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Borst RAJ, Wehrens R, Nsangou M, Arikpo D, Esu E, Al Metleq A, Hobden O, Meremikwu M, Ongolo-Zogo P, Bal R, Kok MO. What makes knowledge translation work in practice? Lessons from a demand-driven and locally led project in Cameroon, Jordan and Nigeria. Health Res Policy Syst 2023; 21:127. [PMID: 38049826 PMCID: PMC10694879 DOI: 10.1186/s12961-023-01083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/26/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Over the years, the knowledge translation (KT) field has moved from promoting linearized models to embracing the importance of interaction and learning. Likewise, there is now increased attention on the transfer of KT approaches to new environments. Some scholars, however, have warned that ideas about transferability still hinge on linear thinking and doing. In the current study, we therefore sought to use a more reflexive approach to KT and to study how actors align KT approaches with their local environments. METHODS Our (auto) ethnographic study took place in a wider KT project. This project intended to combine three components: (1) co-organizing demand-driven, locally led and embedded KT cycles in Cameroon, Jordan, and Nigeria, (2) building upon established KT methods and (3) equipping and empowering local teams. We conducted 63 semi-structured interviews with key KT actors, observed 472 h of KT practices, and collected a paper trail of documents. At the same time, we also compiled project exchanges, such as project documents, plans, protocols, field notes, meeting notes and an archive of (email) correspondence between project members. We analysed all data abductively. RESULTS We show that there were numerous moments where the design of our project indeed enabled us to align with local practices and needs. Yet this often did not suffice, and the project design sometimes conflicted with other logics and values. By analysing these tensions, we want to show that doing KT work which acts upon different values and knowledges and is sensitive towards the different effects that it produces demands both structuring projects in a specific way and requires significant alignment work of KT actors in practice. CONCLUSIONS We show that practising KT more reflexively relies on two important conditions. First, KT projects have to be structured with sufficient discretionary space. Second, even though the structure of a project is important, there will be continuous need for alignment work. It is important to facilitate such alignment work and to further support it. In the discussion of this paper, we therefore articulate three design principles and three sensitivities. These elements can be used to make future KT projects more reflexive and sensitive to (social) complexity.
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Affiliation(s)
- Robert A J Borst
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands.
| | - Rik Wehrens
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
| | - Moustapha Nsangou
- Centre pour le Dévéloppement des Bonnes Pratiques en Santé, Yaoundé, Cameroon
| | - Dachi Arikpo
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Ekpereonne Esu
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
- Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Ali Al Metleq
- The Higher Population Council, General Secretariat, Amman, Jordan
| | - Olivia Hobden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
| | - Martin Meremikwu
- Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Pierre Ongolo-Zogo
- Centre pour le Dévéloppement des Bonnes Pratiques en Santé, Yaoundé, Cameroon
| | - Roland Bal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
| | - Maarten Olivier Kok
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O Box 1738, 3000DR, Rotterdam, the Netherlands
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Al Sabahi S, Wilson MG, Lavis JN, El-Jardali F, Moat K. Examining and Contextualizing Approaches to Establish Policy Support Organizations - A Mixed Method Study. Int J Health Policy Manag 2022; 11:1788-1800. [PMID: 34380206 PMCID: PMC9808249 DOI: 10.34172/ijhpm.2021.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/13/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There has been an increase in the number of policy support organizations (PSOs) that have been created to foster the systematic use of evidence in health system policymaking. Our aim was to identify approaches for establishing a PSO or similar entities by soliciting insights from those with practical experience with developing and operationalizing PSOs in real-world contexts. METHODS We used a sequential mixed method approached. We first conducted a survey to identify the views and experiences of those who were directly involved in the establishment of PSOs that have been developed and implemented across a variety of political-, health- and research-system contexts. The survey findings were then used to develop a purposive sample of PSO leaders and refine an interview guide for interviews with them. RESULTS We received 19 completed surveys from leaders of PSOs in countries across the WHO regions and that operate in different settings (eg, as independent organization or within a university or government department) and conducted interviews with 15 senior managers from nine PSOs. Our findings provide in-depth insights about approaches and strategies across four stages for establishing a PSO, which include: (i) building awareness for the PSO; (ii) developing the PSO; (iii) assessing the PSO to identify potential areas for enhancement; and (iv) supporting maturation to build sustainability in the long-term. Our findings provide rich insights about the process of establishing a PSO from leaders who have undertaken the process. CONCLUSION While all PSOs share the same objective in supporting evidence-informed policy-making (EIPM), there is no single approach that can be considered to be the most successful in establishing a PSO, and each country should identify the approach based on its context.
