Abstract
BackgroundUganda changed its malaria treatment policy in response to evidence of resistance to commonly used antimalarials. The use of evidence in policy development—also referred to as knowledge translation (KT)—is crucial, especially in resource-limited settings. However, KT processes occur amidst a complex web of stakeholder interactions. Stakeholder involvement in evidence generation and in KT activities is essential. In the present study, we explored how stakeholders impacted the uptake of evidence in the malaria treatment policy change in Uganda.MethodsWe employed a qualitative case study methodology involving interviews with key informants and review of documents. A timeline of events was developed, which guided the purposive sampling of respondents and identification of relevant documents. Data were analysed using inductive content analysis techniques.ResultsStakeholders played multiple roles in evidence uptake in the malaria treatment policy change. Donors, the Ministry of Health (MoH), service providers, and researchers engaged in the role of evidence generation. The MoH, parliamentarians, and opinion leaders at the national and local levels engaged in dissemination of evidence. The donors, MoH, researchers, and service providers engaged in the uptake of evidence in policy development and implementation. Stakeholders exerted varying levels of support and influence for different reasons. It is noteworthy that all of the influential stakeholders were divided regarding the best antimalarial alternative to adopt.ConclusionOur results showed a diverse group of stakeholders who played multiple roles, with varying levels of support and influence on the uptake of evidence in the malaria treatment policy change. For a given KT processes, mapping the relevant stakeholders and devising mechanism for their engagement and for how to resolve conflicts of interest and disagreements a priori will enhance uptake of evidence in policy development.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0150-8) contains supplementary material, which is available to authorized users.
Highlights
Uganda changed its malaria treatment policy in response to evidence of resistance to commonly used antimalarials
knowledge translation (KT) processes occur amidst a complex web of interactions between stakeholders, who are hereby defined as individuals who, or institutions which are affected by the policy change, directly influence it, or have an interest in the outcome even when not directly involved [13]
We investigated the extent to which the previously identified roles of stakeholders in KT in Uganda [30] differed from their roles in relation to malaria treatment policy change
Summary
Uganda changed its malaria treatment policy in response to evidence of resistance to commonly used antimalarials. The use of evidence in policy development— referred to as knowledge translation (KT)—is crucial, especially in resource-limited settings. We explored how stakeholders impacted the uptake of evidence in the malaria treatment policy change in Uganda. The use of evidence in policy development is of critical importance, especially in resource-limited settings; data sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system” [8]. KT processes occur amidst a complex web of interactions between stakeholders, who are hereby defined as individuals who, or institutions which are affected by the policy change, directly influence it, or have an interest in the outcome even when not directly involved [13]. Delays have been attributed to researchers devoting more time to generating evidence than to disseminating their results [17]
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