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Varallyay NI, Kennedy C, Bennett SC, Peters DH. Strategies to promote evidence use for health programme improvement: learning from the experiences of embedded implementation research teams in Latin America and the Caribbean. Health Res Policy Syst 2022; 20:38. [PMID: 35392931 PMCID: PMC8991468 DOI: 10.1186/s12961-022-00834-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background To achieve global health targets, innovative approaches are needed to strengthen the implementation of efficacious interventions. New approaches in implementation research that bring together health system decision-makers alongside researchers to collaboratively design, produce and apply research evidence are gaining traction. Embedded implementation research (EIR) approaches led by decision-maker principal investigators (DM PIs) appear promising in this regard. Our aim is to describe the strategies study teams employ in the post-research phase of EIR to promote evidence-informed programme or policy improvement. Methods We conducted a prospective, comparative case study of an EIR initiative in Bolivia, Colombia and Dominican Republic. Guided by a conceptual framework on EIR, we used semi-structured key informant interviews (n = 51) and document reviews (n = 20) to examine three decision-maker-led study teams (“cases”). Focusing on three processes (communication/dissemination, stakeholder engagement with evidence, integrating evidence in decision-making) and the main outcome (enacting improvements), we used thematic analysis to identify associated strategies and enabling or hindering factors. Results Across cases, we observed diverse strategies, shaped substantially by whether the DM PI was positioned to lead the response to study findings within their sphere of work. We found two primary change pathways: (1) DM PIs implement remedial measures directly, and (2) DM PIs seek to influence other stakeholders to respond to study findings. Throughout the post-research phase, EIR teams adapted research use strategies based on the evolving context. Conclusions EIR led by well-positioned DM PIs can facilitate impactful research translation efforts. We draw lessons around the importance of (1) understanding DM PI positionality, (2) ongoing assessment of the evolving context and stakeholders and (3) iterative adaptation to dynamic, uncertain circumstances. Findings may guide EIR practitioners in planning and conducting fit-for-purpose and context-sensitive strategies to advance the use of evidence for programme improvement. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00834-1.
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Affiliation(s)
- N Ilona Varallyay
- Health Systems Program, Department of International Health, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States of America.
| | - Caitlin Kennedy
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States of America
| | - Sara C Bennett
- Health Systems Program, Department of International Health, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States of America
| | - David H Peters
- Department of International Health, Johns Hopkins School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States of America
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Buffardi AL, Njambi-Szlapka S. Questions for future evidence-informed policy initiatives: insights from the evolution and aspirations of National Immunization Technical Advisory Groups. Health Res Policy Syst 2020; 18:40. [PMID: 32321521 PMCID: PMC7178973 DOI: 10.1186/s12961-020-00551-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 03/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Attention to evidence-informed policy has grown; however, efforts to strengthen the quality and use of evidence are not starting from a blank slate. Changes in health architectures and financing pose different considerations for investments in evidence-informed policy than in the past. We identify major trends that have shifted the environment in which health policies are made, and use the evolution and future aspirations of National Immunization Technical Advisory Groups (NITAGs) in low- and middle-income countries to identify questions the sector must confront when determining how best to structure and strengthen evidence-informed health policy. DISCUSSION Trends over the last two decades have resulted in a dense arena with many issue-specific groups, discrete initiatives to strengthen evidence-informed policy and increasing responsibility for subnational institutions. Many countries face a shifting resource base, which for some reduces the amount of resources for health. There is global momentum around universal health coverage, reflecting a broader systems approach, but few examples of how the vast array of stakeholders relate within it are available. NITAG aspirations reflect four interconnected themes related to their scope, their integration in national policy processes, health financing and relationships with ministries of finance, and NITAG positioning relative to other domestic and international entities, raising questions such as, What are the bounds of issue-specific groups and their relationship to allocation decision-making processes across health areas? How do technical advisory groups interface with what are inherently political processes? When are finances considered, by whom and how? What is the future of existing groups whose creation was intended to enhance national ownership but who need continued external support to function? When should new entities be created, in what form and with what mandate? CONCLUSIONS Countries must determine who makes decisions about resources, when, using what criteria, and how to do so in a robust yet efficient way given the existing and future landscape. While answers to these questions are necessarily country specific, they are collective matters that cannot be addressed by specialised groups alone and have implications for new investments in evidence-informed policy.
