Skip to main content
Top
Published in: Health Research Policy and Systems 1/2015

Open Access 01-12-2016 | Research

Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches

Authors: Etienne V. Langlois, Victor Becerril Montekio, Taryn Young, Kayla Song, Jacqueline Alcalde-Rabanal, Nhan Tran

Published in: Health Research Policy and Systems | Issue 1/2015

Login to get access

Abstract

Background

There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings.

Methods

The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals’ abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a ‘buddying’ process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design.

Results

In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge.

Conclusions

The collaborative evidence-to-policy approaches underline the importance of iterations and continuity in the engagement of researchers and policymakers/programme managers, in order to account for swift evolutions in health policy planning and implementation. In developing and supporting evidence-to-policy interventions, due consideration should be given to fit-for-purpose approaches, as different needs in policymaking cycles require adapted processes and knowledge. Greater consideration should be provided to approaches embedding the use of research in real-world policymaking, better suited to the complex adaptive nature of health systems.
Appendix
Available only for authorised users
Literature
1.
go back to reference El-Jardali F, Lavis J, Moat K, Pantoja T, Ataya N. Capturing lessons learned from evidence-to-policy initiatives through structured reflection. Health Res Policy Syst. 2014;12:2.CrossRefPubMedPubMedCentral El-Jardali F, Lavis J, Moat K, Pantoja T, Ataya N. Capturing lessons learned from evidence-to-policy initiatives through structured reflection. Health Res Policy Syst. 2014;12:2.CrossRefPubMedPubMedCentral
2.
go back to reference Cordero C, Delino R, Jeyaseelan L, Lansang MA, Lozano JM, Kumar S, et al. Funding agencies in low- and middle-income countries: support for knowledge translation. Bull World Health Organ. 2008;86(7):524–34.CrossRefPubMedPubMedCentral Cordero C, Delino R, Jeyaseelan L, Lansang MA, Lozano JM, Kumar S, et al. Funding agencies in low- and middle-income countries: support for knowledge translation. Bull World Health Organ. 2008;86(7):524–34.CrossRefPubMedPubMedCentral
3.
go back to reference Syed SB, Hyder AA, Bloom G, Sundaram S, Bhuiya A, Zhenzhong Z, Kanjilal B. Future Health Systems: Innovation for Equity. Exploring evidence-policy linkages in health research plans: a case study from six countries. Health Res Policy Syst. 2008;6:4.CrossRefPubMedPubMedCentral Syed SB, Hyder AA, Bloom G, Sundaram S, Bhuiya A, Zhenzhong Z, Kanjilal B. Future Health Systems: Innovation for Equity. Exploring evidence-policy linkages in health research plans: a case study from six countries. Health Res Policy Syst. 2008;6:4.CrossRefPubMedPubMedCentral
5.
go back to reference de Savigny D, Adam T. Systems thinking for health systems strengthening. Geneva: Alliance for Health Policy and Systems Research; 2009. p. 107. de Savigny D, Adam T. Systems thinking for health systems strengthening. Geneva: Alliance for Health Policy and Systems Research; 2009. p. 107.
6.
go back to reference Smits PA, Denis JL. How research funding agencies support science integration into policy and practice: an international overview. Implement Sci. 2014;9:28.CrossRefPubMedPubMedCentral Smits PA, Denis JL. How research funding agencies support science integration into policy and practice: an international overview. Implement Sci. 2014;9:28.CrossRefPubMedPubMedCentral
7.
go back to reference Mitton C, Adair CE, McKenzie E, Patten SB, Waye Perry B. Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q. 2007;85(4):729–68.CrossRefPubMedPubMedCentral Mitton C, Adair CE, McKenzie E, Patten SB, Waye Perry B. Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q. 2007;85(4):729–68.CrossRefPubMedPubMedCentral
8.
