Health Policy Process Research Articles

Corporate political activity of baby food companies in Thailand

BackgroundRecent studies show corporate political activity (CPA) can have detrimental impacts on health policy processes. The Control of Marketing Promotion of Infant and Young Child Food Act B.E. 2560 (the Act) was implemented in Thailand in 2017, but there have been no studies documenting CPA during its policy processes. Furthermore, the effects of CPA on the Act and how non-industry stakeholders dealt with the CPA have not been explored. This study aimed to analyze the CPA of baby food companies in Thailand, its effects on the Act, and how policymakers have responded to CPA around the Act.MethodsThis qualitative study applied an established framework developed by Mialon and colleagues to collect and systematically analyze publicly available information from seven baby food companies with the highest percentage market share in Thailand. In-depth interviews were also used to explore how people involved in the policy process of the Act experienced the CPA of baby food companies, the consequent effects on the Act, and how they responded to the CPA.ResultsDuring development of the Act, baby food companies used two main strategies, ‘information and messaging’ and ‘constituency building’. We found the companies met policymakers, and they employed evidence or provided information that was favorable to companies. Also, they established relationships with policymakers, health organizations, communities and media. The effects of CPA were that the scope of products controlled by the Act was reduced, and CPA led relevant people to misunderstand and have concerns about the Act. Officials and others countered the influence of CPA by raising awareness and building understanding among involved people, as well as avoiding contact with companies informally.ConclusionsCPA consists of a variety of practices that resulted in a weakened Act in Thailand. Government officials and other non-industry stakeholders employed strategies to counteract this influence. This study suggests the Department of Health, and other relevant government agencies, would benefit from establishing safeguards and protections against CPA. Efforts to raise awareness about the harms of CPA within and outside of government and establish a systematic monitoring system, including avoid conflict of interest in policy process would improve policymaking and implementation of the Act.

Policymakers’ Research Capacities, Engagement, and Use of Research in Public Health Policymaking

The use of research in public health policymaking is one of the prerequisites for successfully implemented health policies which have better population health as an outcome. This policy process is influenced by the actors involved under the policy umbrella, with inter-related contextual factors and specific structural and institutional circumstances. Our study investigates how policymakers’ research capacities influence the use of research in the health policy process and identify areas where capacity-building interventions give the most meaning and impact. Furthermore, we investigate policymakers’ research engagement and use this to inform public health policy in the public sector in Denmark. We collect and report data using Seeking, Engaging with, and Evaluation Research (SEER) methodology. Policymakers are reported to have research capacity, but it is questionable how those competences have actually been used in policymaking. Decision-makers were often not aware or did not know about the existing organizational tools and systems for research engagement and use and two third of respondents had not been part of any research activities or had any collaboration with researchers. Overall, research use in public health policymaking and evaluation was limited. As a conclusion, we propose that capacity-building interventions for increasing research use and collaboration in EIPM should be context-oriented, measurable, and sustainable in developing individual and organizational competences.

Stakeholder engagement in the health policy process in a low income country: a qualitative study of stakeholder perceptions of the challenges to effective inclusion in Malawi

BackgroundInclusive engagement in healthcare policies and decision-making is essential to address the needs of patients and communities, reduce health inequities and increase the accountability of the government. In low income countries such as Malawi, with significant health challenges, stakeholder inclusion is particularly important to improve performance and service delivery. The 2017 National Health Plan II (NHP II) and accompanying Health Sector Strategic Plan II (HSSP II) aimed to improve the functioning of the healthcare system. The Ministry of Health for Malawi intended to involve all key health sector stakeholders in their development. This study explores the extent of stakeholder engagement in the health policy process through local level stakeholders’ perceptions of their involvement in the NHP II and HSSP II.MethodsA qualitative study design was used. Interviews were conducted with 19 representatives of organisations operating at the local level, such as CSOs and local government. Open questions were asked about experiences and perceptions of the development of the NHP II and HSSP II. Inductive content analysis was performed.ResultsStakeholders perceived barriers to inclusive and meaningful engagement in the health policy process. Five categories were identified: tokenistic involvement; stakeholder hierarchy; mutual distrust; preferred stakeholders; no culture of engagement.ConclusionsSerious challenges to the meaningful and equitable engagement of local level stakeholder groups in the health policy process were identified. Issues of trust, accountability and hierarchy in donor-citizen-government relations must be addressed to support stakeholder engagement. Engagement must go beyond tokenism to embed a range of stakeholders in the process with feedback mechanisms to ensure impact from their contributions. Local level stakeholders can be empowered to advocate for and participate in consultation exercises alongside greater top-down efforts to engage stakeholders via diverse and inclusive methods. These issues are not unique to Malawi or to health policy-making.