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Affiliation(s)
- Anne L. Buffardi
- Overseas Development Institution (ODI), 203 Blackfriars Rd, London, SE1 8NJ United Kingdom
| | - Susan Njambi-Szlapka
- Overseas Development Institution (ODI), 203 Blackfriars Rd, London, SE1 8NJ United Kingdom
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Keene CM, Aluvaala J, Murphy GAV, Abuya N, Gathara D, English M. Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya. BMJ Glob Health 2019; 4:e001195. [PMID: 30997163 PMCID: PMC6441269 DOI: 10.1136/bmjgh-2018-001195] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 01/06/2023] Open
Abstract
Neonatal deaths contribute a growing proportion to childhood mortality, and increasing access to inpatient newborn care has been identified as a potential driver of improvements in child health. However, previous work by this research team identified substantial gaps in the coverage and standardisation of inpatient newborn care in Nairobi City County, Kenya. To address the issue in this particular setting, we sought to draft recommendations on the categorisation of neonatal inpatient services through a process of policy review, evidence collation and examination of guidance in other countries. This work supported discussions by a panel of local experts representing a diverse set of stakeholders, who focused on formulating pragmatic, context-relevant guidance. Experts in the discussions rapidly agreed on overarching priorities guiding their decision-making, and that three categories of inpatient neonatal care (standard, intermediate and intensive care) were appropriate. Through a modified nominal group technique, they achieved consensus on allocating 36 of the 38 proposed services to these categories and made linked recommendations on minimum healthcare worker requirements (skill mix and staff numbers). This process was embedded in the local context where the need had been identified, and required only modest resources to produce recommendations on the categorisation of newborn inpatient care that the experts agreed could be relevant in other Kenyan settings. Recommendations prioritised the strengthening of existing facilities linked to a need to develop effective referral systems. In particular, expansion of access to the standard category of inpatient neonatal care was recommended. The process and the agreed categorisations could inform discussion in other low-resource settings seeking to address unmet needs for inpatient neonatal care.
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Affiliation(s)
- Claire Marriott Keene
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Jalemba Aluvaala
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Georgina A V Murphy
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Nancy Abuya
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Nairobi City County Government, Nairobi, Kenya
| | - David Gathara
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
| | - Mike English
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
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Ogbe E, Van Braeckel D, Temmerman M, Larsson EC, Keygnaert I, De Los Reyes Aragón W, Cheng F, Lazdane G, Cooper D, Shamu S, Gichangi P, Dias S, Barrett H, Nobels A, Pei K, Galle A, Esho T, Knight L, Tabana H, Degomme O. Opportunities for linking research to policy: lessons learned from implementation research in sexual and reproductive health within the ANSER network. Health Res Policy Syst 2018; 16:123. [PMID: 30558612 PMCID: PMC6297973 DOI: 10.1186/s12961-018-0397-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/22/2018] [Indexed: 11/16/2022] Open
Abstract
Background The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for policy-makers to use research evidence in their work. Methods A participatory workshop with researchers was organised in November 2017 by the Academic Network for Sexual and Reproductive Health and Rights Policy (ANSER) to address this gap. ANSER is a consortium of experienced researchers, some of whom have policy-making experience, working on sexual and reproductive health and rights issues across 16 countries and 5 continents. The experiential learning cycle was used to guide the workshop discussions based on case studies and to encourage participants to focus on key lessons learned. Workshop findings were thematically analysed using specific stages from Hanney et al.’s (Health Res Policy Syst 1:2, 2003) framework on the place of policy-making in the stages of assessment of research utilisation and outcomes. Results The workshop identified key strategies for translating research into policy, including joint agenda-setting between researchers and policy-makers, as well as building trust and partnerships with different stakeholders. These were linked to stages within Hanney et al.’s framework as opportunities for engaging with policy-makers to ensure uptake of research findings. Conclusion The engagement of stakeholders during the research development and implementation phases, especially at strategic moments, has a positive impact on uptake of research findings. The strategies and stages described in this paper can be applied to improve utilisation of research findings into policy development and implementation globally.
