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Kagoma P, Mongi R, Kapologwe NA, Kengia J, Kalolo A. Health research evidence: its current usage in health planning, determinants and readiness to use knowledge translation tools among health planning teams in Tanzania-an exploratory mixed-methods study protocol. BMJ Open 2024; 14:e081517. [PMID: 38925687 PMCID: PMC11202719 DOI: 10.1136/bmjopen-2023-081517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Achieving universal health coverage requires using research evidence to inform decision-making. However, little information is available on the use of research evidence in planning in lower middle-income countries, including Tanzania. This paper presents a protocol that aims to investigate the usage of research evidence in health planning, determinants and readiness of the planning team members to use knowledge translation tools in Tanzania. METHODS AND ANALYSIS This study will employ a sequential exploratory mixed-methods design, with participants selected from national, regional and council levels. Qualitative data will be collected through a maximum of 52 in-depth interviews and 12 focused group discussions until saturation. To collect quantitative data, a structured questionnaire will be used to survey 422 participants, and a document review will be conducted from health facilities. Qualitative data will be analysed using thematic analysis, while descriptive and inferential analyses will be employed for quantitative data. ETHICS AND DISSEMINATION The study participants will provide written informed consent, and all recorded data will be stored on a secured research server accessible only to the investigators. Ethical approval has been obtained from the University of Dodoma Research Ethics Committee (ref. MA.84/261/02/'A'/64/91). The findings of this study will inform policymakers, researchers and implementers in the country on the use of research evidence in decision-making. We will disseminate our findings through publications, conferences, workshops and interactive communication with national, regional, council and health facility planning teams.
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Affiliation(s)
- Pius Kagoma
- Health, Social welfare and Nutrition services, President's Office Regional Administration and Local Government (PO-RALG), Dodoma, Tanzania, United Republic of
| | - Richard Mongi
- Public Health and Community Nursing, University of Dodoma School of Nursing and Public Health, Dodoma, Tanzania, United Republic of
| | - Ntuli A Kapologwe
- Preventive Services, Ministry of Health (MoH), Dodoma, Tanzania, United Republic of
| | - James Kengia
- Health, Social welfare and Nutrition services, President's Office, Regional Administration and Local Government (PO-RALG), Dodoma, Tanzania, United Republic of
| | - Albino Kalolo
- Public Health, Saint Francis University College of Health and Allied Sciences, Ifakara, Tanzania, United Republic of
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Semahegn A, Manyazewal T, Hanlon C, Getachew E, Fekadu B, Assefa E, Kassa M, Hopkins M, Woldehanna T, Davey G, Fekadu A. Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review. Health Res Policy Syst 2023; 21:131. [PMID: 38057873 PMCID: PMC10699029 DOI: 10.1186/s12961-023-01084-5] [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: 06/05/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND An estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review. METHODS The scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question. RESULTS A total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms. CONCLUSION Important barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.
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Affiliation(s)
- Agumasie Semahegn
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
| | - Tsegahun Manyazewal
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Services and Population Research Department, King's College London, London, UK
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eyerusalem Getachew
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bethelhem Fekadu
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Esubalew Assefa
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Department of Economics, Faculty of Arts and Social Sciences, The Open University, Milton Keynes, UK
| | | | - Michael Hopkins
- Science Policy Research Unit, University of Sussex, Brighton, UK
| | - Tassew Woldehanna
- College of Business and Economics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gail Davey
- Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK
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Abekah-Nkrumah G, Ottie-Boakye D, Ermel J, Issiaka S. Determinants of evidence use by frontline maternal, newborn and child health staff in selected health facilities in Ghana. Health Res Policy Syst 2022; 20:77. [PMID: 35764998 PMCID: PMC9238001 DOI: 10.1186/s12961-022-00881-8] [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: 10/10/2021] [Accepted: 06/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background The current paper examines the level of use of evidence and factors affecting the use of evidence by frontline maternal, newborn and child health (MNCH) and reproductive and child health (RCH) staff in practice decisions in selected health facilities in Ghana. Methods Data on use of evidence and its correlates was collected from 509 frontline healthcare staff drawn from 44 health facilities in three regions in Ghana. Means were used to examine the level of use of evidence, whiles cross-tabulations and Partial Least Squares-based regression were used to examine factors associated with the use of evidence in practice decisions by frontline MNCH/RCH staff. Findings The findings suggest a high level of use of evidence by frontline MNCH/RCH staff in practice decisions (score of 3.98 out of 5), albeit that evidence use is skewed towards the use of practice guidelines and policies. For the antecedents of evidence use, attitude had the highest score (3.99), followed by knowledge (3.8), access to evidence (3.77) and organizational structure (3.57), using a threshold of 5. The regression results indicate that attitudes and knowledge of frontline MNCH/RCH staff, organizational structure (strongest association), years of experience, being a male and working in a mission health facility are significantly positive correlated with evidence use, whiles working in a private health facility or in the post-natal clinic is negatively correlated with the use of evidence. Conclusion We argue that any effort to improve the use of evidence by frontline MNCH/RCH staff in practice decisions should focus on improving attitudes and knowledge of staff as well as challenges related to the structure of the organisation. Given however that the score for attitude was relatively high, emphases to improve evidence use should be on access to evidence and organizational structure in particular, which had the lowest score even though it has the strongest association with the use of evidence. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00881-8.