Telephones in public health policy processes in sub-Saharan Africa: a scoping review

Background The telephone is being put to work in the quest for universal health coverage in sub-Saharan Africa. Multiple mobile health pilot projects are being deployed. The use of mobile technologies including citizens in the formulation, analysis, and revision of public health policies in sub-Saharan Africa is recent. This citizen m-participation could influence the democratic engagement of citizens and leaders in the planning, budgeting, and transparency of local governance processes of health systems. Methods We conducted a scoping review. A total of 995 papers were initially identified, 37 documents were finally included in the final synthesis after a review of the abstract and full text by two researchers. Results Despite multiple challenges, the social, technological, and instrumental feasibility of citizen m-participation in health decision-making processes is real. The documents highlight the contribution of m-Citizen Participation to the ongoing construction of a robust health democracy. However, government commitment and leadership for this innovation remain weak. This slows down the processes of inclusion and empowerment of patients on their health needs. Conclusions Evidence suggests that citizen m-participation is relevant to the inclusion of citizens in health decision-making processes. However, research is limited. We recommend participatory action research mechanisms focused on citizen inclusion in health decision-making processes in sub-Saharan Africa to expand the knowledge base on this innovation.

The Structure and Process of Health Policy Making in Japan

The Structure and Process of Health Policy Making in Japan

When Scientific Knowledge and Ignorance Make It Difficult to Improve Occupational Health: A French and European Perspective.

This article analyzes the consequences of the increasing reference to scientific expertise in the decision and implementation process of occupational health policy. Based on examples (exposure limits and attributable fractions) taken from an interdisciplinary seminar conducted in 2014 to 2015 in France, it shows how the measurement or regulation of a problem through biomedicine-based tools produces blind spots. It also uses a case study to show the contradictions between scientific and academic aims and public health intervention. Other indirect implications are also examined, such as the limitation of trade unions' scope for action. Finally, the article suggests launching a broad political debate accessible to nonspecialists about collective occupational health issues-a dialogue made difficult by the rise of the afore-mentioned techno-scientific perspective.

Population Health Content Within Speech-Language Pathology Programs: An Exploratory Study

Purpose The purpose of this survey was to determine current and desired coverage of population health concepts within speech-language pathology programs. Method Thirty-five of 253 (13.8%) Council on Academic Accreditation in Audiology and Speech-Language Pathology program directors responded to an online survey. Results Respondents agreed that 21 of 23 population health domains should be included in the curriculum, with six of the domains having at least moderate coverage within current programs. The largest gaps between current and desired coverage were in global health issues, health policy process, organization of clinical and public health systems, and health promotion interventions. Conclusion Speech-language pathology faculty can use the results to inform their decisions about incorporating population health concepts into their programs. Supplemental Material https://doi.org/10.23641/asha.14044058

A Draconian Law: Examining the Navigation of Coalition Politics and Policy Reform by Health Provider Associations in Karnataka, India.

A comprehensive picture of provider coalitions in health policy making remains incomplete because of the lack of empirically driven insights from low- and middle-income countries. The authors examined the politics of provider coalitions in the health sector in Karnataka, India, by investigating policy processes between 2016 and 2018 for developing amendments to the Karnataka Private Medical Establishments Act. Through this case, they explore how provider associations function, coalesce, and compete and the implications of their actions on policy outcomes. They conducted in-depth interviews, document analysis, and nonparticipant observations of two conferences organized by associations. They found that provider associations played a major role in drafting the amendments and negotiating competing interests within and between doctors and hospital associations. Despite the fragmentation, the associations came together to reinterpret the intentions of the amendments as being against the interests of the profession, culminating in a statewide protest and strike. Despite this show of strength, provider associations only secured modest modifications. This case demonstrates the complex and unpredictable influence of provider associations in health policy processes in India. The authors' analysis highlights the importance of further empirical study on the influence of professional and trade associations across a range of health policy cases in low- and middle-income countries.

Participation of nurse managers in the health policy process: a qualitative study of barriers and facilitators.

