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Damba FU, Mtshali NG, Chimbari MJ. Barriers and facilitators of translating doctoral research findings into policy: The case of a selected health sciences school in a South African university. Heliyon 2024; 10:e37314. [PMID: 39347414 PMCID: PMC11437976 DOI: 10.1016/j.heliyon.2024.e37314] [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: 06/17/2022] [Revised: 07/16/2024] [Accepted: 08/30/2024] [Indexed: 10/01/2024] Open
Abstract
Background Although the barriers and facilitators of translating health research into policy are generally well documented, not much has been reported for universities in low-and middle-income countries. We identified and analyzed barriers and facilitators of translating doctoral research findings into policy in a selected health sciences school in a South African university. Methods The study adopted a quantitative descriptive research design. We conveniently collected data through an online questionnaire administered to 47 PhD graduates, 11 PhD final year students and 21 PhD supervisors of the School of Nursing and Public Health. Descriptive statistics was performed, and data were summarized using percentages. Results More than half (72.4 %) of the students reported not involving Department of Health during formulation of research questions for their projects and 62.1 % reported not directly sharing research findings with the Department of Health. 53.4 % of the students indicated that they attended Department of Health research days and only 39.7 % said they presented research findings at the meetings. Only 39.7 % of the students who shared their research results to the Department of Health received feedback. About 52.4 % of the academic supervisors believed the introduction of the quartile system as a measure of impact of publications may reduce policy impact. An individual PhD supervisor supervises an average of 6 PhD students at any given time. 85.7 % of PhD supervisors reported that they consider stakeholders needs/interests when assisting students to identify research topics. Conclusion The study revealed the need for universities to make policymakers aware of available evidence, conduct research that is informed by the Department of Health's research agenda, involve the Department of Health in identifying research projects, and disseminate findings using platforms accessible to policymakers. Other key considerations are political will to utilize evidence, packaging evidence in a user-friendly manner and building the capacity of policymakers to use evidence.
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Affiliation(s)
- Florence Upenyu Damba
- University of KwaZulu-Natal, School of Nursing and Public Health, College of Health Sciences, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041, South Africa
| | - Ntombifikile Gloria Mtshali
- University of KwaZulu-Natal, School of Nursing and Public Health, College of Health Sciences, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041, South Africa
| | - Moses John Chimbari
- University of KwaZulu-Natal, School of Nursing and Public Health, College of Health Sciences, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041, South Africa
- Great Zimbabwe University, P.O. Box 1235, Masvingo, Zimbabwe
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Marme G, Kuzma J, Zimmerman PA, Harris N, Rutherford S. Investigating socio-ecological factors influencing implementation of tuberculosis infection prevention and control in rural Papua New Guinea. J Public Health (Oxf) 2024; 46:267-276. [PMID: 38326281 DOI: 10.1093/pubmed/fdae018] [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: 05/27/2023] [Revised: 12/04/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) is a highly transmissible infectious disease killing millions of people yearly, particularly in low-income countries. TB is most likely to be transmitted in healthcare settings with poor infection control practices. Implementing TB infection prevention and control (TB-IPC) is pivotal to preventing TB transmission in healthcare settings. This study investigated diverse stakeholders' perspectives relating to barriers and strategies for TB-IPC in rural hospitals in Papua New Guinea. METHODS Multiple qualitative case studies were conducted with 32 key stakeholders with experience in TB services. Data collection drew on three primary sources to triangulate data: semi-structured interviews, document reviews and field notes. The data were analyzed using hybrid deductive-inductive thematic analysis. RESULTS Our results reveal that key stakeholders perceive multiple interdependent factors that affect TB-IPC practice. The key emerging themes include strategic planning for and prioritizing TB-IPC guidelines; governance, leadership and accountability at the provincial level; community attitudes towards TB control; institutional capacity to deliver TB care, healthcare workers' safety, and long-term partnership and integration of TB-IPC programmes into the broad IPC programme. CONCLUSIONS The evidence suggests that a multi-perspective approach is crucial for TB-IPC guidelines in healthcare institutions. Interventions focusing on addressing health systems strengthening may improve the implementation of TB-IPC guidelines.