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Affiliation(s)
| | - Michael G. Wilson
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - John N. Lavis
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Department of Political Science, McMaster University, Hamilton, ON, Canada
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Fadi El-Jardali
- Knowledge to Policy Center, American University of Beirut, Beirut, Lebanon
| | - Kaelan Moat
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
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Ellen ME, Ben-Sheleg E. Evidence-Informed Policy-Making: Are We Doing Enough? Comment on "Examining and Contextualizing Approaches to Establish Policy Support Organizations - A Mixed Method Study". Int J Health Policy Manag 2022; 11:1974-1976. [PMID: 35279040 PMCID: PMC9808221 DOI: 10.34172/ijhpm.2022.7010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/19/2022] [Indexed: 01/12/2023] Open
Abstract
In their study of manifestations of policy support organizations (PSOs), Al Sabahi et al found that PSOs are united in their goal to support evidence-informed policy-making (EIPM), albeit with differing approaches. Their article is an important contribution to the body of research on evidence utilization and implementation. The unprecedented evidence climate presented by coronavirus disease 2019 (COVID-19) provides a unique window to motivate EIPM implementation. Research such as Al Sabahi and colleagues must prompt a dialogue regarding how best to address some of the current shortcomings in the field of EIPM. Monitoring and evaluation of best practices in EIPM is scarce. EIPM uptake is unsatisfactory, and the scientific community needs to ask itself why that is and what can be done. And, we should strive to develop a gradient that discerns between the convenient and the essential so countries can evaluate and pursue the policies to best address their greatest pain points through evidence.
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Affiliation(s)
- Moriah E. Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
- Israel Implementation Science and Policy Engagement Centre, Ben-Gurion University of the Negev, Be’er Sheva, Israel
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Eliana Ben-Sheleg
- Israel Implementation Science and Policy Engagement Centre, Ben-Gurion University of the Negev, Be’er Sheva, Israel
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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Kuchenmüller T, Boeira L, Oliver S, Moat K, El-Jardali F, Barreto J, Lavis J. Domains and processes for institutionalizing evidence-informed health policy-making: a critical interpretive synthesis. Health Res Policy Syst 2022; 20:27. [PMID: 35246139 PMCID: PMC8894559 DOI: 10.1186/s12961-022-00820-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/25/2022] [Indexed: 02/08/2023] Open
Abstract
Background While calls for institutionalization of evidence-informed policy-making (EIP) have become stronger in recent years, there is a paucity of methods that governments and organizational knowledge brokers can use to sustain and integrate EIP as part of mainstream health policy-making. The objective of this paper was to conduct a knowledge synthesis of the published and grey literatures to develop a theoretical framework with the key features of EIP institutionalization. Methods
We applied a critical interpretive synthesis (CIS) that allowed for a systematic, yet iterative and dynamic analysis of heterogeneous bodies of literature to develop an explanatory framework for EIP institutionalization. We used a “compass” question to create a detailed search strategy and conducted electronic searches to identify papers based on their potential relevance to EIP institutionalization. Papers were screened and extracted independently and in duplicate. A constant comparative method was applied to develop a framework on EIP institutionalization. The CIS was triangulated with the findings of stakeholder dialogues that involved civil servants, policy-makers and researchers. Results We identified 3001 references, of which 88 papers met our eligibility criteria. This CIS resulted in a definition of EIP institutionalization as the “process and outcome of (re-)creating, maintaining and reinforcing norms, regulations, and standard practices that, based on collective meaning and values, actions as well as endowment of resources, allow evidence to become—over time—a legitimate and taken-for-granted part of health policy-making”. The resulting theoretical framework comprised six key domains of EIP institutionalization that capture both structure and agency: (1) governance; (2) standards and routinized processes; (3) partnership, collective action and support; (4) leadership and commitment; (5) resources; and (6) culture. Furthermore, EIP institutionalization is being achieved through five overlapping stages: (i) precipitating events; (ii) de-institutionalization; (iii) semi-institutionalization (comprising theorization and diffusion); (iv) (re)-institutionalization; and (v) renewed de-institutionalization processes. Conclusions This CIS advances the theoretical and conceptual discussions on EIP institutionalization, and provides new insights into an evidence-informed framework for initiating, strengthening and/or assessing efforts to institutionalize EIP. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00820-7.
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Affiliation(s)
- Tanja Kuchenmüller
- Research for Health, Science Division, World Health Organization, Geneva, Switzerland.
| | | | - Sandy Oliver
- Social Research Institute, University College London, London, United Kingdom.,Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Kaelan Moat
- McMaster Health Forum/WHO Collaborating Centre for Evidence-Informed Policy, McMaster University, Hamilton, ON, Canada.,Department of Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Fadi El-Jardali
- Knowledge to Policy (K2P) Center/WHO Collaborating Centre for Evidence-Informed Policy and Practice, American University of Beirut, Beirut, Lebanon.,Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
| | | | - John Lavis
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa.,McMaster Health Forum/WHO Collaborating Centre for Evidence-Informed Policy, McMaster University, Hamilton, ON, Canada.,Department of Health Evidence and Impact, McMaster University, Hamilton, ON, Canada
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