To explore the barriers and facilitators concerning nurse managers' participation in the health policy-making process. Despite encouragement for participation in policy-making, nurse managers are seldom involved in this process. A qualitative descriptive research design based on purposive sampling was conducted. Semi-structured one-to-one interviews were conducted with nurse managers and key informants (n=16). Interviews were digitally recorded, transcribed verbatim, and analyzed by thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist was applied to study reporting. Three levels of barriers were found to nurse managers' participation in health policy-making. The individual level included weakness in characteristics of nurse managers, and the organizational level constituted the inefficient structure. In addition, the environment-related level encompassed external barriers to the organization. Finally, three facilitators with the potential were identified for improving nurse managers' participation in the policy-making process, including improvements in collaboration and communication, governmental and non-governmental organizational activities, and reforms in the health policy-making process. Nurse managers need to use the window of opportunity to participate in health policy-making. More importantly, they should be informed about health policy in order to meet the demands of the rapidly changing healthcare environment. Drawing upon their professional organizations and positions, nurse leaders require to network and make a space to stimulate their participation in the policy. Nurse managers need to develop political skills and utilize strategies to help their participation in health policy-making, leading to better implementation of policies, efficiency, and effectiveness in the health system.

Making information and communications technologies (ICTs) work for health: protocol for a mixed-methods study exploring processes for institutionalising geo-referenced health information systems to strengthen maternal neonatal and child health (MNCH) service planning, referral and oversight in urban Bangladesh

IntroductionDisparities in health outcomes and access to maternal neonatal and child health (MNCH) are apparent among urban poor compared with national, rural or urban averages. A fundamental first step in...

Priorities for sexual and reproductive health in Morocco as part of universal health coverage: maternal health as a national priority

Maternal health (MH) is a national priority of Morocco. Factors influencing the agenda set by the reproductive and maternal health policy process at the national level were evaluated using the Shiffman and Smith framework. This framework included the influence of the actors, the power of the ideas used, the nature of the political context, and the characteristics of the issue itself. Factors were evaluated by a review of documents and interviews with policy-makers, partners and individuals in the private sector, civil society and non-governmental organisations (NGOs) involved in MH, and decision-makers responsible for implementing health-financing strategies in Morocco. Evaluations showed that maternal mortality in Morocco was considered human rights and social development as well as a public health problem. The actors responsible for MH, including members of the government, researchers, national technical experts, members of the private sector, United Nations partners and NGOs, agreed on progress made in MH and universal health care (UHC). Stakeholders also agreed on the prioritisation process for MH and its inclusion in the health benefits package. Prioritisation of MH was found to depend on national health priorities set by the government and its close partners, as well as on the availability of human and financial resources. Interventions at the operational level were based on evidence, best practices, allocation of adequate financial and human resources, and rigorous monitoring and accountability. However, MH and health financing are experiencing difficulties in many areas, related to social and economic and health disparities, and gender inequality, and quality of care.

How actors, processes, context and evidence influenced the development of Malawi's Health Sector Strategic Plan II.

Health sector strategic plans are health policies outlining health service delivery in low- and middle- income countries, guiding health sectors to meet health needs while maximizing resources. However, little research has explored the formulation of these plans. This study utilized qualitative methods to explore the formulation of Malawi's Health Sector Strategic Plan II, including processes utilized, actors involved, important contextual factors and the use of evidence-based decision-making. Thirteen semi-structured key informant interviews with health policy actors were conducted to explore perceptions and experiences of formulating the policy. Data analysis used an inductive-deductive approach and interpretation of the data was guided by an adapted version of the Walt and Gilson Health Policy Triangle. Our results indicate that HSSP II formulation was complex and inclusive but that the Ministry of Health may have given up ownership of the formulation process to development partners to ensure their continued involvement. Disagreements between actors centered around inclusion of critical services in the Essential Health Package and selection of performance-based financing as purchasing strategy. Resource constraints and the Cashgate Scandal are critical contextual elements influencing the formulation and content of the policy. Evidence-based decision-making contributed to the plan's development despite respondents' divergent opinions regarding evidence availability, quality and the weight that evidence carried. The study raises questions regarding the roles of policy actors during health policy formulation, the inclusivity of health policy processes and their potential influence on government ownership of health policy, as well as the use of evidence in developing health sector strategic plans.

6.B. Workshop: Partnerships with the private sector to tackle NCDs - do healthy profits trump healthy people?