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Affiliation(s)
- Gigil Marme
- School of Medicine & Dentistry (Public Health), Griffith University, Gold Coast, QLD 4215, Australia
| | - Jerzy Kuzma
- Department of Medicine, Divine Word University, Madang Province 511, Papua New Guinea
| | - Peta-Anne Zimmerman
- Graduate Infection Prevention and Control Program, School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4215, Australia
| | - Neil Harris
- Higher Degree Research, Health Group, School of Medicine and Dentistry (Public Health), Griffith University, Gold Coast, QLD 4215, Australia
| | - Shannon Rutherford
- School of Medicine & Dentistry (Public Health), Griffith University, Gold Coast, QLD 4215, Australia
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Morankar S, Abraham G, Shroff Z, Birhanu Z. "Research ends with publication": a qualitative study on the use of health policy and systems research in Ethiopia. Health Res Policy Syst 2024; 22:1. [PMID: 38167041 PMCID: PMC10759454 DOI: 10.1186/s12961-023-01091-6] [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: 11/19/2021] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Decision-making about the design and implementation of health care policies should be supported by research evidence. This article reports on a qualitative study on the experiences of both research institutes and policymakers in Ethiopia in generating and using research evidence to inform health policy decision-making. METHODS Semi-structured interviews were conducted from January through March 2020, with representatives of research institutes and with policymakers in Ethiopia. The data collected during the interviews were analyzed thematically. RESULTS Half of the institutions represented had engaged in health policy and systems research (HPSR). These institutes' capacities were limited by multiple factors, including unsupportive research environments; the limited number of researchers with extensive experience; high turnover among senior researchers; lack of staff motivation mechanisms; underdeveloped research culture; limited technical and analytical capacity among researchers; lack of core funding for HPSR; ineffective financial management; and, lack of connections with health policy platforms. Research institutes also lacked the capacity in strategic packaging of findings to influence policy decision-making, although some programs have recently improved in this area. Meanwhile, there lacked a culture of using evidence in policymaking settings. In general, we found that policymakers had poor attitudes towards the quality or value of the evidence, and had little capacity to interpret evidence and apply findings to policy options. As a result, much of the research produced by the institutes have only been relevant academically, with little impact on policy. However, respondents reported that the environment is slowly changing, and the recent creation of a Research Advisory Council at the Ministry of Health offers a promising model. CONCLUSIONS Despite some recent changes, in Ethiopia researchers and policymakers alike often tend to consider health policy and systems research (HPSR) to be not very valuable since the findings generated are rarely used for evidence-informed policy development. Research institutes and researchers need to strengthen their technical, analytical, and administrative capacities (through, among other efforts, seeking more funding for research, and better incentives to attract, retain and build skills among qualified researchers); they also need to improve their understanding of the evidence-to-policy cycle and how to engage effectively with policymakers.
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Affiliation(s)
- Sudhakar Morankar
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gelila Abraham
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia
- Health Policy and Management Department, Public Health Faculty, Jimma Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Zubin Shroff
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Zewdie Birhanu
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia.
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia.
