Research Evidence In Health Policy Research Articles

Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review

BackgroundAn estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review.MethodsThe scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question.ResultsA total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms.ConclusionImportant barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.

The experience of a regional network of health policy and systems actors in translating evidence into policy and action in West Africa.

To identify strategies and interventions to strengthen the generation and use of research evidence in health policy and practice decision-making and implementation in the West African sub-region (knowledge translation). The study design was cross-sectional. Data sources were from a desk review, West African Network of Emerging Leaders (WANEL) member brainstorming, and group discussion outputs from WANEL members and session participants' discussions and reflections during an organised session at the 2019 African Health Economics and Policy Association meeting in Accra. Strategies and interventions identified included developing a Community of Practice, a repository of health policy and systems research (HPSR) evidence, stakeholder mapping, and engagement for action, advocacy, and partnership. Approaches for improving evidence uptake beyond traditional knowledge translation activities included the use of cultural considerations in presenting research results and mentoring younger people, the presentation of results in the form of solutions to political problems for decision-makers, and the use of research results as advocacy tools by civil society organisations. Development of skills in stakeholder mapping, advocacy, effective presentation of research results, leadership skills, networking, and network analysis for researchers was also identified as important. To strengthen the generation and use of research evidence in health policy and practice decision-making in West Africa requires capacity building and multiple interventions targeted synergistically at researchers, decision-makers, and practitioners. Funding for the study was provided by the COMPCAHSS project (#108237) supported by IDRC.

Strategies, facilitators, and barriers to interaction between health researchers and policy makers: Protocol for a systematic review.

This systematic review protocol is developed with the objective to identify the strategies, facilitators, and barriers to interaction between researchers and policy makers to use research evidence in health policy making. It seems that review of interactive methods between researchers and policy makers can help to understand the role of researchers on evidence-informed policy making. Moreover, identifying barriers and facilitators of these interactions can help universities and institutions associated to health policy making in planning to improve the interaction between researchers and policy makers to facilitate evidence-informed policy making.

Strengthening capacity to use research evidence in health sector policy-making: experience from Kenya and Malawi

BackgroundAmong the many barriers to evidence use in decision-making, weak capacity for evidence use has attracted a lot of focus in the last decade. The study aims to inform and enrich ongoing and future efforts to strengthen capacity for evidence use by presenting and discussing the experiences and lessons of a project implemented in Kenya and Malawi to strengthen individual and institutional capacity for evidence use within the ministries of health (MoHs).MethodsThis paper draws on the internal and external evaluations of a 3-year project funded by the United Kingdom’s Department for International Development, the Strengthening Capacity to Use Research Evidence in Health Policy (SECURE Health). To strengthen individual capacity, the project implemented a training and mentorship programme for 60 mid-level policy-makers in the two MoHs. To strengthen institutional capacity, the project conducted sustained advocacy with top leaders to strengthen structures that enable evidence-informed decision-making (EIDM), supported Kenya to develop research-for-health policies and priorities, supported Malawi to review the implementation of its health research agenda, developed EIDM guidelines for both MoHs, and supported bi-annual evidence dialogues to improve interactions and raise the profile of evidence. Internal evaluation included baseline and endline surveys (93 baseline and 92 endline interviews), 60 in-depth interviews, and intervention-specific evaluations (pre–post tests for training workshops, feedback forms for policy dialogues and tracking effects of advocacy efforts). The external evaluation was implemented alongside project implementation, conducting three annual evaluations.ResultsThe results show that training and mentorship programmes in EIDM were effective in improving competencies of civil servants. However, such programmes need to train a critical mass to be effective in enhancing EIDM practice at the MoHs. On strengthening institutional capacity for EIDM, while the project achieved some success, it did not realise long-lasting effects because of its limited time of implementation and limited focus on sustained political economy analysis, which meant that the intervention was negatively affected by frequently changing interests within the MoHs.ConclusionsAlthough training and mentorship are effective in improving EIDM competencies, they need to be incorporated in existing pre-service and in-service training programmes for sustainability. Strengthening institutional capacity for evidence use is complex and needs sustained political commitment and long-term investments.