go back to reference Lavis JN, Boyko JA, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 14: Organising and using policy dialogues to support evidence-informed policymaking. Health Res Policy Syst. 2009;7 Suppl 1:S14.CrossRefPubMed Lavis JN, Boyko JA, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 14: Organising and using policy dialogues to support evidence-informed policymaking. Health Res Policy Syst. 2009;7 Suppl 1:S14.CrossRefPubMed
9.
go back to reference Gagliardi AR, Webster F, Perrier L, Bell M, Straus S. Exploring mentorship as a strategy to build capacity for knowledge translation research and practice: a scoping systematic review. Implement Sci. 2014;9:122.CrossRefPubMedPubMedCentral Gagliardi AR, Webster F, Perrier L, Bell M, Straus S. Exploring mentorship as a strategy to build capacity for knowledge translation research and practice: a scoping systematic review. Implement Sci. 2014;9:122.CrossRefPubMedPubMedCentral
11.
go back to reference Puljak L. Using social media for knowledge translation, promotion of evidence-based medicine and high-quality information on health. J Evid Based Med. 2015. Ahead of print. Puljak L. Using social media for knowledge translation, promotion of evidence-based medicine and high-quality information on health. J Evid Based Med. 2015. Ahead of print.
12.
go back to reference Murphy K, Fafard P. Taking power, politics, and policy problems seriously: the limits of knowledge translation for urban health research. J Urban Health. 2012;89(4):723–32.CrossRefPubMedPubMedCentral Murphy K, Fafard P. Taking power, politics, and policy problems seriously: the limits of knowledge translation for urban health research. J Urban Health. 2012;89(4):723–32.CrossRefPubMedPubMedCentral
13.
14.
go back to reference Orem JN, Mafigiri DK, Marchal B, Ssengooba F, Macq J, Criel B. Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda. BMC Public Health. 2012;12:109.CrossRefPubMedPubMedCentral Orem JN, Mafigiri DK, Marchal B, Ssengooba F, Macq J, Criel B. Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda. BMC Public Health. 2012;12:109.CrossRefPubMedPubMedCentral
15.
go back to reference Davison CM, Ndumbe-Eyoh S, Clement C. Critical examination of knowledge to action models and implications for promoting health equity. Int J Equity Health. 2015;14(1):49.CrossRefPubMedPubMedCentral Davison CM, Ndumbe-Eyoh S, Clement C. Critical examination of knowledge to action models and implications for promoting health equity. Int J Equity Health. 2015;14(1):49.CrossRefPubMedPubMedCentral
16.
18.
go back to reference Lavis J, Davies H, Oxman A, Denis JL, Golden-Biddle K, Ferlie E. Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Policy. 2005;10 Suppl 1:35–48.CrossRefPubMed Lavis J, Davies H, Oxman A, Denis JL, Golden-Biddle K, Ferlie E. Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Policy. 2005;10 Suppl 1:35–48.CrossRefPubMed
19.
go back to reference Oliver K, Innvar S, Lorenc T, Woodman J, Thomas J. A systematic review of barriers to and facilitators of the use of evidence by policymakers. BMC Health Serv Res. 2014;14:2.CrossRefPubMedPubMedCentral Oliver K, Innvar S, Lorenc T, Woodman J, Thomas J. A systematic review of barriers to and facilitators of the use of evidence by policymakers. BMC Health Serv Res. 2014;14:2.CrossRefPubMedPubMedCentral
20.
go back to reference Oliver K, Lorenc T, Innvaer S. New directions in evidence-based policy research: a critical analysis of the literature. Health Res Policy Syst. 2014;12:34.CrossRefPubMedPubMedCentral Oliver K, Lorenc T, Innvaer S. New directions in evidence-based policy research: a critical analysis of the literature. Health Res Policy Syst. 2014;12:34.CrossRefPubMedPubMedCentral
22.
go back to reference Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38(1):4–23.CrossRefPubMedPubMedCentral Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38(1):4–23.CrossRefPubMedPubMedCentral
23.
go back to reference Bigdeli M, Javadi D, Hoebert J, Laing R, Ranson K. Alliance for Health Policy and Systems Research Network of Researchers on Access to Medicines. Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries. Health Res Policy Syst. 2013;11:37.CrossRefPubMedPubMedCentral Bigdeli M, Javadi D, Hoebert J, Laing R, Ranson K. Alliance for Health Policy and Systems Research Network of Researchers on Access to Medicines. Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries. Health Res Policy Syst. 2013;11:37.CrossRefPubMedPubMedCentral