Abstract The determinants of health and well-being are partly driven by the interests - narrowly financial? - of big corporate players. Tackling the root causes of threats to health and well-being is often at odds with the business interests of economic operators and lobbies, and even in the era of Sustainable Development Goals, it is not yet clear for most citizens how companies hold themselves to account on non-financial impacts. Their explicit role, level of funding and tactics are therefore not yet always open to the high level of transparency that may be required to involve these “giants” trustfully in the health policy process. At the same time, as health policy seeks to shape market conditions, we actively want economic operators to be stakeholders ever more directly affected by public policy. Data from the Global Burden of Disease Study shows an overwhelming strain in the EU as a result of non-communicable diseases (NCDs), with estimates that they cause over 91% of deaths and almost 87% of Disability-Adjusted Life-Years. Risk factors for NCDs are associated with the production, marketing and consumption of commercially produced food and beverages, particularly those containing sugar, salt, trans unsaturated fatty acids, alcohol and tobacco. But the food and drink industry is also the EU's biggest manufacturing sector, and in half of Member States represents the biggest employer in manufacturing. The power of markets and business in health - the 'commercial determinants' of health - are undeniable in this context, and the political difficulty of regulating such behemoth market players is all too clear. Policy decision-makers face a complex challenge in trying to effectively address the root causes of NCDs, while navigating strong transnational interests, lobbies and marketing impacts of industry stakeholders. The objective of this workshop is to discuss issues around the right framing for any partnership working with industry to tackle NCDs. Under what conditions might all stakeholders usefully sit at the table across divides in interests and values, and are there lines to be drawn as to who we are willing to partner with, when, how and on which policy issues? What are the risks, and how might It be it possible to balance these? Do we need new ways of partnership working? Can we find co-benefits and learn from innovative models? Or are the profit-driven motives of the commercial sector sometimes simply incompatible with health interests? Format-wise, two speakers will first present different perspectives on engaging with the private sector on NCDs - one supportive and the other more cautionary. The second segment of the workshop will comprise a panel discussion, incorporating the contributions of online attendees concerning their experiences of working on this topic and questions for panelists submitted through the webinar too's Q&A chat function. Key messages Corporate strategies and products strongly influence consumption patterns and impact health worldwide. Health actors must be risk-aware of partnership work with the private sector, while harnessing opportunities to engage with socially innovative business models to maximise positive health impacts.

5.K. Workshop: Innovative methods for population health research: lessons from the European Joint Action InfAct

Abstract Health information is essential to inform decision-makers, researchers and the public. The availability of health and non-health information generated from different sources is increasing. The possibility to link administrative data sources with other databases offers unique opportunity to answer research questions which, for example, require a large sample size or detailed data on hard-to-reach population. However, the linking of information from multiple data sources for population health surveillance and research can be complex and may require advanced expertise and skills in analyzing big data. Therefore, more efficient ways of linking and analyzing health information using big data across European countries are required. Nevertheless, the use of data linkage and the new technology such as artificial intelligence for data analysis across national public health institutes and health information and statistics offices across European countries varies. The Joint Action on Health Information (InfAct) aims to establish a solid infrastructure on EU health information through improving the availability of comparable, robust and policy-relevant health status data and health system performance information. In the area of innovation in health information, InfAct focuses on developing guidance and recommendations based on case studies in data linkage and analysis for population health research. The main objectives of this workshop are to share the experiences gained in using new methodological approaches for population health research, to highlight the underlying limitations and lessons learnt, and their implications for the facilitation of health policy processes. The workshop will begin with the latest developments in new methods for data analysis using artificial intelligence, followed by the presentation of potential uses of the hospital admissions/mortality ratio to assess the variability of non-communicable diseases within a country. Then, a java interactive tool to analyze industrial pollution for public health surveillance will be introduced, followed by an update on the development of a federated architecture for population health research that provides solutions to interoperability challenges. Finally, a new business model for health information in the age of digitalization will be presented. Interactive exchange with the delegates will facilitate knowledge and opinion exchange regarding new approaches in population health research, and support learning from the experiences of the Joint Action. A commentary will summarize the main discussion points, and be submitted to the European Journal of Public Health. Key messages The main outputs of the Joint Action InfAct will contribute to the development of new methods for population health research. The results will support knowledge exchange among EU Member States, and facilitate the adoption of good practices considering country context.

