As the Lancet authors wrote, "Our central challenge is therefore not a knowledge gap but a translation deficit. Given the urgencies we face, producing research is not enough. It must be translated into public policy and scaled up." And Neil replied, "I fully agree the central challenge is a translation deficit, but it is important to recognise the key manifestation of this deficit is indeed a knowledge gap. We are talking here not about the gap of what is known to science, but the gap between what is known and the knowledge of individual policymakers, health professionals and the public."
Neil is right, there is a knowledge gap - and the Lancet is right, one of the causes of this gap is the failure to translate research into policy. But this is certainly not the only one.
What are the other causes? Here are some candidates, in no particular order:
1. A lack of health literacy - the intended recipient is also partially to blame for the gap
2. The wrong research being carried out - inaappropriate for local priorities/purely academic, etc.
3. A lack of health systems/health services research (relates to 2, but is a separate problem on its own)
4. Inappropriate media used - digital when it should be analogue, TV when it should be radio, telephone when it should be face-to-face - and vice-versa for all of these in given situations
5. The wrong languge used - sometimes literally (as the recent Translators Without Borders research suggested), and sometimes in terms of being wrong for the target audience owing to its technical/jargon-laden unreadability
6. The simple lack of an answer: when a new enemy appears on the horizon, we often simply don't know what to do. This was the case when HIV/AIDS and Ebola broke out, and it is often the case in emergency situations.
7. Distrust in the message - as we saw recently in North Kivu, DR Congo, where there was widespread disbelief that Ebola existed - apparently the result of the fact that the target population simply distrusted local and national authorities and health professionals.
8. etc. etc.
The knowledge gap is a symptom (or manifestation, as Neil says), and there are many root causes, all of which need addressing.
HIFA profile: Chris Zielinski: As a Visiting Fellow in the Centre for Global Health, Chris leads the Partnerships in Health Information (Phi) programme at the University of Winchester. Formerly an NGO, Phi supports knowledge development and brokers healthcare information exchanges of all kinds. Chris has held senior positions in publishing and knowledge management with WHO in Brazzaville, Geneva, Cairo and New Delhi, with FAO in Rome, ILO in Geneva, and UNIDO in Vienna. Chris also spent three years in London as Chief Executive of the Authors Licensing and Collecting Society. He was the founder of the ExtraMED project (Third World biomedical journals on CD-ROM), and managed the Gates Foundation-supported Health Information Resource Centres project. He served on WHO’s Ethical Review Committee, and was an originator of the African Health Observatory. Chris has been a director of the World Association of Medical Editors, UK Copyright Licensing Agency, Educational Recording Agency, and International Association of Audiovisual Writers and Directors. He has served on the boards of several NGOs and ethics groupings (information and computer ethics and bioethics). UK-based, he is also building houses in Zambia. chris AT chriszielinski.com
His publications are at www.ResearchGate.net and https://winchester.academia.edu/ChrisZielinski/ and his blogs are http://ziggytheblue.wordrpress.com and https://www.tumblr.com/blog/ziggytheblue