Use of research findings in maternal and newborn health policy: a survey

Abstract

BackgroundMany effective interventions for maternal and newborn health are translated only slowly into policies and health service delivery models in settings with high maternal and newborn morbidity and mortality. Informed Decisions for Actions in Maternal and Newborn Health (IDEAS) is a 5-year project funded by the Bill & Melinda Gates Foundation, in regions with a high burden of maternal and neonatal mortality: northeast Nigeria, Uttar Pradesh in India, and Ethiopia. The project is a multi-method assessment of complex interventions for maternal and newborn health, and is implemented by the London School of Hygiene & Tropical Medicine. One objective is to assess the extent to which innovative maternal and newborn health-care models are scaled up, and to identify factors that aid and inhibit scale-up. As part of this assessment we did a series of qualitative interviews to explore how research findings and knowledge from pilot projects are used by externally funded grantees to persuade policy makers to scale up programmes for maternal and newborn health. MethodsWe developed a qualitative survey based on frameworks for scale-up and dissemination of innovations and transfer of knowledge into action to explore the views of grantees, policy makers, development agencies, and other stakeholders. We selected participants on the basis of having a role in maternal and newborn health and being willing and able to speak about the subject knowledgeably and in depth. We did in-depth interviews face-to-face and by telephone in Nigeria and India, a method that enables participants to express opinions and raise issues that are most relevant to them. The interviews were analysed by a team of researchers with framework analysis for policy research. FindingsWe interviewed 100 participants. Willingness of policy makers to consider research findings largely depended on how they perceive the quality of the evidence. Their perception is affected by whether the research was done by an independent organisation and whether health outcomes could be attributed to particular components of complex, multilayered programmes. How evidence is disseminated affects the likelihood of its inclusion in policy. It is more likely to be included if presented by people deemed legitimate (eg, experts in the field); if the audience includes high-level decision makers and donors who have the authority to act on the data; and if it includes taking decision makers to programme sites to create emotional buy-in. InterpretationPolitics is central to decision making for health. Researchers and implementers of donor and other externally funded health programmes therefore should understand how research findings and knowledge generated in pilot projects can support decision making for scale up of maternal and newborn health. FundingBill & Melinda Gates Foundation.