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Affiliation(s)
| | - Emilomo Ogbe
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium.
| | - Dirk Van Braeckel
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | | | - Elin C Larsson
- Department of Women's and Children's Health, Uppsala University/Karolinska Institutet, Uppsala, Sweden
| | - Ines Keygnaert
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | | | - Feng Cheng
- School of Medicine and Research Centre for Public Health, Tsinghua University, Beijing, China
| | - Gunta Lazdane
- Department of Obstetrics and Gynaecology, Riga Stradins University, Riga, Latvia
| | - Diane Cooper
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Simukai Shamu
- Foundation for Professional Development, Pretoria, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Gichangi
- University of Nairobi, Ghent University and International Centre for Reproductive Health, Nairobi, Kenya
| | - Sónia Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Hazel Barrett
- Centre for Trust, Peace and Social relations, Coventry University, Coventry, United Kingdom
| | - Anne Nobels
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Kaiyan Pei
- National Research Institute for Family Planning, Beijing, China
| | - Anna Galle
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Tammary Esho
- Department of Community and Public Health, Technical University of Kenya, Nairobi, Kenya
| | - Lucia Knight
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Hanani Tabana
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Olivier Degomme
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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Cawley C, McRobie E, Oti S, Njamwea B, Nyaguara A, Odhiambo F, Otieno F, Njage M, Shoham T, Church K, Mee P, Todd J, Zaba B, Reniers G, Wringe A. Identifying gaps in HIV policy and practice along the HIV care continuum: evidence from a national policy review and health facility surveys in urban and rural Kenya. Health Policy Plan 2018; 32:1316-1326. [PMID: 28981667 PMCID: PMC5886069 DOI: 10.1093/heapol/czx091] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/14/2022] Open
Abstract
The last decade has seen rapid evolution in guidance from the WHO concerning the provision of HIV services along the diagnosis-to-treatment continuum, but the extent to which these recommendations are adopted as national policies in Kenya, and subsequently implemented in health facilities, is not well understood. Identifying gaps in policy coverage and implementation is important for highlighting areas for improving service delivery, leading to better health outcomes. We compared WHO guidance with national policies for HIV testing and counselling, prevention of mother-to-child transmission, HIV treatment and retention in care. We then investigated implementation of these national policies in health facilities in one rural (Kisumu) and one urban (Nairobi) sites in Kenya. Implementation was documented using structured questionnaires that were administered to in-charge staff at 10 health facilities in Nairobi and 34 in Kisumu. Policies were defined as widely implemented if they were reported to occur in > 70% facilities, partially implemented if reported to occur in 30–70% facilities, and having limited implementation if reported to occur in < 30% facilities. Overall, Kenyan national HIV care and treatment policies were well aligned with WHO guidance. Policies promoting access to treatment and retention in care were widely implemented, but there was partial or limited implementation of several policies promoting access to HIV testing, and the more recent policy of Option B+ for HIV-positive pregnant women. Efforts are needed to improve implementation of policies designed to increase rates of diagnosis, thus facilitating entry into HIV care, if morbidity and mortality burdens are to be further reduced in Kenya, and as the country moves towards universal access to antiretroviral therapy.
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Affiliation(s)
- Caoimhe Cawley
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen McRobie
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Samuel Oti
- African Population and Health Research Centre, P.O. Box 10787-00100, Nairobi, Kenya
| | - Brian Njamwea
- African Population and Health Research Centre, P.O. Box 10787-00100, Nairobi, Kenya
| | - Amek Nyaguara
- KEMRI/CDC Center for Global Health Research (CGHR), P.O. Box 1578, Kisumu, Kenya
| | - Frank Odhiambo
- KEMRI/CDC Center for Global Health Research (CGHR), P.O. Box 1578, Kisumu, Kenya
| | - Fredrick Otieno
- KEMRI/CDC Center for Global Health Research (CGHR), P.O. Box 1578, Kisumu, Kenya
| | | | - Tara Shoham
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kathryn Church
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Mee
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jim Todd
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Basia Zaba
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Georges Reniers
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Alison Wringe
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Hanney SR, González-Block MA. 'Knowledge for better health' revisited - the increasing significance of health research systems: a review by departing Editors-in-Chief. Health Res Policy Syst 2017; 15:81. [PMID: 28965493 PMCID: PMC5623979 DOI: 10.1186/s12961-017-0248-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 01/22/2023] Open
Abstract
How can nations organise research investments to obtain the best bundle of knowledge and the maximum level of improved health, spread as equitably as possible? This question was the central focus of a major initiative from WHO led by Prof Tikki Pang, which resulted in a range of developments, including the publication of a conceptual framework for national health research systems - Knowledge for better health - in 2003, and in the founding of the journal Health Research Policy and Systems (HARPS). As Editors-in-Chief of the journal since 2006, we mark our retirement by tracking both the progress of the journal and the development of national health research systems. HARPS has maintained its focus on a range of central themes that are key components of a national health research system in any country. These include building capacity to conduct and use health research, identifying appropriate priorities, securing funds and allocating them accountably, producing scientifically valid research outputs, promoting the use of research in polices and practice in order to improve health, and monitoring and evaluating the health research system. Some of the themes covered in HARPS are now receiving increased attention and, for example, with the assessment of research impact and development of knowledge translation platforms, the journal has covered their progress throughout that expansion of interest. In addition, there is increasing recognition of new imperatives, including the importance of promoting gender equality in health research if benefits are to be maximised. In this Editorial, we outline some of the diverse and developing perspectives considered within each theme, as well as considering how they are held together by the growing desire to build effective health research systems in all countries.From 2003 until mid-June 2017, HARPS published 590 articles on the above and related themes, with authors being located in 76 countries. We present quantitative data tracing the journal's growth and the increasing external recognition of its role. We thank the many colleagues who have kindly contributed to the journal's success, and finish on an exciting note by welcoming the new Editors-in-Chief who will take HARPS forward.
