill Institute for National and Global Health Law, Georgetown University, Washington, DC, USAGeorgetown Global Health LTD/GTE Nigeria, Abuja, NigeriaEastern Mediterranean Public Health Network, Amman, JordanLee Kuan Yew School of Public Policy, National University of Singapore, SingaporeIndependent consultant, Dhaka, BangladeshDivision of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South AfricaCenter for Global Health Science and Security, Georgetown University, Washington, DC, USAIndependent consultant, Washington, DC, USACenter for Global Health Science and Security, Georgetown University, Washington, DC, USABackground Uncertainty is defined as limited knowledge or lack of predictability about past, present or future events. The COVID-19 pandemic management was significantly impacted by uncertainty, as the gaps between existing information and the necessary knowledge hindered decision-making. Current uncertainty literature primarily focuses on natural disasters, leaving a gap in understanding decision-making under uncertainty in times of public health emergencies. Analysing strategies for making decisions under uncertainty during the pandemic is crucial for future pandemic preparedness.Methods Using a comparative research design, we study the strategies governments used to make decisions under uncertainty during the COVID-19 pandemic. We collected data through desk reviews, stakeholder interviews and focus group discussions with stakeholders from government, academia and civil society from six purposefully selected countries: Nigeria, Singapore, South Africa, Bangladesh, Jordan and the UK.Results Regardless of political, geographic and economic context, all six countries adopted common strategies to make decisions under three types of uncertainties. Decision-making under epistemic uncertainty involved seeking expert advice and collecting evidence from other countries and international organisations. Decision-making under strategic uncertainty involved coordination, collaboration and communication. Decision-making under institutional uncertainty involved using or adapting pre-existing experiences, structures and relationships and establishing new institutions and processes.Conclusions We contribute to the theory and practice of public health crisis decision-making by presenting a unified national-level applied decision-making framework for events involving uncertainty. We provide practical guidance for approaches to enhance decision-making in future health crises that could also be used for other emergencies.https://gh.bmj.com/content/10/2/e018124.full |
| spellingShingle | Clare Wenham Alexandra L Phelan Winifred Ukponu Sumegha Asthana Tahmina Shirin Claire J Standley Adachioma Chinonso Ihueze Sanjana Mukherjee Ibrahim B Gobir Mohannad Al Nsour JJ Woo Mohammad Mushtuq Husain Nevashan Govender Roujia Lin Sumit Asthana Renee Vongai Mutare Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study BMJ Global Health |
| title | Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study |
| title_full | Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study |
| title_fullStr | Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study |
| title_full_unstemmed | Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study |
| title_short | Decision-making under epistemic, strategic and institutional uncertainty during COVID-19: findings from a six-country empirical study |
| title_sort | decision making under epistemic strategic and institutional uncertainty during covid 19 findings from a six country empirical study |
| url | https://gh.bmj.com/content/10/2/e018124.full |
| work_keys_str_mv | AT clarewenham decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT alexandralphelan decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT winifredukponu decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT sumeghaasthana decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT tahminashirin decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT clairejstandley decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT adachiomachinonsoihueze decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT sanjanamukherjee decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT ibrahimbgobir decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT mohannadalnsour decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT jjwoo decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT mohammadmushtuqhusain decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT nevashangovender decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT roujialin decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT sumitasthana decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy AT reneevongaimutare decisionmakingunderepistemicstrategicandinstitutionaluncertaintyduringcovid19findingsfromasixcountryempiricalstudy |