Innovative ways to facilitate uptake of research findings for policy and practice

The importance and need for evidence in policy making and programme implementation cannot be overemphasized. However, the main challenge for health systems researchers especially in the field of public health, is how to take the knowledge or evidence generated to the policy makers and programme implementers for ultimate translation into tangible practices (the ‘know-do gap’). The barriers that the policy makers face in using research evidence include lack of experience and capacity for assessing evidence, lack of trust and negative attitude towards research community etc. (individual level); unfavourable organizational culture, competing interests, frequent staff turn over, pressure from interest groups, issues of censorship and control etc. (organizational level); relationship between the two communities including communication barriers; timeliness, relevance etc. Interestingly, how to overcome these barriers, and how effective the different interventions are that have been tried (‘what works’), remains largely unknown.

A number of initiatives have been tried in different contexts to enhance capacity of the policy makers/practitioners and researchers to overcome the existing ‘know-do’ gap. Of concern, most of these projects were implemented in a piece-meal manner and for developing individual level capacity (‘push’ from the research community) rather than developing institutional/ organizational capacity, challenging sustainability and impact. More importantly, these individual capacity developments failed to provide any evidence of success. Instead, we need to support initiatives from the users of research evidence i.e., policy makers/practitioners (‘pull’ from the users), and also, activities for building relationship between ‘research producers and users’ (linkage and exchange activities---‘interactive’)!

Besides problems-based and participatory, prolonged and supportive training, interventions must go beyond the traditional approach e.g., ‘embedded’ ways of working! Recently, some innovative approaches have been tested to advance this approach. Two examples are mentioned here:  

1) ‘Consensus-building Workshop’ with researchers and policymakers/programme managers on fundamentals of evidence-based policy-making and implementation research is effective to find a common ground and language.

2) ‘Secondment’ (defined as “where an employee temporarily transfers to another job for a defined period of time for a specific purpose, to the mutual benefit of all parties”) of the researchers and policymakers/programme managers to each other’s institutions facilitate settings for understanding the work environment and challenges. This coming together of the researchers and policy makers/frontline implementers in a ‘symbiotic’ relationship where the latter provide real life feedback from the grassroots and researchers use it for refining methods for rigorous evidence generation, ensure that the ‘knowledge generated is valid and is aligned with the health needs of the society’.

Evaluation of efforts for research uptake for evidence-based policy making is complex and rare. The usual methods for this kind of evaluation include: bibliometric methods, sample surveys of researchers and policy makers, and qualitative methods to capture perspectives. All or any combination of these methods may be used in an iterative manner to provide dynamic feedback on-the-move for fine-tuning of specific interventions undertaken (‘learning by doing’). This can be done in two steps. A micro-level, real-time evaluation which will be embedded in the particular intervention (e.g., understanding, assimilating and applying evidence/research findings by policy makers including enabling institutional environment) activity. This will be supported by macro-level evaluation of the effects of specific interventions on pre-identified outcomes (customized for the particular intervention e.g., capacity to use evidence from SysRev by the policy makers/practitioners in their respective field of work).  

Source: from an on-going proposal in development

Further reading:

1) Uneke et al. J Edu Health Promot 2018; 7 – 28.

2) Uneke et al. Int J health Policy Manag 2018; 7(6): 522- 31.