Strengthening health policy development and management systems in low- and middle- income countries: South Africa's approach

The development and management of health policies, strategies and guidelines (collectively, policies) in many low- and middle-income countries (LMICs) are often ad hoc and fragmented due to resource constraints a variety of other reasons within ministries of health. The ad hoc nature of these policy processes can undermine the quality of health policy analysis, decision-making and ultimately public health program implementation. To identify potential areas for policy system strengthening, we reviewed the literature to identify potential best practices for ministries and departments of health in LMICs regarding the development and management of health policies. This review led us to identify 34 potential best practices for health policy systems categorized across all five stages of the health policy process. While our review focused on best practices for ministries of health in LMICs, many of these proposed best practices may be applicable to policy processes in high income countries. After presenting these 34 potential best practices, we discuss the potential of operationalizing these potential best practices at ministries of health through the adoption of policy development and management manuals and policy information management systems using the South Africa National Department of Health's experience as an example.

Failed intentions? Meeting the water needs of people living with HIV in South Africa

Researchers, activists, practitioners and policy-makers have grappled with the challenge of providing people living with HIV (PLHIV) with an adequate amount of safe water. Comprising 13% of the overall population of South Africa in 2018, 7.52 million PLHIV need water for drinking and taking medication; preparing food; and personal hygiene and cleaning to minimise infections. This article examines the responses of the different stakeholders to this challenge and their impact on the water and health policy process. It finds that activists were able to emphasise the dimensions of the challenge; practitioners worked to implement provision more effectively within existing policy frameworks; and a range of stakeholders made a thoughtful and promising policy proposal for direct action, which the Department of Water and Sanitation ultimately failed to embrace. This article is based on an extensive review of academic research and publications by development agencies on HIV and water as well as engagement with policies and documents in the South African water sector related to water services delivery for PLHIV. While the widespread provision of antiretrovirals from 2004 has changed the context, the above findings are significant in understanding and reviewing the impact of various stakeholders on the water and health policy process. They raise questions regarding the effectiveness of NGO advocacy, the means of delivering improved services to specific populations, and the ability of a range of stakeholders to inform the policy approaches of government departments.

Failed intentions? Meeting the water needs of people living with HIV in South Africa

Researchers, activists, practitioners and policy-makers have grappled with the challenge of providing people living with HIV (PLHIV) with an adequate amount of safe water. Comprising 13% of the overall population of South Africa in 2018, 7.52 million PLHIV need water for drinking and taking medication; preparing food; and personal hygiene and cleaning to minimise infections. This article examines the responses of the different stakeholders to this challenge and their impact on the water and health policy process. It finds that activists were able to emphasise the dimensions of the challenge; practitioners worked to implement provision more effectively within existing policy frameworks; and a range of stakeholders made a thoughtful and promising policy proposal for direct action, which the Department of Water and Sanitation ultimately failed to embrace. This article is based on an extensive review of academic research and publications by development agencies on HIV and water as well as engagement with policies and documents in the South African water sector related to water services delivery for PLHIV. While the widespread provision of antiretrovirals from 2004 has changed the context, the above findings are significant in understanding and reviewing the impact of various stakeholders on the water and health policy process. They raise questions regarding the effectiveness of NGO advocacy, the means of delivering improved services to specific populations, and the ability of a range of stakeholders to inform the policy approaches of government departments.

The regulation of complementary and alternative medicine professions in Ontario, Canada

BackgroundThis paper explains the regulation of complementary and alternative medicine (CAM) health professions, through the comparison of four distinct examples in Ontario, Canada including: chiropractors, naturopaths, homeopaths, and traditional Chinese medicine (TCM) practitioners. MethodsThis study analyzes the agenda setting and formulation stage of the policy process. In other words, it explores what happened between stakeholders before each of these CAM professions achieved regulation. Alford’s model of dominant, challenging and repressed structured interests (DSIs, CSIs, and RSIs respectively) is used to describe the competition between various players within the healthcare system and their position in the health policy process. ResultsAll four CAM professions have existed as a RSI at some point in their history, however, over the last century has sought to align themselves with various (or even become) challenging structural interests (CSIs) in order to be recognized as a regulated health profession. Dominant structural interests (DSIs), particularly the medical profession, initially largely ignored these professions’ practices, unless sufficient public support of CAM practitioners’ therapies warranted them to consider the need to regulate them. ConclusionUnregulated CAM professions may increase their likelihood of becoming regulated if they: (1) gain popularity/strong support from patients or the general public, (2) organize themselves sufficiently that they pose a direct threat to one or more scopes of practice desirable by the DSIs and/or (3) are willing to adopt standards in education, training, and ethics that may [initially] reduce their scope of practice or profession’s membership or slow their profession’s growth.