24.
go back to reference Ranson K, Law TJ, Bennett S. Establishing health systems financing research priorities in developing countries using a participatory methodology. Soc Sci Med. 2010;70(12):1933–42.CrossRefPubMed Ranson K, Law TJ, Bennett S. Establishing health systems financing research priorities in developing countries using a participatory methodology. Soc Sci Med. 2010;70(12):1933–42.CrossRefPubMed
25.
go back to reference Instituto Nacional de Salud Pública (INSP). Overview of the National Institute of Public Health in Mexico. 2015. http://www.insp.mx. Accessed 25/01/2015. Instituto Nacional de Salud Pública (INSP). Overview of the National Institute of Public Health in Mexico. 2015. http://​www.​insp.​mx. Accessed 25/01/2015.
26.
go back to reference Peters D, Tran N, Adams T. Implementation Research in Health: A Practical Guide. Geneva: Alliance for Health Policy and Systems Research, World Health Organization; 2013. Peters D, Tran N, Adams T. Implementation Research in Health: A Practical Guide. Geneva: Alliance for Health Policy and Systems Research, World Health Organization; 2013.
27.
go back to reference Kengeya-Kayondo J, Gonzalez Block MA, Bochorisvili I. Implementation Research for the Control of Diseases of Poverty: Strengthening the Evidence Base for Access to New and Improved Tools, Strategies and Interventions. Geneva: World Health Organization and Special Programme for Research and Training in Tropical Diseases; 2011. Kengeya-Kayondo J, Gonzalez Block MA, Bochorisvili I. Implementation Research for the Control of Diseases of Poverty: Strengthening the Evidence Base for Access to New and Improved Tools, Strategies and Interventions. Geneva: World Health Organization and Special Programme for Research and Training in Tropical Diseases; 2011.
28.
go back to reference Gonzalez Block MA, Gonzalez Robledo LM, Cuadra Hernandez SM. Diagnosis of capacity to perform essential public health functions in the Central American countries, the Dominican Republic, and the Mexican states of Chiapas and Quintana Roo. Rev Panam Salud Publica. 2013;33(4):271–9.CrossRefPubMed Gonzalez Block MA, Gonzalez Robledo LM, Cuadra Hernandez SM. Diagnosis of capacity to perform essential public health functions in the Central American countries, the Dominican Republic, and the Mexican states of Chiapas and Quintana Roo. Rev Panam Salud Publica. 2013;33(4):271–9.CrossRefPubMed
29.
go back to reference Minkler M, Salvatore A. Participatory approaches for the study design and analysis of dissemination and implementation research. In: Colditz G, Brownson RC, Proctor EK, editors. Dissemination and Implementation Research in Health: Translating Science to Practice. New York: Oxford University Press; 2012. Minkler M, Salvatore A. Participatory approaches for the study design and analysis of dissemination and implementation research. In: Colditz G, Brownson RC, Proctor EK, editors. Dissemination and Implementation Research in Health: Translating Science to Practice. New York: Oxford University Press; 2012.
30.
go back to reference Wenger-Trayner E, Fenton-O'Creevy M, Hutchinson S, Kubiak C, Wenger-Trayner B. Learning in Landscapes of Practice. Boundaries, identity, and knowledgeability in practice-based learning. London: Routledge; 2015. Wenger-Trayner E, Fenton-O'Creevy M, Hutchinson S, Kubiak C, Wenger-Trayner B. Learning in Landscapes of Practice. Boundaries, identity, and knowledgeability in practice-based learning. London: Routledge; 2015.
32.
go back to reference Trochim W. An introduction to concept mapping for planning and evaluation. Eval Program Plan. 1989;12:1–16.CrossRef Trochim W. An introduction to concept mapping for planning and evaluation. Eval Program Plan. 1989;12:1–16.CrossRef
33.