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Affiliation(s)
- Stephen R. Hanney
- Health Economics Research Group, Institute of Environment, Health and Societies, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH United Kingdom
| | - Miguel A. González-Block
- Universidad Anáhuac, Av. Universidad Anáhuac 46, Lomas Anáhuac, 52786 Huixquilucan Mexico City, Mexico
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de Haas B, van der Kwaak A. Exploring linkages between research, policy and practice in the Netherlands: perspectives on sexual and reproductive health and rights knowledge flows. Health Res Policy Syst 2017; 15:40. [PMID: 28494770 PMCID: PMC5427570 DOI: 10.1186/s12961-017-0201-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 04/17/2017] [Indexed: 11/26/2022] Open
Abstract
Background The attention to and demand for stronger linkages between research, policy and practice are increasing, especially in fields concerned with sensitive and challenging issues such as sexual and reproductive health and rights (SRHR). The study described in this article was conducted in the Netherlands among actors working in international development, especially the domain of SRHR. It explores the perceived flow of knowledge between research, policy and practice, the perceived impeding factors, and suggested strategies for improvement. Methods A narrative literature review was performed and 28 key informants were interviewed between May and August 2015. Most interviewees were either active or passive members of Share-Net Netherlands, an SRHR knowledge platform. All interviews, which lasted 70 minutes on average, were recorded, transcribed verbatim and coded in MAXQDA. Results Linkages between research, policy and practice are many and diffuse. The demands for and supplies of knowledge within and across the fields vary and do not always match, which is shown by participants’ research purposes and approaches. Participants identified various barriers to strengthening knowledge flows, including a lack of familiarity with practices in other fields, power relations and the undervaluation of tacit knowledge. They suggested a more visible and concrete demand for and supply of knowledge, the development of a joint knowledge agenda, more opportunities for the interdisciplinary creation of knowledge, and the development of a system for learning and sharing knowledge. Conclusion This study shows the willingness to undertake, and the perceived advantages of, interdisciplinary dialogues and joint creation of knowledge to advance SRHR research, policies and practices. Whereas barriers to the flow of knowledge may maintain present understandings of knowledge and of whose knowledge is valid, enabling factors, such as interactions between research, policy and practice in knowledge-sharing activities, may challenge such perceptions and create an enabling environment for generating innovative knowledge and increasing knowledge use. Knowledge platforms are recommended to place more emphasis on sharing and documenting tacit knowledge through interdisciplinary dialogues, to address power relations and to set criteria for interdisciplinary funding.
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Affiliation(s)
- Billie de Haas
- Independent researcher, Piri Reisplein 42, 1057 KH, Amsterdam, the Netherlands.