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Affiliation(s)
- Gordon Abekah-Nkrumah
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, P. O. Box 72, Accra, Ghana.
| | - Doris Ottie-Boakye
- Regional Institute for Population Studies, University of Ghana, Legon, P. O. Box LG 96, Accra, Ghana
| | - Johnson Ermel
- West African Health Organisation, 01 BP 153, Bobo-Dioulasso 01, Burkina Faso
| | - Sombié Issiaka
- West African Health Organisation, 01 BP 153, Bobo-Dioulasso 01, Burkina Faso
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Reichmann S, Wieser B. Open science at the science-policy interface: bringing in the evidence? Health Res Policy Syst 2022; 20:70. [PMID: 35725491 PMCID: PMC9208144 DOI: 10.1186/s12961-022-00867-6] [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: 10/28/2021] [Accepted: 05/16/2022] [Indexed: 12/04/2022] Open
Abstract
Part of the current enthusiasm about open science stems from its promises to reform scientific practice in service of the common good, to ensure that scientific outputs will be found and reused more easily, and to enhance scientific impact on policy and society. With this article, we question this optimism by analysing the potential for open science practices to enhance research uptake at the science–policy interface. Science advice is critical to help policy-makers make informed decisions. Likewise, some interpretations of open science hold that making research processes and outputs more transparent and accessible will also enhance the uptake of results by policy and society at large. However, we argue that this hope is based on an unjustifiably simplistic understanding of the science–policy interface that leaves key terms (“impact”, “uptake”) undefined. We show that this understanding—based upon linear models of research uptake—likewise grounds the influential “evidence–policy gap” diagnosis which holds that to improve research uptake, communication and interaction between researchers and policy-makers need to be improved. The overall normative stance of both discussions has sidelined empirical description of the science–policy interface, ignoring questions about the underlying differences between the policy domain and academia. Importantly, both open science and literature on closing the evidence–policy gap recommend improving communication (in terms of either the content or the means) as a viable strategy. To correct some of these views, we combine insights from policy theory with a narrative review of the literature on the evidence–policy gap in the health domain and find that removing barriers to access by itself will not be enough to foster research uptake.
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Ross-Hellauer T, Reichmann S, Cole NL, Fessl A, Klebel T, Pontika N. Dynamics of cumulative advantage and threats to equity in open science: a scoping review. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211032. [PMID: 35116143 PMCID: PMC8767192 DOI: 10.1098/rsos.211032] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
Open Science holds the promise to make scientific endeavours more inclusive, participatory, understandable, accessible and re-usable for large audiences. However, making processes open will not per se drive wide reuse or participation unless also accompanied by the capacity (in terms of knowledge, skills, financial resources, technological readiness and motivation) to do so. These capacities vary considerably across regions, institutions and demographics. Those advantaged by such factors will remain potentially privileged, putting Open Science's agenda of inclusivity at risk of propagating conditions of 'cumulative advantage'. With this paper, we systematically scope existing research addressing the question: 'What evidence and discourse exists in the literature about the ways in which dynamics and structures of inequality could persist or be exacerbated in the transition to Open Science, across disciplines, regions and demographics?' Aiming to synthesize findings, identify gaps in the literature and inform future research and policy, our results identify threats to equity associated with all aspects of Open Science, including Open Access, Open and FAIR Data, Open Methods, Open Evaluation, Citizen Science, as well as its interfaces with society, industry and policy. Key threats include: stratifications of publishing due to the exclusionary nature of the author-pays model of Open Access; potential widening of the digital divide due to the infrastructure-dependent, highly situated nature of open data practices; risks of diminishing qualitative methodologies as 'reproducibility' becomes synonymous with quality; new risks of bias and exclusion in means of transparent evaluation; and crucial asymmetries in the Open Science relationships with industry and the public, which privileges the former and fails to fully include the latter.
