Applying knowledge translation tools to inform policy: the case of mental health in Lebanon.

Farah Yehia,Fadi El Jardali

doi:10.1186/s12961-015-0018-7

Abstract

BackgroundMany reform efforts in health systems fall short because the use of research evidence to inform policy remains scarce. In Lebanon, one in four adults suffers from a mental illness, yet access to mental healthcare services in primary healthcare (PHC) settings is limited. Using an “integrated” knowledge framework to link research to action, this study examines the process of influencing the mental health agenda in Lebanon through the application of Knowledge Translation (KT) tools and the use of a KT Platform (KTP) as an intermediary between researchers and policymakers.MethodsThis study employed the following KT tools: 1) development of a policy brief to address the lack of access to mental health services in PHC centres, 2) semi-structured interviews with 10 policymakers and key informants, 3) convening of a national policy dialogue, 4) evaluation of the policy brief and dialogue, and 5) a post-dialogue survey.ResultsFindings from the key informant interviews and a comprehensive synthesis of evidence were used to develop a policy brief which defined the problem and presented three elements of a policy approach to address it. This policy brief was circulated to 24 participants prior to the dialogue to inform the discussion. The policy dialogue validated the evidence synthesized in the brief, whereby integrating mental health into PHC services was the element most supported by evidence as well as participants. The post-dialogue survey showed that, in the following 6 months, several implementation steps were taken by stakeholders, including establishing national taskforce, training PHC staff, and updating the national essential drug list to include psychiatric medications. Relationships among policymakers, researchers, and stakeholders were strengthened as they conducted their own workshops and meetings after the dialogue to further discuss implementation, and their awareness about and demand for KT tools increased.ConclusionsThis case study showed that the use of KT tools in Lebanon to help generate evidence-informed programs is promising. This experience provided insights into the most helpful features of the tools. The role of the KTP in engaging stakeholders, particularly policymakers, prior to the dialogue and linking them with researchers was vital in securing their support for the KT process and uptake of the research evidence.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-015-0018-7) contains supplementary material, which is available to authorized users.

Highlights

Many reform efforts in health systems fall short because the use of research evidence to inform policy remains scarce
Knowledge to Policy Center (K2P) has a set of adapted criteria for selecting priority topics, and mental health satisfied the majority of those criteria, including the topic is important, there is public interest on it, there is sufficient local evidence to quantify the problem, there is relevant research evidence and available options to address it, there is an opportunity for change, it has national and regional relevance, and it has been recognized as a policy challenge
The below results describe findings based on the synthesized evidence in the policy brief, followed by findings from the discussions that took place at the policy dialogue

Summary

Introduction

Many reform efforts in health systems fall short because the use of research evidence to inform policy remains scarce. Using an “integrated” knowledge framework to link research to action, this study examines the process of influencing the mental health agenda in Lebanon through the application of Knowledge Translation (KT) tools and the use of a KT Platform (KTP) as an intermediary between researchers and policymakers. In response to the gaps in evidence-informed health policymaking in Lebanon, a KTP, named the Knowledge to Policy Center (K2P), was established in 2013 at the American University of Beirut. It draws on a breadth of synthesized evidence and context-specific knowledge about a priority topic to impact policy agendas and action. K2P does not restrict itself to research evidence but integrates multiple types of knowledge to inform policy dialogue, including grey literature and expertise of stakeholders

Methods

Results

Discussion

Conclusion