How knowledge brokers mobilise health evidence in low- and middle-income countries

10 October, 2019

With thanks to Irina Ibraghimova and LRC Network:

CITATION: ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries

Authors: Norton, Theresa C.1; Rodriguez, Daniela C.2; Howell, Catherine3; Reynolds, Charlene3; Willems, Sara4

Source: Evidence & Policy: A Journal of Research, Debate and Practice

Publisher: Policy Press

DOI: https://doi.org/10.1332/174426419X15679622689515

ABSTRACT

Background: Little is known about how knowledge brokers (KBs) operate in low- and middle-income countries (LMICs) to translate evidence for health policy and practice. These intermediaries facilitate relationships between evidence producers and users to address public health issues.

Aims and objectives: To increase understanding, a mixed-methods study collected data from KBs who had acted on evidence from the 2015 Global Maternal Newborn Health Conference in Mexico.

Methods: Of the 1000 in-person participants, 252 plus 72 online participants (n=324) from 56 countries completed an online survey, and 20 participants from 15 countries were interviewed. Thematic analysis and application of knowledge translation (KT) theory explored factors influencing KB actions leading to evidence uptake. Descriptive statistics of respondent characteristics were used for cross-case comparison. Findings: Results suggest factors supporting the KB role in evidence uptake, which include active relationships with evidence users through embedded KB roles, targeted and tailored evidence communication to fit the context, user receptiveness to evidence from a similar country setting, adaptability in the KB role, and action orientation of KBs.

Discussion and conclusions: Initiatives to increase evidence uptake in LMICs should work to establish supportive structures for embedded KT, identify processes for ongoing cross-country learning, and strengthen KBs already showing effectiveness in their roles.

key messages

- Little is known about how knowledge brokers mobilise evidence in low- and middle-income countries.

- A multi-country study of knowledge brokers identified promising practices for evidence uptake.

- Embedded brokers who adapted messaging and evidence to context in active relationships worked well.

- Capacity building should use KB promising practices and facilitate multi-country evidence exchange.

SELECTED EXTRACTS

[Note from moderator (Neil PW): One of the challenges of papers such as this is to define terms. The term 'knowledge broker' is itself challenging to define...]

'Because uptake of health research evidence takes place in complex health systems, one mechanism that has emerged in evidence advocacy is linkage agents or intermediaries between evidence producers and users who help navigate the complexities of evidence-to-action. Organisations or individuals in these linkage roles are often referred to as knowledge brokers (KBs). They facilitate the translation of knowledge into evidence-informed decision making (EIDM) in health policy and

practice (Canadian Health Services Research Foundation, 2003; Van Kammen et al, 2006; Lomas, 2007; Dobbins et al, 2009; Pennell et al, 2013; Dagenais et al, 2015;

Jessani et al, 2016; Norton et al, 2016; Kim et al, 2018). A key value of KBs is their ability to raise awareness of relevant evidence, which might not otherwise occur with passive dissemination (for example, publishing alone).

'KBs may be embedded in organisations, such as in Knowledge Translation (KT) units, or function as consultants for the duration of a project. Individuals with a primary professional role to which KB duties are added may work as policy advocates, health programme implementers, faculty members, or ministry of health staff. KB activities often include building relationships and professional networks among research users and producers to foster the flow and use of evidence (Van Kammen

et al, 2006; Dobbins et al, 2009), critically appraising evidence (Weiss and Bucuvalas, 1980; Lind and Persborn, 2000; Jessani et al, 2016; Van Eerd et al, 2016), and mobilising change based on evidence (Van Eerd et al, 2016). In fulfilling their role, KBs operating in LMICs may face more challenges than in higher-income settings, such as greater resource and infrastructure limitations and international pressures.'

Best wishes, Neil

Coordinator, HIFA Project on Evidence-Informed Policy and Practice

http://www.hifa.org/projects/evidence-informed-policy-and-practice

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org