Workshop: Leveraging evidence for policy making: lessons from the European Joint Action on Health Information

Abstract Leveraging evidence to inform best practices in health policy and health care is pivotal for better health outcomes. This has been widely recognized by international organizations such as the World Health Organization, and national health authorities. Health information (data on health and health systems) can be used to inform interventions at national, regional and local level. However, getting evidence into the hands of key stakeholders is still a challenge in many European countries. There are many obstacles, for instance interoperability between data systems is an issue, and the resources allocated for health reporting and monitoring are sometimes insufficient. There is an uneven evolution of data collection practices across Europe which may imply differences in the capacity to use evidence for policy development. While public health agencies aim to improve health for all, building bridges for better knowledge translation requires tools to pave the way forward. As the nature and volume of data that are generated increases, countries increasingly need frameworks with which to appraise, and apply evidence. This relies on the innovative use of health information in public health and the health policy process, and increased solidarity in data sharing among actors in the health system. This workshop aims to provide delegates with a clear understanding of the strategies that can support the use of evidence in the European context. Five case examples from the European Joint Action on Health information (InfAct) will be presented. The panelists will provide solutions that support the transfer of knowledge from scientific research, and public health surveillance into policies and innovative programmes. The objectives are two-fold: 1) to provide delegates with an overview of the accessibility of health information for public health policy in EU-Member States; 2) to present solutions that focus on better data sharing, and new roles for stakeholders working in health and policy. The workshop will begin with an introduction to the latest developments in health data collection, quality assessment, and on the availability of health information in Europe. Next, strategies to prioritize health information for policy development will be presented. Across countries, there is increasing interest on how to use “real world data” which requires an understanding of the interoperability frameworks available in Europe - this will be the focus of the third and fourth presentations. Finally, a new tool for evaluating the impact of health information developed with input from European experts in 38 countries will be introduced. The session will have an outcomes-oriented approach. We will build on the opportunity for interactive exchange with the delegates. Dialogue on what can be done, and what is needed to leverage data for action will be transcribed. This will inform a commentary that can later be submitted to the European Journal of Public Health. Key messages There are wide differences across Europe in the development of information systems and data reuse. It is crucial to facilitate the use of evidence for policy development and decision-making. The EU-Joint Action InfAct is promoting evidence-informed policy-making by structuring health information exchanges in Europe, and providing tools for a sustainable impact in policy and practice.

Danish policymakers and research evidence in public health policy process

Abstract Background Evidence-informed policymaking in public health, understood as interaction of the best available research evidence and “other types of evidence”, is known to have sound influence on population well-being. However, lack of using and producing research evidence by public health policymakers has been well documented. The aim of this study was to assess policymakers’ research involvement in the research process as well as motivators and barriers for the use and production of research evidence. Methods A cross-sectional online survey was carried out in the period of Dec 2018 - Jan 2019 using a pre-tested, self-administrated questionnaire. Participants were Danish policymakers’ members of the Danish Society of Public Health (DSPH) and with practical experience being involved in a health policy-making process. The questionnaire was distributed through the DSPH members email list. Reported outcome variables; for this abstract are parts of the larger study: health policymakers’ research involvement in the last 12Mo; policymakers’ motivators and barriers to use and produce research in policy-making. Results Response rate: 100/480 (15%). 78% were involved in critical evaluation of research for policy-making; 77% were able to identify relevant research literature; 41% did not use research evidence; 40% did not conduct any surveys; 57% did not write research reports; 65% never used reference systems; 46% did not analyze any research data. The three motivators reported to use and produce research in the last 12Mo were: identification of the problem that needs to be addressed; development of research skills; and job satisfaction. The three main barriers were: other job-related priorities; lack of time for research; lack of research funding. Conclusions This study reinforced that public health policymakers need more practical knowledge and skills as well as organizational support and management to use and produce research evidence for evidence-informed policy-making. Key messages Successful evidence-informed policymaking requires capacity-building interventions targeting policymakers, supported, implemented and evaluated by their organizations. Policymakers do not dismiss evidence-informed policy practice, but their “positions” and conditions at a work place sometimes do not allow them to fully follow it.