Situation analysis on evidence-informed health policy-making in Poland

Abstract Background Over the last few years, increased international attention has been paid to bridging the gap between health research and policy-making. The situation analysis on evidence-informed policy-making (EIP) in Poland aims to increase understanding of interactions among a country’s research and policy-making communities, to determine where and how to best establish a knowledge translation platform (KTP), i.e. an organization or network that through its structure and functioning brings the worlds of research and policy together. Methods The methods were guided by the EVIPNet Europe Situation Analysis Manual and included a literature review, key-informant interviews and survey data analysis. Results In Poland, the existence of incentives or requirements stipulating the use of research evidence in health policy varies, depending on the type of policy. The use of evidence is a standard practice in drug policy, and in decisions related to the inclusion of services in the health benefit package. In other areas, some good practice examples of using evidence in policy can be identified. Yet these are rather individual, isolated and bottom-up initiatives, which neither occur systematically, nor routinely. Key challenges in view of strengthening a systemic approach to EIP relate to: overlapping mandates of key health system and research institutions, generally low research capacity and lack of knowledge translation skills. Conclusions Establishing and operationalizing a KTP can be an effective means of supporting sustainable EIP. Building such infrastructure, however, is a longer-term and complex process that needs to be based on the current characteristics of the country’s EIP landscape. The proposed model of a future KTP in Poland is a network with a joint secretariat within the Ministry of Health. Such form can take advantage of existing organizations’ competencies via information exchange and cooperation. Key messages Although systemic mechanisms for evidence-informed health policy are missing in Poland, its importance is recognized among major health system stakeholders. The proposed model of a future knowledge translation platform in Poland is a network with a joint secretariat within the Ministry of Health.

Levels of research evidence in health policy assessment in Malawi.

The purpose of this study is to examine levels of health research evidence in health policies in Malawi. The study selected a typology of health policies in Malawi from 2002 to 2017. The study adopted the SPIRIT conceptual framework and assessed the levels of research evidence in health policy, systems and services research using the revised SAGE policy assessment tool. Documentary analysis was used to assess levels of health research evidence in health policies in Malawi. In 29 (96.7 per cent) of the health policies, policy formulators including healthcare directors and managers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 28 (93.3 per cent) of the health policies, they searched for grey literature and other government documents. In only 6 (20 per cent) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted. Overall, in 23 (76.7 per cent) of the health policy documents, health research evidence played a minimal role and had very little influence on the policy documents or decision-making. The empirical evidence in the health policy documents are limited because of insufficient research citation, low retrievability of health research evidence in the policy documents and biased selectivity of what constitutes health research evidence. The study indicates that unfiltered information (data from policy evaluations and registries) constitutes majority of the research evidence in health policies both in health policy, systems and services research. The study seeks to advocate for the use of filtered information (peer reviewed, clinical trials and data from systematic reviews) in formulating health policies. There is dearth of literature on the levels of health research evidence in health policy-making both in health policy, systems and services research. This study seeks to bridge the gap with empirical evidence from a developing country perspective.

How is the use of research evidence in health policy perceived? A comparison between the reporting of researchers and policy-makers