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Lundmark C, Nilsson J, Krook-Riekkola A. Taking Stock of Knowledge Transfer Studies: Finding Ways Forward. ENVIRONMENTAL MANAGEMENT 2023; 72:1146-1162. [PMID: 37688647 PMCID: PMC10570201 DOI: 10.1007/s00267-023-01877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/24/2023] [Indexed: 09/11/2023]
Abstract
Knowledge transfer (KT) from academia to practice is important in many fields, but comprehensive studies on identifying the most effective forms of KT are scarce. This paper aims to provide an overview of KT theory and presents a cross-disciplinary scoping review of empirically oriented peer-reviewed articles. The review offers guidance for researchers seeking to communicate effectively with practitioners. It explores the effects of research communications, delves into the understanding and measurement of these effects, attempts to identify the most effective forms of communication, and highlights important considerations when designing KT strategies. Few studies in our sample (eight of 27) systematically measured effects of KT, and merely four studies compared multiple forms of KT. Nevertheless, most studies estimated effects from KT, regardless of the chosen form (e.g., workshops or lectures). Most studies estimated knowledge change as the primary outcome. Additionally, several studies explored altered beliefs such as increased self-efficacy. A third of the studies addressed how the knowledge was applied, ranging from sharing information to developing new habits. The identified effects were, however, both small and volatile. Our findings underscore the significance of continuity and repeated interactions to enhance the impact of KT initiatives. Furthermore, researchers need to develop a comprehensive set of tools to facilitate successful KT, considering factors such as expertise, communication skills, trust-building, and participant-centered approaches. By employing these strategies, researchers can effectively bridge the gap between academia and practice, facilitating successful KT in various fields.
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Affiliation(s)
- Carina Lundmark
- Department of Social Sciences, Technology and Arts, Luleå University of Technology, SE-971 87, Luleå, Sweden.
| | - Jens Nilsson
- Department of Social Sciences, Technology and Arts, Luleå University of Technology, SE-971 87, Luleå, Sweden
| | - Anna Krook-Riekkola
- Department of Engineering Sciences and Mathematics, Luleå University of Technology, SE-971 87, Luleå, Sweden
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Brooks C, Mirzoev T, Chowdhury D, Deuri SP, Madill A. Using evidence in mental health policy agenda-setting in low- and middle-income countries: a conceptual meta-framework from a scoping umbrella review. Health Policy Plan 2023; 38:876-893. [PMID: 37329301 PMCID: PMC10394497 DOI: 10.1093/heapol/czad038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/15/2023] [Accepted: 07/12/2023] [Indexed: 06/19/2023] Open
Abstract
The purpose of this article is to close the gap in frameworks for the use of evidence in the mental health policy agenda-setting in low- and middle-income countries (LMICs). Agenda-setting is important because mental health remains a culturally sensitive and neglected issue in LMICs. Moreover, effective evidence-informed agenda-setting can help achieve, and sustain, the status of mental health as a policy priority in these low-resource contexts. A scoping 'review of reviews' of evidence-to-policy frameworks was conducted, which followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Nineteen reviews met the inclusion criteria. A meta-framework was developed from analysis and narrative synthesis of these 19 reviews, which integrates the key elements identified across studies. It comprises the concepts of evidence, actors, process, context and approach, which are linked via the cross-cutting dimensions of beliefs, values and interests; capacity; power and politics; and trust and relationships. Five accompanying questions act as a guide for applying the meta-framework with relevance to mental health agenda-setting in LMICs. This is a novel and integrative meta-framework for mental health policy agenda-setting in LMICs and, as such, an important contribution to this under-researched area. Two major recommendations are identified from the development of the framework to enhance its implementation. First, given the paucity of formal evidence on mental health in LMICs, informal evidence based on stakeholder experience could be better utilized in these contexts. Second, the use of evidence in mental health agenda-setting in LMICs would be enhanced by involving a broader range of stakeholders in generating, communicating and promoting relevant information.