| | - Anke van der Kwaak
- Royal Tropical Institute, Mauritskade 63, 1092 AD, Amsterdam, the Netherlands
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Guieu A, Zhang WH, Lafort Y, Decat P, De Meyer S, Wang S, Kerstens B, Duysburgh E. Practical lessons for bringing policy-makers on board in sexual and reproductive health research. BMC Health Serv Res 2016; 16:649. [PMID: 27835973 PMCID: PMC5106764 DOI: 10.1186/s12913-016-1889-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 10/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need to translate research into policy, i.e. making research findings a driving force in agenda-setting and policy change, is increasingly acknowledged. However, little is known about translation mechanisms in the field of sexual and reproductive health (SRH) outside North American or European contexts. This paper seeks to give an overview of the existing knowledge on this topic as well as to document practical challenges and remedies from the perspectives of researchers involved in four SRH research consortium projects in Latin America, sub-Saharan Africa, China and India. METHODS A literature review and relevant project documents were used to develop an interview guide through which researchers could reflect on their experiences in engaging with policy-makers, and particularly on the obstacles met and the strategies deployed by the four project consortia to circumvent them. RESULTS Our findings confirm current recommendations on an early and steady involvement of policy-makers, however they also suggest that local barriers between researchers and policy-making spheres and individuals can represent major hindrances to the realization of translation objectives. Although many of the challenges might be common to different contexts, creating locally-adapted responses is deemed key to overcome them. Researchers' experiences also indicate that - although inevitable - recognizing and addressing these challenges is a difficult, time- and energy-consuming process for all partners involved. Despite a lack of existing knowledge on translation efforts in SRH research outside North American or European contexts, and more particularly in low and middle-income countries, it is clear that existing pressure on health and policy systems in these settings further complicates them. CONCLUSIONS This article brings together literature findings and researchers' own experiences in translating research results into policy and highlights the major challenges research conducted on sexual and reproductive health outside North American or European contexts can meet. Future SRH projects should be particularly attentive to these potential obstacles in order to tailor appropriate and consistent strategies within their existing resources.
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Affiliation(s)
- Aurore Guieu
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium. .,MOMI consortium, . .,DIFFER consortium, .
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,MOMI consortium.,INPAC consortium
| | - Yves Lafort
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,DIFFER consortium
| | - Peter Decat
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,CERCA consortium
| | - Sara De Meyer
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,CERCA consortium
| | - Shuchen Wang
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,INPAC consortium
| | - Birgit Kerstens
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,MOMI consortium
| | - Els Duysburgh
- International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP114, Ghent, 9000, Belgium.,MOMI consortium
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Uzochukwu B, Onwujekwe O, Mbachu C, Okwuosa C, Etiaba E, Nyström ME, Gilson L. The challenge of bridging the gap between researchers and policy makers: experiences of a Health Policy Research Group in engaging policy makers to support evidence informed policy making in Nigeria. Global Health 2016; 12:67. [PMID: 27809862 PMCID: PMC5095957 DOI: 10.1186/s12992-016-0209-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 10/20/2016] [Indexed: 11/26/2022] Open
Abstract
Background Getting research into policy and practice (GRIPP) is a process of going from research evidence to decisions and action. To integrate research findings into the policy making process and to communicate research findings to policymakers is a key challenge world-wide. This paper reports the experiences of a research group in a Nigerian university when seeking to ‘do’ GRIPP, and the important features and challenges of this process within the African context. Methods In-depth interviews were conducted with nine purposively selected policy makers in various organizations and six researchers from the universities and research institute in a Nigerian who had been involved in 15 selected joint studies/projects with Health Policy Research Group (HPRG). The interviews explored their understanding and experience of the methods and processes used by the HPRG to generate research questions and research results; their involvement in the process and whether the methods were perceived as effective in relation to influencing policy and practice and factors that influenced the uptake of research results. Results The results are represented in a model with the four GRIPP strategies found: i) stakeholders’ request for evidence to support the use of certain strategies or to scale up health interventions; ii) policymakers and stakeholders seeking evidence from researchers; iii) involving stakeholders in designing research objectives and throughout the research process; and iv) facilitating policy maker-researcher engagement in finding best ways of using research findings to influence policy and practice and to actively disseminate research findings to relevant stakeholders and policymakers. The challenges to research utilization in health policy found were to address the capacity of policy makers to demand and to uptake research, the communication gap between researchers, donors and policymakers, the management of the political process of GRIPP, the lack of willingness of some policy makers to use research, the limited research funding and the resistance to change. Conclusions Country based Health Policy and Systems Research groups can influence domestic policy makers if appropriate strategies are employed. The model presented gives some direction to potential strategies for getting research into policy and practice in the health care sector in Nigeria and elsewhere.