BackgroundThe use of health policy and systems research (HPSR) to inform health policy-making is an international challenge. Incorporating HPSR into decision-making primarily involves two groups, namely researchers (knowledge producers) and policy-makers (knowledge users). The purpose of this study was to compare the perceptions of Israeli health systems and policy researchers and health services policy-makers regarding the role of HPSR, factors influencing its uses and potential facilitators and barriers to HPSR, and implementation of knowledge transfer and exchange (KTE) activities.MethodsA cross-sectional survey was administered to researchers and policy-makers in Israel. The survey consisted of seven closed questions. Descriptive analyses were carried out for closed-ended questions and comparative analysis were conducted between groups using the χ2 test.ResultsA total of 37 researchers and 32 policy-makers responded to the survey. While some views were in alignment, others showed differences. More policy-makers than researchers perceived that the use of HPSR in policy was hindered by practical implementation constraints, whereas more researchers felt that its use was hindered by a lack of coordination between knowledge producers and users. A larger percentage of policy-makers, as compared to researchers, reported that facilitators to the KTE process are in place and a larger percentage of researchers perceived barriers within the KTE environment. A larger percentage of policy-makers perceived KTE activities were in place as compared to researchers. Results also showed large differences in the perceptions of the two groups regarding policy formulation and which organisations they perceived as exerting strong influence on policy-making.ConclusionsThis research demonstrated that there are differences in the perceptions of knowledge producers and users about the process of KTE. Future work should focus on minimising the challenges highlighted here and implementing new KTE activities. These activities could include making the researchers aware of the most effective manner in which to package their results, providing training to policy-makers and assuring that policy-makers have technical access to appropriate databases to search for HPSR. These results underscore the need for the groups to communicate and clarify to each other what they can offer and what they require.

Health systems and policy research evidence in health policy making in Israel: what are researchers' practices in transferring knowledge to policy makers?

BackgroundEnsuring the use of research evidence in health system management and policy decisions is an important challenge in this century. Knowledge transfer and exchange (KTE) has emerged as a paradigm to address the challenges and start closing the ‘know-do’ gap. This area of work is gaining momentum in most developed countries, yet, to date, no work has been performed in Israel within this area. The purpose of this study was to identify which KTE activities health systems and policy researchers in Israel have undertaken.MethodsA cross-sectional web-based survey of researchers who have conducted health systems and policy research in Israel was developed. The survey consisted of a demographics section, quantitative scales, and open-ended questions. The survey was sent to all health systems and policy researchers in Israel (n = 125).ResultsThe study response rate (28%) was relatively low as compared to other studies in the same field (range of 42% to 88%). Our survey found that more than a third of the health systems and policy researchers in Israel reported that they were frequently or always involved in the following KTE activities: interactions with target audience through the research process (i.e., during developing a research question or executing the research; 35% to 42%) or through formal or informal meetings during conferences, workshops, or conversations (40%). Less than half of the health systems and policy researchers in Israel are engaged in bridging activities aimed to facilitate target audiences to use research.ConclusionsThis is a fairly new area in Israel and therefore the level of engagement of researchers in KTE activities is not very high. The low response rates could be because KTE is a new field in Israel and minimal KTE initiatives have been undertaken. It is preferable to have higher response rates, yet, after several initiatives, this was the outcome. While the findings are relevant, they may not reflect the total population of health system and policy researchers in Israel. Health system and policy researchers in Israel need to be introduced to the benefits and potential advantages of KTE in an organized and systematic way.

Supporting Evidence-Informed Health Policy Making: The Development and Contents of an Online Repository of Policy-Relevant Documents Addressing Healthcare Renewal in Canada

(1) To develop an online repository of policy-relevant documents, other than and complementary to those from the peer-reviewed scientific literature, addressing healthcare renewal in Canada; and (2) to describe the distribution of document contents. An iterative scoping review approach was undertaken. Documents were identified through website hand-searches and referrals from 19 Canadian health organizations. Descriptive frequencies were calculated, such as for document type. In July 2014, 1," documents were in the Evidence-Informed Healthcare Renewal Portal. The top three types of documents were situation analyses (n = 390, 38%), health and health system data (n = 191, 18%) and jurisdictional reviews (n = 115, 11%). The top three national priority areas addressed were health human resources (n = 778, 75%), quality as a performance indicator (n = 502, 49%) and information technology (n = 385, 37%). The process of developing a systematic method for identifying these documents has yielded a new resource to support evidence-informed health policy making and has identified a large volume of policy-relevant documents addressing healthcare renewal priority areas in Canada.