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Affiliation(s)
- Tony Ross-Hellauer
- Know-Center GmbH, Graz, Austria
- Open and Reproducible Research Group, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria
| | - Stefan Reichmann
- Open and Reproducible Research Group, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria
| | - Nicki Lisa Cole
- Know-Center GmbH, Graz, Austria
- Open and Reproducible Research Group, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria
| | - Angela Fessl
- Know-Center GmbH, Graz, Austria
- Open and Reproducible Research Group, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria
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Mallidou A, Dordunoo D, Borycki E, Kushniruk A, Sadeghi-Yekta K, Fraser J, Asuri S. Perspectives and Experiences of Policy Makers, Researchers, Health Information Technology Professionals, and the Public on Evidence-Based Health Policies: Protocol for a Qualitative Study. JMIR Res Protoc 2020; 9:e16268. [PMID: 33331825 PMCID: PMC7775201 DOI: 10.2196/16268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/03/2020] [Accepted: 02/22/2020] [Indexed: 11/13/2022] Open
Abstract
Background Evidence-based health policy (EBHP) development is critical to the judicious use of public funds. EBHPs increase transparency, accountability, effectiveness, and efficiency of policies. Encouraging collaboration between researchers or knowledge producers and policy makers is important because both communities have distinct professional cultures, resulting in them working separately without understanding each other. Knowledge sharing is a complex process that requires understanding of cultural aspects that may reduce cultural differences and increase the use of common language. Health information technology (HIT) is a useful tool to increase knowledge translation, which may result in the transparent use of evidence and networking in developing EBHPs. Our vision is to leverage HIT tools for a better health system that includes digitalized, open source, evidence-based, and transparent ways for collaboration and development of robust mechanisms and for sharing of synthesized evidence with knowledge user–friendly forms. Objective The aim of this study is to develop a conceptual framework on Knowledge translation and health Information Technology for Transparency (KhITT) in policy making and EBHPs (ie, the KhITT framework). The framework will be informed by the views of four key stakeholder groups (ie, policy makers, knowledge producers, HIT professionals, and the public) toward EBHP. The informants may also describe practices that demonstrate the EBHP development process and suggest technology platforms to enable this process. Methods We propose an exploratory, descriptive qualitative study to take place in British Columbia, Canada, using in-depth semistructured interviews. To ensure data saturation and trustworthiness, we will use a nonprobability, purposive snowball sample of up to 15 eligible participants in each of the four stakeholder groups. We will analyze the data using content analysis. Results The KhITT framework focuses on various stakeholders’ perspectives to better understand their perceived needs and priorities in identifying issues with EBHP, in order to make informed recommendations. Ethics approval has been obtained by the harmonized Behavioural Research Ethics Board at the University of British Columbia. We anticipate that we will complete data collection and analysis by December 2020. Preliminary results will be published in summer 2021. Conclusions Our ultimate goal of this study is to develop a conceptual framework and describe the technology platforms that would enable the EBHP process. We anticipate that our rigorous content analysis will be able to produce insights and themes that are able to address our objectives, contribute to an in-depth understanding of the EBHP process within British Columbia, highlight all influential factors, explicitly disseminate and communicate the study results, identify issues with EBHP and provide informed recommendations to address them, and enhance efforts toward transparent EBHPs. International Registered Report Identifier (IRRID) PRR1-10.2196/16268
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Affiliation(s)
| | - Dzifa Dordunoo
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Elizabeth Borycki
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Andre Kushniruk
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | | | - Julie Fraser
- Professional Regulatory Practice Department, Fraser Health, Vancouver, BC, Canada
| | - Sirisha Asuri
- Primary Care Division, BC Ministry of Health, Victoria, BC, Canada
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