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Affiliation(s)
- Chloe Brooks
- School of Psychology, University of Leeds, Lifton Terrace, Leeds LS2 9JT, UK
| | - Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Diptarup Chowdhury
- Department of Clinical Psychology, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam 784001, India
| | - Sonia Pereira Deuri
- Department of Psychiatric Social Work, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam 784001, India
| | - Anna Madill
- School of Psychology, University of Leeds, Lifton Terrace, Leeds LS2 9JT, UK
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Sakala M, Chawani MS, Kazanga-Chiumia I, Hara H, Abdullahi L, Kambalame D, Banda J, Mitambo C, Terlouw A, Oronje R. Functionality of technical working groups in enabling evidence-informed decision-making within Malawi's Ministry of Health: a cross-sectional qualitative study. Health Res Policy Syst 2023; 21:44. [PMID: 37280657 DOI: 10.1186/s12961-023-00987-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The roles and functionality of technical working groups (TWGs) in the health sectors vary across countries, still they aim to support government and ministries in formulating evidence-informed recommendations for policies and facilitate dialogue and alignment of activities among stakeholders within the health sector. Thus, TWGs have a role in enhancing the functionality and effectiveness of the health system structure. However, in Malawi, the functionality of TWGs and how they utilize research evidence to contribute to decision-making is not monitored. This study sought to understand the TWGs' performance and functionality in enabling evidence-informed decision-making (EIDM) in Malawi's health sector. METHODS A cross-sectional descriptive qualitative study. Data were collected through interviews, documents review and observation of three TWG meetings. Qualitative data were analysed using a thematic approach. The WHO-UNICEF Joint Reporting Form (JRF) was used to guide the assessment of TWG functionality. RESULTS TWG functionality varied in the Ministry of Health (MoH) in Malawi. The reasons for those perceived to be functioning well included meeting frequently, diverse representation of members, and that their recommendations to MoH were usually considered when decisions were made. For the TWGs that were perceived as not functioning well, the main reasons included lack of funding, periodic meetings and discussions that needed to provide clear decisions on the actions to be taken. In addition, evidence was recognized as important in decision-making, and research was valued by decision-makers within the MoH. However, some of the TWGs lacked reliable mechanisms for generating, accessing and synthesizing research. They also needed more capacity to review and use the research to inform their decisions. CONCLUSIONS TWGs are highly valued and play a critical role in strengthening EIDM within the MoH. Our paper highlights the complexity and barriers of TWG functionality in supporting pathways for health policy-making in Malawi. These results have implications for EIDM in the health sector. This suggests that the MoH should actively develop reliable interventions and evidence tools, strengthen capacity-building and increase funding for EIDM.
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Affiliation(s)
- Melody Sakala
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
| | - Marlen Stacey Chawani
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Hleziwe Hara
- African Institute for Development Policy, Lilongwe, Malawi
| | | | | | | | | | - Anja Terlouw
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Liverpool School of Tropical Medicine, Liverpool, England
| | - Rose Oronje
- African Institute for Development Policy, Lilongwe, Malawi
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Uneke CJ, Okedo-Alex IN, Akamike IC, Uneke BI, Eze II, Chukwu OE, Otubo KI, Urochukwu HC. Institutional roles, structures, funding and research partnerships towards evidence-informed policy-making: a multisector survey among policy-makers in Nigeria. Health Res Policy Syst 2023; 21:36. [PMID: 37237324 DOI: 10.1186/s12961-023-00971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/27/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Evidence-informed policy-making aims to ensure that the best and most relevant evidence is systematically generated and used for policy-making. The aim of this study was to assess institutional structures, funding, policy-maker perspectives on researcher-policy-maker interactions and the use of research evidence in policy-making in five states in Nigeria. METHODS This was a cross-sectional study carried out among 209 participants from two geopolitical zones in Nigeria. Study participants included programme officers/secretaries, managers/department/facility heads and state coordinators/directors/presidents/chairpersons in various ministries and the National Assembly. A pretested semi-structured self-administered questionnaire on a five-point Likert scale was used to collect information on institutional structures for policy and policy-making in participants' organizations, the use of research evidence in policy and policy-making processes, and the status of funding for policy-relevant research in the