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Decision-making under epistemic, strategic and institutional uncertainty during Covid-19

Findings from a six-country empirical study

Bibliographic Data

ID21880013
AuthorsSumegha Asthana (0000-0003-4186-2136, Georgetown University), Sanjana Mukherjee (0000-0002-6039-9506, Georgetown University), Alexandra Phelan (0000-0002-3084-9158, Johns Hopkins University), Alexandra L Phelan (Johns Hopkins University), Ibrahim Bola Gobir (0000-0002-3640-7772, Georgetown University), J J Woo (0000-0002-2954-6432, National University of Singapore), JJ Woo (National University of Singapore), Clare Wenham (0000-0001-5378-3203, London School of Economics and Political Science), Mohammad Mushtuq Husain (0009-0008-6608-5744, Independent University), Tahmina Shirin (0000-0002-5061-3783, Institute of Epidemiology, Disease Control and Research), Nevashan Govender (0000-0003-3249-4263, National Health Laboratory Service), Mohannad Al Nsour (0000-0003-1212-1611, Eastern Mediterranean Public Health Network), Winifred Ukponu (0000-0002-2128-2129, Georgetown Global Health LTD/GTE Nigeria, Abuja, Nigeria), Adachioma Chinonso Ihueze (Independent consultant, Cambridge, Ontario, Canada), Roujia Lin (0009-0007-9728-9427, Georgetown University), Sumit Asthana (Georgetown University), Renee Vongai Mutare (Georgetown University), Claire J Standley (0000-0002-4291-9723, Georgetown University)
Year2025
Volume10
Issue2
Pagese018124
Publication date2025-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-018124
PMID39914876
OpenAlexW4407185206
LanguageEN
Citations received4
References cited56

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

Business · Economics · Management science · Political science · Preparedness · Public health · Public relations · Stakeholder · Uncertainty · COVID-19 impact on air quality · Disaster Management and Resilience · Medicine · Viral Infections and Outbreaks Research

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Unique citing works4
Citations per year4
Citation span2025 - 2026 (2)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 4
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