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Affiliation(s)
- Benjamin Uzochukwu
- Department of Community Medicine, College of Medicine, University of Nigeria, Enugu-campus, Nigeria. .,Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-campus, Nigeria. .,Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-campus, Nigeria.
| | - Obinna Onwujekwe
- Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu-campus, Nigeria.,Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-campus, Nigeria.,Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-campus, Nigeria
| | - Chinyere Mbachu
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-campus, Nigeria
| | - Chinenye Okwuosa
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-campus, Nigeria
| | - Enyi Etiaba
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-campus, Nigeria.,Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-campus, Nigeria
| | - Monica E Nyström
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden.,Department of Public Health and Clinical Medicine, Umeå university, 901 87, Umeå, Sweden
| | - Lucy Gilson
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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MacPherson EE, Richards E, Namakhoma I, Theobald S. Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature. Glob Health Action 2014; 7:23717. [PMID: 24972916 PMCID: PMC4074359 DOI: 10.3402/gha.v7.23717] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/24/2014] [Accepted: 05/13/2014] [Indexed: 11/28/2022] Open
Abstract
Background Gender inequalities are important social determinants of health. We set out to critically review the literature relating to gender equity and sexual and reproductive health (SRH) in Eastern and Southern Africa with the aim of identifying priorities for action. Design During November 2011, we identified studies relating to SRH and gender equity through a comprehensive literature search. Results We found gender inequalities to be common across a range of health issues relating to SRH with women being particularly disadvantaged. Social and biological determinants combined to increase women's vulnerability to maternal mortality, HIV, and gender-based violence. Health systems significantly disadvantaged women in terms of access to care. Men fared worse in relation to HIV testing and care with social norms leading to men presenting later for treatment. Conclusions Gender inequity in SRH requires multiple complementary approaches to address the structural drivers of unequal health outcomes. These could include interventions that alter the structural environment in which ill-health is created. Interventions are required both within and beyond the health system.
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Affiliation(s)
- Eleanor E MacPherson
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;
| | - Esther Richards
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ireen Namakhoma
- Research for Equity and Community Health Trust, Lilongwe, Malawi
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Kok MO, Schuit AJ. Contribution mapping: a method for mapping the contribution of research to enhance its impact. Health Res Policy Syst 2012; 10:21. [PMID: 22748169 PMCID: PMC3464695 DOI: 10.1186/1478-4505-10-21] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/02/2012] [Indexed: 11/28/2022] Open
Abstract
Background At a time of growing emphasis on both the use of research and accountability, it is important for research funders, researchers and other stakeholders to monitor and evaluate the extent to which research contributes to better action for health, and find ways to enhance the likelihood that beneficial contributions are realized. Past attempts to assess research 'impact' struggle with operationalizing 'impact', identifying the users of research and attributing impact to research projects as source. In this article we describe Contribution Mapping, a novel approach to research monitoring and evaluation that aims to assess contributions instead of impacts. The approach focuses on processes and actors and systematically assesses anticipatory efforts that aim to enhance contributions, so-called alignment efforts. The approach is designed to be useful for both accountability purposes and for assisting in better employing research to contribute to better action for health. Methods Contribution Mapping is inspired by a perspective from social studies of science on how research and knowledge utilization processes evolve. For each research project that is assessed, a three-phase process map is developed that includes the main actors, activities and alignment efforts during research formulation, production and knowledge extension (e.g. dissemination and utilization). The approach focuses on the actors involved in, or interacting with, a research project (the linked actors) and the most likely influential users, who are referred to as potential key users. In the first stage, the investigators of the assessed project are interviewed to develop a preliminary version of the process map and first estimation of research-related contributions. In the second stage, potential key-users and other informants are interviewed to trace, explore and triangulate possible contributions. In the third stage, the presence and role of alignment efforts is analyzed and the preliminary results are shared with relevant stakeholders for feedback and validation. After inconsistencies are clarified or described, the results are shared with stakeholders for learning, improvement and accountability purposes. Conclusion Contribution Mapping provides an interesting alternative to existing methods that aim to assess research impact. The method is expected to be useful for research monitoring, single case studies, comparing multiple cases and indicating how research can better be employed to contribute to better action for health.
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Affiliation(s)
- Maarten O Kok
- Department of Health Sciences, V U University, Amsterdam, The Netherlands.
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Hanney SR, González-Block MA. Yes, research can inform health policy; but can we bridge the 'Do-Knowing It's Been Done' gap? Health Res Policy Syst 2011; 9:23. [PMID: 21679397 PMCID: PMC3142246 DOI: 10.1186/1478-4505-9-23] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 06/16/2011] [Indexed: 11/10/2022] Open
Affiliation(s)
- Stephen R Hanney
- Health Economics Research Group, Brunel University, Uxbridge, UK.
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