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Incorporating research evidence into decision-making processes: researcher and decision-maker perceptions from five low- and middle-income countries

CITATION: Shroff Z, Aulakh B, Gilson L, Agyepong IA, El-Jardali F, Ghaffar A. Incorporating research evidence into decision-making processes: researcher and decision-maker perceptions from five low- and middle-income countries. Health Res Policy Syst. 2015 Nov 30;13:70. doi: 10.1186/s12961-015-0059-y.
Abstract / Summary: 
BACKGROUND: The 'Sponsoring National Processes for Evidence-Informed Policy Making in the Health Sector of Developing Countries' program was launched by the Alliance for Health Policy and Systems Research, WHO, in July 2008. The program aimed to catalyse the use of evidence generated through health policy and systems research in policymaking processes through (1) promoting researchers and policy advocates to present their evidence in a manner that is easy for policymakers to understand and use, (2) creating mechanisms to spur the demand for and application of research evidence in policymaking, and (3) increased interaction between researchers, policy advocates, and policymakers. Grants ran for three years and five projects were supported in Argentina, Bangladesh, Cameroon, Nigeria and Zambia. This paper seeks to understand why projects in some settings were perceived by the key stakeholders involved to have made progress towards their goals, whereas others were perceived to have not done so well. Additionally, by comparing experiences across five countries, we seek to illustrate general learnings to inform future evidence-to-policy efforts in low- and middle-income countries. METHODS: We adopted the theory of knowledge translation developed by Jacobson et al. (J Health Serv Res Policy 8(2):94-9, 2003) as a framing device to reflect on project experiences across the five cases. Using data from the projects' external evaluation reports, which included information from semi-structured interviews and quantitative evaluation surveys of those involved in projects, and supplemented by information from the projects' individual technical reports, we applied the theoretical framework with a partially grounded approach to analyse each of the cases and make comparisons.   RESULTS AND CONCLUSION: There was wide variation across projects in the type of activities carried out as well as their intensity. Based on our findings, we can conclude that projects perceived as having made progress towards their goals were characterized by the coming together of a number of domains identified by the theory. The domains of Jacobson's theoretical framework, initially developed for high-income settings, are of relevance to the low- and middle-income country context, but may need modification to be fully applicable to these settings. Specifically, the relative fragility of institutions and the concomitantly more significant role of individual leaders point to the need to look at leadership as an additional domain influencing the evidence-to-policy process.
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'There are a number of models that seek to explain the incorporation of research evidence into decision-making. These include (1) ‘push’ models, which emphasize the role of producers of research to provide information to decision-makers, (2) ‘pull models’, which give primacy to efforts by research users such as decision-makers to ‘extract information’ from the world of research, (3) ‘exchange models’, which prioritize the creation of linkages or partnerships between producers and users of research, and (4) integrated approaches combining elements of the three aforementioned approaches that make use of knowledge translation platforms that bring together research consumers and producers and encourage both push and pull efforts towards clearly defined goals, often established through priority setting mechanisms'

'Reflecting on our experiences from these AHPSR-supported projects in five countries across three continents, we can conclude that the successful incorporation of evidence into policymaking is indeed greatly aided by the coming together of a number of domains [19]. The combination of (1) an interested and informed group of policymakers, (2) a research issue that generates sufficient interest in both the research and policymaking communities and that policymakers are seeking immediate solutions for, (3) the availability of methodologically sound research that is easy to understand, (4) good working relationships between researchers and policymakers, and (5) with a clear understanding of expected outcomes and adequate and widespread dissemination of research findings, makes incorporation of research evidence into policymaking more probable.'

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Shroff Z, Aulakh B, Gilson L, Agyepong IA, El-Jardali F, Ghaffar A. 

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