participants' organizations. Data were analysed using IBM SPSS version 20 software. RESULTS The majority of the respondents were older than 45 years (73.2%), were male (63.2) and had spent 5 years or less (74.6%) in their present position. The majority of the respondents' organizations had a policy in place on research involving all key stakeholders (63.6%), integration of stakeholders' views within the policy on research (58.9%) and a forum to coordinate the setting of research priorities (61.2%). A high mean score of 3.26 was found for the use of routine data generated from within the participants' organizations. Funding for policy-relevant research was captured in the budget (mean = 3.47) but was inadequate (mean = 2.53) and mostly donor-driven (mean = 3.64). Funding approval and release/access processes were also reported to be cumbersome, with mean scores of 3.74 and 3.89, respectively. The results showed that capacity existed among career policy-makers and the Department of Planning, Research and Statistics to advocate for internal funds (mean = 3.55) and to attract external funds such as grants (3.76) for policy-relevant research. Interaction as part of the priority-setting process (mean = 3.01) was the most highly rated form of policy-maker-researcher interaction, while long-term partnerships with researchers (mean = 2.61) had the lower mean score. The agreement that involving policy-makers in the planning and execution of programmes could enhance the evidence-to-policy process had the highest score (mean = 4.40). CONCLUSION The study revealed that although institutional structures such as institutional policies, fora and stakeholder engagement existed in the organizations studied, there was suboptimal use of evidence obtained from research initiated by both internal and external researchers. Organizations surveyed had budget lines for research, but this funding was depicted as inadequate. There was suboptimal actual participation of policy-makers in the co-creation, production and dissemination of evidence. The implementation of contextually relevant and sustained mutual institutional policy-maker-researcher engagement approaches is needed to promote evidence-informed policy-making. Thus there is a need for institutional prioritization and commitment to research evidence generation.
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Affiliation(s)
- Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria.
| | - Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Bilikis Iyabo Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Irene Ifeyinwa Eze
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Onyekachi Echefu Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Kingsley Igboji Otubo
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Henry C Urochukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
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Abdullahi L, Hara H, Kahurani E, Kamthunzi V, Nthakomwa L, Oronje R, Madise N. EIDM training as a key intervention among researchers to enhance research uptake and policy engagement: an evaluation study. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18018.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In the past decade, the field of Evidence Informed Decision Making (EIDM) has been evolving faster than before. This shows a need for capacity enhancement amongst evidence producers and evidence users in EIDM training. Through the Enhance DELTAS programme, led by the African Institute for Development Policy (AFIDEP), we provided research uptake and policy engagement training, mentorship and webinars to awardees of the Developing Excellence in Leadership, Training and Science (DELTAS) Africa initiative, led by the African Academy of Sciences (AAS). Two workshops were offered to individual early career DELTAS researchers in policy engagement and evidence uptake, referred to as ENHD101, and among research leaders to enhance institutional capacity on policy engagement and evidence uptake, (ENHD102). Overall, over the eight months’ period of training, mentorship and webinars, the programme attracted 31 early career researchers and 20 research leaders. Following the programme, the early career researchers understood the importance of EIDM for better health policies and programmes. In addition, the team appreciated the complexities of the policymaking processes as they developed the policy engagement strategy for their research. The utilisation of the EIDM knowledge was reflected during the mentorship with policy briefs as end product. For research leaders, they appreciated their role in strengthening capacity for EIDM in decision-making spaces. Although during the programme none of the research leaders participated in strengthening capacity for EIDM, the team anticipated improving in the area in the long run. In addition, the research leaders developed and implemented institutional strategies for policy engagement and research uptake through use of social media to influence policymakers. In conclusion, the project supported capacity building of African researchers in EIDM. It was evident that enhancing knowledge and skills on EIDM through an integrated approach to include training, mentorship, and webinars demonstrated enhanced capacity for policy engagement and evidence uptake.
