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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Paing PY, Kyaw ZL, Schojan M, Traill T, Thura S, Tin N, Sein TT, Myint HHT, Bolton P, Lee C. Development of a knowledge broker group to support evidence-informed policy: lessons learned from Myanmar. Health Res Policy Syst 2021; 19:153. [PMID: 34963496 PMCID: PMC8713039 DOI: 10.1186/s12961-021-00806-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, policy-makers face challenges to using evidence in health decision-making, particularly lack of interaction between research and policy. Knowledge-brokering mechanisms can fill research–policy gaps and facilitate evidence-informed policy-making. In Myanmar, the need to promote evidence-informed policy is significant, and thus a mechanism was set up for this purpose. This paper discusses lessons learned from the development of the Knowledge Broker Group–Myanmar (KBG-M), supported by the Johns Hopkins Bloomberg School of Public Health’s Applied Mental Health Research Group (JHU) and Community Partners International (CPI). Methods Sixteen stakeholders were interviewed to explore challenges in formulating evidence-informed policy. Two workshops were held: the first to further understand the needs of policy-makers and discuss knowledge-brokering approaches, and the second to co-create the KBG-M structure and process. The KBG-M was then envisioned as an independent body, with former officials of the Ministry of Health and Sports (MoHS) and representatives from the nongovernmental sector actively engaging in the health sector, with an official collaboration with the MoHS. Results A development task force that served as an advisory committee was established. Then, steps were taken to establish the KBG-M and obtain official recognition from the MoHS. Finally, when the technical agreement with the MoHS was nearly complete, the process stopped because of the military coup on 1 February 2021, and is now on hold indefinitely. Conclusions Learning from this process may be helpful for future or current knowledge-brokering efforts, particularly in fragile, conflict-affected settings. Experienced and committed advisory committee members enhanced stakeholder relationships. Responsive coordination mechanisms allowed for adjustments to a changing bureaucratic landscape. Coordination with similar initiatives avoided overlap and identified areas needing technical support. Recommendations to continue the work of the KBG-M itself or similar platforms include the following: increase resilience to contextual changes by ensuring diverse partnerships, maintain advisory committee members experienced and influential in the policy-making process, ensure strong organizational and funding support for effective functioning and sustainability, have budget and timeline flexibility to allow sufficient time and resources for establishment, organize ongoing needs assessments to identify areas needing technical support and to develop responsive corrective approaches, and conduct information sharing and collaboration between stakeholders to ensure alignment.
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Affiliation(s)
- Pyone Yadanar Paing
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar.
| | - Zarni Lynn Kyaw
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Matthew Schojan
- Department of Mental Health, Global Mental Health Research Group, Johns Hopkins School of Public Health, 624 N. Broadway, Baltimore, MD, United States of America
| | - Tom Traill
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Si Thura
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Nilar Tin
- Public Health Professional, Yangon, Myanmar
| | - Than-Tun Sein
- Anthropology Department, Ramanya Hall, Yangon University, Yangon University PO, Yangon, Myanmar
| | - Hnin Hnin Tha Myint
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Paul Bolton
- Department of Mental Health, Global Mental Health Research Group, Johns Hopkins School of Public Health, 624 N. Broadway, Baltimore, MD, United States of America
| | - Catherine Lee
- Department of Mental Health, Global Mental Health Research Group, Johns Hopkins School of Public Health, 624 N. Broadway, Baltimore, MD, United States of America
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