Use of evidence to inform policymaking in Malawi

13 April, 2019

On HIFA we have had much discussion on country-level policymaking, sponsored by the Special Programme on Research and Training in Tropical Diseases, WHO and The Lancet. This new study suggests we are a million miles away from evidence-informed policy in the real world. The implications are profound.

The study finds that in 97% of health policies in Malawi, policymakers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 93% they searched for grey literature and other government documents. 'In only 6 (20 per cent) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted.' Unfortunately the full text is restricted access so the learning for most of us is limited. It would be interesting to hear from the authors Mapulanga P, Raju J, and Matingwina T. If you happen to know them, please forward this message to them and invite them to join us.

CITATION: Leadersh Health Serv (Bradf Engl). 2019 May 7;32(2):226-250. doi:

10.1108/LHS-09-2018-0050. Epub 2019 Mar 21.

Levels of research evidence in health policy assessment in Malawi.

Mapulanga P(1), Raju J(1), Matingwina T(2).

PURPOSE: The purpose of this study is to examine levels of health research evidence in health policies in Malawi.

DESIGN/METHODOLOGY/APPROACH: The study selected a typology of health policies in Malawi from 2002 to 2017. The study adopted the SPIRIT conceptual framework and assessed the levels of research evidence in health policy, systems and services research using the revised SAGE policy assessment tool. Documentary analysis was used to assess levels of health research evidence in health policies in Malawi.

FINDINGS: In 29 (96.7 per cent) of the health policies, policy formulators including healthcare directors and managers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 28 (93.3 per cent) of the health policies, they searched for grey literature and other government documents. In only 6 (20 per cent) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted. Overall, in 23 (76.7 per cent) of the health policy documents, health research evidence played a minimal role and had very little influence on the policy documents or decision-making.

RESEARCH LIMITATIONS/IMPLICATIONS: The empirical evidence in the health policy documents are limited because of insufficient research citation, low retrievability of health research evidence in the policy documents and biased selectivity of what constitutes health research evidence.

PRACTICAL IMPLICATIONS: The study indicates that unfiltered information (data from policy evaluations and registries) constitutes majority of the research evidence in health policies both in health policy, systems and services research. The study seeks to advocate for the use of filtered information (peer reviewed, clinical trials and data from systematic reviews) in formulating health policies.

ORIGINALITY/VALUE: There is dearth of literature on the levels of health research evidence in health policy-making both in health policy, systems and services research. This study seeks to bridge the gap with empirical evidence from a developing country perspective.

DOI: 10.1108/LHS-09-2018-0050

PMID: 30945596

--

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