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Mwendera CA, Mzilahowa T, Njiokou F, N'falé S, Amegee Quach J, Thomsen E, Dabire R, Ranson H, Alhassan N, Oronje R, Worrall E. Knowledge translation and evidence generation to increase the impact of vector control in Burkina Faso, Cameroon and Malawi. BMJ Glob Health 2022; 7:e008378. [PMID: 35545288 PMCID: PMC9096501 DOI: 10.1136/bmjgh-2021-008378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/13/2022] [Indexed: 11/07/2022] Open
Abstract
Lack of context-specific evidence and inadequate evidence-use for decision-making contribute to poor health. This paper reports on our work aimed at addressing the knowledge translation (KT) gap between evidence generators and users. We present our experiences of strengthening KT via technical advisory groups (TAGs) in parallel with increasing evidence generation through research fellowships and operational research. Vectorborne diseases (VBDs) impose substantial health and economic burdens in sub-Saharan Africa despite being preventable with vector control. The Partnership for Increasing the Impact of Vector Control aimed to reduce the burden of VBDs in Burkina Faso, Cameroon, Malawi and at regional and global levels. TAGs can promote evidence-use in policy and practice by engaging relevant stakeholders in both research and policy processes. TAGs and related activities are best facilitated by a coordinator with skills in research and policy. Contextual factors should influence the design and governance of TAGs, which will likely evolve over time. Relevant national stakeholders should be included in TAGs and be actively involved in developing research agendas to increase the relevance and acceptability of research findings for decision-making. The countries present three differing contexts with longer-term research and evaluation necessary to draw lessons on impact.
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Affiliation(s)
| | - Themba Mzilahowa
- Malaria Alert Centre, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Flobert Njiokou
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon
| | - Sagnon N'falé
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Jessica Amegee Quach
- Centre for Capacity Research, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Edward Thomsen
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Roch Dabire
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Hilary Ranson
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rose Oronje
- African Institute for Development Policy, Nairobi, Kenya
| | - Eve Worrall
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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Macaulay B, Reinap M, Wilson MG, Kuchenmüller T. Integrating citizen engagement into evidence-informed health policy-making in eastern Europe and central Asia: scoping study and future research priorities. Health Res Policy Syst 2022; 20:11. [PMID: 35042516 PMCID: PMC8764649 DOI: 10.1186/s12961-021-00808-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/16/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The perspectives of citizens are an important and often overlooked source of evidence for informing health policy. Despite growing encouragement for its adoption, little is known regarding how citizen engagement may be integrated into evidence-informed health policy-making in low- and middle-income counties (LMICs) and newly democratic states (NDSs). We aimed to identify the factors and variables affecting the potential integration of citizen engagement into evidence-informed health policy-making in LMICs and NDSs and understand whether its implementation may require a different approach outside of high-income western democracies. Further, we assessed the context-specific considerations for the practical implementation of citizen engagement in one focus region-eastern Europe and central Asia. METHODS First, adopting a scoping review methodology, we conducted and updated searches of six electronic databases, as well as a comprehensive grey literature search, on citizen engagement in LMICs and NDSs, published before December 2019. We extracted insights about the approaches to citizen engagement, as well as implementation considerations (facilitators and barriers) and additional political factors, in developing an analysis framework. Second, we undertook exploratory methods to identify relevant literature on the socio-political environment of the focus region, before subjecting these sources to the same analysis framework. RESULTS Our searches identified 479 unique sources, of which 28 were adjudged to be relevant. The effective integration of citizen engagement within policy-making processes in LMICs and NDSs was found to be predominantly dependent upon the willingness and capacity of citizens and policy-makers. In the focus region, the implementation of citizen engagement within evidence-informed health policy-making is constrained by a lack of mutual trust between citizens and policy-makers. This is exacerbated by inadequate incentives and capacity for either side to engage. CONCLUSIONS This research found no reason why citizen engagement could not adopt the same form in LMICs and NDSs as it does in high-income western democracies. However, it is recognized that certain political contexts may require additional support in developing and implementing citizen engagement, such as through trialling mechanisms at subnational scales. While specifically outlining the potential for citizen engagement, this study highlights the need for further research on its practical implementation.