go back to reference Centre for Evidence-based Health Care. Overview of the Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University. 2015. www.sun.ac.za/cebhc. Accessed 20/11/2015. Centre for Evidence-based Health Care. Overview of the Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University. 2015. www.​sun.​ac.​za/​cebhc. Accessed 20/11/2015.
34.
go back to reference Innvaer S, Vist G, Trommald M, Oxman A. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy. 2002;7(4):239–44.CrossRefPubMed Innvaer S, Vist G, Trommald M, Oxman A. Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy. 2002;7(4):239–44.CrossRefPubMed
35.
go back to reference Lavis J, Ross S, McLeod C, Gildiner A. Measuring the impact of health research. J Health Serv Res Policy. 2003;8(3):165–70.CrossRefPubMed Lavis J, Ross S, McLeod C, Gildiner A. Measuring the impact of health research. J Health Serv Res Policy. 2003;8(3):165–70.CrossRefPubMed
36.
go back to reference Naude CE, Zani B, Ongolo-Zogo P, Wiysonge CS, Dudley L, Kredo T, et al. Research evidence and policy: qualitative study in selected provinces in South Africa and Cameroon. Implement Sci. 2015;10:126.CrossRefPubMedPubMedCentral Naude CE, Zani B, Ongolo-Zogo P, Wiysonge CS, Dudley L, Kredo T, et al. Research evidence and policy: qualitative study in selected provinces in South Africa and Cameroon. Implement Sci. 2015;10:126.CrossRefPubMedPubMedCentral
37.
go back to reference Lavis JN, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP). Health Res Policy Syst. 2009;7 Suppl 1:I1.CrossRefPubMed Lavis JN, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP). Health Res Policy Syst. 2009;7 Suppl 1:I1.CrossRefPubMed
38.
go back to reference Shearer J, Rupert T. Policy BUDDIES: BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills: Evaluation Report. Seattle: PATH; 2015. Shearer J, Rupert T. Policy BUDDIES: BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills: Evaluation Report. Seattle: PATH; 2015.
39.
go back to reference Ritzer G. Modern Sociological Theory. 5th ed. New York: McGraw-Hill; 2000. Ritzer G. Modern Sociological Theory. 5th ed. New York: McGraw-Hill; 2000.
40.
go back to reference Nonaka I. A dynamic theory of organizational knowledge creation. Organ Sci. 1994;5(1):14–37.CrossRef Nonaka I. A dynamic theory of organizational knowledge creation. Organ Sci. 1994;5(1):14–37.CrossRef
41.
go back to reference Kothari AR, Bickford JJ, Edwards N, Dobbins MJ, Meyer M. Uncovering tacit knowledge: a pilot study to broaden the concept of knowledge in knowledge translation. BMC Health Serv Res. 2011;11:198.CrossRefPubMedPubMedCentral Kothari AR, Bickford JJ, Edwards N, Dobbins MJ, Meyer M. Uncovering tacit knowledge: a pilot study to broaden the concept of knowledge in knowledge translation. BMC Health Serv Res. 2011;11:198.CrossRefPubMedPubMedCentral
42.
go back to reference Gonzalez-Block MA, Rouvier M, Becerril V, Sesia P. Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico. BMC Public Health. 2011;11:164.CrossRefPubMedPubMedCentral Gonzalez-Block MA, Rouvier M, Becerril V, Sesia P. Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico. BMC Public Health. 2011;11:164.CrossRefPubMedPubMedCentral
44.
go back to reference Koon AD, Nambiar D, Rao KD. Embedding of Research into Decision-Making Processes. Geneva: Alliance for Health Policy and Systems Research; 2012. Koon AD, Nambiar D, Rao KD. Embedding of Research into Decision-Making Processes. Geneva: Alliance for Health Policy and Systems Research; 2012.
45.
go back to reference OECD. The Challenge of Capacity Development: Working Towards Good Practice. Paris: OECD; 2006. OECD. The Challenge of Capacity Development: Working Towards Good Practice. Paris: OECD; 2006.
Metadata
Title
Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches
Authors
Etienne V. Langlois
Victor Becerril Montekio
Taryn Young
Kayla Song
Jacqueline Alcalde-Rabanal
Nhan Tran
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Health Research Policy and Systems / Issue 1/2015
Electronic ISSN: 1478-4505
DOI
https://doi.org/10.1186/s12961-016-0089-0

Other articles of this Issue 1/2015

Health Research Policy and Systems 1/2015 Go to the issue