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Affiliation(s)
- Bobby Macaulay
- World Health Organization Regional Office for Europe, Copenhagen, Denmark.
| | - Marge Reinap
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Michael G Wilson
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Tanja Kuchenmüller
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Busza J, Lemma S, Janson A, Adem SO, Berhanu D, Defar A, Persson LÅ, Källestål C. Strengthening routine health data analysis in Ethiopia: the Operational Research and Coaching for Analysts (ORCA) experience. Glob Health Action 2021; 14:1901390. [PMID: 33789545 PMCID: PMC8018453 DOI: 10.1080/16549716.2021.1901390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Many routine health information systems (RHIS) show persistent gaps between recording and reporting data and their effective use in solving problems. Strengthening RHIS has become a global priority to track and address national health goals. In Ethiopia, the Ministry of Health and Bill & Melinda Gates Foundation introduced the Operational Research and Coaching for Analysts (ORCA) capacity development project, co-designed with the London School of Hygiene & Tropical Medicine, which delivered training, coaching and mentoring support. We present the development, experiences, and perceptions of ORCA as a mechanism to enhance data quality, analysis, interpretation and use. ORCA integrated capacity development activities into national data analysts’ routine workload over a period of 2 years. Participating analysts were drawn from across the Ministry of Health directorates and two of its closely aligned agencies: the Ethiopian Public Health Institute and the Ethiopian Pharmaceutical Supply Agency. We used mixed methods (knowledge questionnaire, semi-structured interviews, programme records) to document the fidelity, feasibility, reach, and acceptability of ORCA and identify early signs of improved knowledge and changing institutional practices. Thirty-six participants completed the programme. Working in interdisciplinary groups on specific national health indicators, they received training workshops and support for study design, fieldwork, and analysis to build skills in assessing data quality and interpreting findings relevant to policy. Personal development grants and laptops provided incentives for sustained engagement. Participants appreciated ORCA’s applied and practical approach as well as good communication from administrators and clear links to national strategy. They also expressed frustration with delays, difficulties prioritising project work over routine responsibilities, and lack of formal accreditation. Knowledge and analytic skills increased and participants were able to integrate experiences from the project into their future work. Health system managers saw potential in longer-term improvements in data analysis and application to policy, although no clear changes were observed yet.
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Affiliation(s)
- Joanna Busza
- Centre for Evaluation, Department of Public Health, Environment & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Seblewengel Lemma
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Annika Janson
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.,Department of Women´s and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Della Berhanu
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Atkure Defar
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Lars-Åke Persson
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Carina Källestål
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Windle A, Javanparast S, Freeman T, Baum F. Assessing organisational capacity for evidence-informed health policy and planning: an adaptation of the ORACLe tool for Australian primary health care organizations. Health Res Policy Syst 2021; 19:25. [PMID: 33602272 PMCID: PMC7893729 DOI: 10.1186/s12961-021-00682-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background Many nations have established primary health care (PHC) organizations that conduct PHC planning for defined geographical areas. The Australian Government established Primary Health Networks (PHNs) in 2015 to develop and commission PHC strategies to address local needs. There has been little written about the capacity of such organizations for evidence-informed planning, and no tools have been developed to assess this capacity, despite their potential to contribute to a comprehensive effective and efficient PHC sector. Methods We adapted the ORACLe tool, originally designed to examine evidence-informed policy-making capacity, to examine organizational capacity for evidence-informed planning in meso-level PHC organizations, using PHNs as an example. Semi-structured interviews were conducted with 14 participants from five PHNs, using the ORACLe tool, and scores assigned to responses, in seven domains of capacity. Results There was considerable variation between PHNs and capacity domains. Generally, higher capacity was demonstrated in regard to mechanisms which could inform planning through research, and support relationships with researchers. PHNs showed lower capacity for evaluating initiatives, tools and support for staff, and staff training. Discussion and conclusions We critique the importance of weightings and scope of some capacity domains in the ORACLe tool. Despite this, with some minor modifications, we conclude the ORACLe tool can identify capacity strengths and limitations in meso-level PHC organizations. Well-targeted capacity development enables PHC organizations’ strategies to be better informed by evidence, for optimal impact on PHC and population health outcomes.
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Affiliation(s)
- Alice Windle
- College of Medicine and Public Health, Southgate Institute for Health Society and Equity, Flinders University, Adelaide, SA, Australia.
| | - Sara Javanparast
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Toby Freeman
- College of Medicine and Public Health, Southgate Institute for Health Society and Equity, Flinders University, Adelaide, SA, Australia
| | - Fran Baum
- College of Medicine and Public Health, Southgate Institute for Health Society and Equity, Flinders University, Adelaide, SA, Australia
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Shafaghat T, Imani Nasab MH, Bahrami MA, Kavosi Z, Roozrokh Arshadi Montazer M, Rahimi Zarchi MK, Bastani P. A mapping of facilitators and barriers to evidence-based management in health systems: a scoping review study. Syst Rev 2021; 10:42. [PMID: 33516269 PMCID: PMC7847165 DOI: 10.1186/s13643-021-01595-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare settings are complex, and the decision-making process is usually complicated, too. Precise use of best evidence from different sources for increasing the desired outcomes is the result of EBM. Therefore, this study aimed to map the potential facilitators and barriers to EBM in health systems to help the healthcare managers to better implement EBM in their organizations. METHODS The present study was a scoping review (SR) conducted in 2020 based on the integration of the frameworks presented by Arksey and O'Malley (2005) and Levac et al. (2010) considering the Joanna Briggs Institute guideline (2015). These frameworks consist of 6 steps. After finalizing the search strategy, 7 databases were searched, and the PRISMA-ScR was used to manage the retrieval and inclusion of the evidence. Microsoft Excel 2013 was used to extract the data, and the graphic description was presented. The summative analysis approach was used applying MAXQDA10. RESULTS According to the systematic search, 4815 studies were retrieved after eliminating duplicates and unrelated articles, 49 articles remained to extract EBM facilitators and barriers. Six main aspects attitude toward EBM, external factors, contextual factors, resources, policies and procedures, and research capacity and data availability were summarized as EBM facilitators. The barriers to EBM were similarly summarized as attitude toward EBM, external factors, contextual factors, policies and procedures, limited resources, and research capacity and data availability. The streamgraphs describe that the international attention to the sub-aspects of facilitators and barriers of EBM has been increased since 2011. CONCLUSIONS The importance of decision-making regarding complex health systems, especially in terms of resource constraints and uncertainty conditions, requires EBM in the health system as much as possible. Identifying the factors that facilitate the use of evidence, as well as its barriers to management and decision-making in the organization, can play an important role in making systematic and reliable decisions that can be defended by the officials and ultimately lead to greater savings in organization resources and prevent them from being wasted.
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Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Amin Bahrami
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Roozrokh Arshadi Montazer
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Health Policy and Management Research Center, Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Peivand Bastani
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
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Surur AS, Fekadu A, Makonnen E, Hailu A. Challenges and Opportunities for Drug Discovery in Developing Countries: The Example of Cutaneous Leishmaniasis. ACS Med Chem Lett 2020; 11:2058-2062. [PMID: 33214808 DOI: 10.1021/acsmedchemlett.0c00446] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The current drug discovery paradigm has failed to address the treatment need for diseases of high priority to developing countries. Cutaneous leishmaniasis is a good example of such diseases with virtually no new effective drug developed in the past 70 years. The past two decades had witnessed relatively increased attention toward neglected diseases by stimulating pharmaceutical industries through introductions of Priority Review Vouchers (PRVs) and Product Development Partnerships (PDPs). However, the lion's share of resources allocated for research and development by PRVs and PDPs is directed toward research organizations and pharmaceutical industries in developed countries. This new approach has also not led to the development of drugs for most neglected diseases including cutaneous leishmaniasis. Improving the medical discovery capacity of countries where these diseases are prevalent and enabling exploration of the hitherto untapped natural resources are an effective and sustainable solution.
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Affiliation(s)
- Abdrrahman S. Surur
- World Bank Center of Excellence for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- World Bank Center of Excellence for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Eyasu Makonnen
- World Bank Center of Excellence for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Asrat Hailu
- World Bank Center of Excellence for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
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