Dear HIFA colleagues,
HIFA has been involved in international qualitative research looking at the role of civil society organisations in policymaking, resulting in a number of publications: https://www.hifa.org/projects/support-systems-how-can-decision-making-pr...
Several of our colleagues have published a related paper that is of interest. (HIFA was not directly involved with this paper.)
CITATION: Dennis Waithaka, Simon Lewin, Jacinta Nzinga, Unni Gopinathan, Claire Glenton, Edwine Barasa, Benjamin Tsofa, Examining evidence use in vaccine policymaking in Kenya: a qualitative case study, Health Policy and Planning, 2026;, czag100, https://doi.org/10.1093/heapol/czag100
ABSTRACT
Although evidence-informed health policymaking is widely promoted, evidence use in vaccine policymaking and the institutional and actor dynamics shaping it remain poorly understood. This study investigates what types of evidence was used and how it was used in vaccine policymaking in Kenya. Using a qualitative case study design, we focused on the introduction and roll-out of HPV and malaria vaccines. Data collection included 34 in-depth interviews with national Ministry of Health officials, Kenya National Immunization Technical Advisory Group members, County Expanded Programme of Immunization logisticians, international partners, and local civil society organizations; 417 hr of observation of vaccine-related policy and planning meetings; and a review of relevant policy and planning documents. Framework analysis was used to analyse the data, guided by two analytical frameworks: (i) a spectrum approach for categorizing evidence along two dimensions—scientific to tacit and global to local—and (ii) Weiss’s models of research use, which interpret patterns of evidence utilization in policymaking. The findings show that international actors, through their financial and technical authority, substantially influenced national policymakers’ adoption of global guidance and scientific evidence. Local programmatic expertise played a crucial role in validation and contextualization of global guidance and scientific evidence to fit local contexts. The dominance of medical and public health professionals in decision-making spaces led to the prioritization of evidence on vaccines’ public health benefits over socio-political considerations. Local civil society’s influence in vaccine policymaking was limited, with its community-based experiential knowledge primarily informing advocacy, communication, and social mobilization, rather than vaccine prioritization and policy decisions. We conclude that strengthening evidence-informed policymaking requires more inclusive approaches that value diverse evidence types. Addressing power imbalances that shape what counts as credible evidence and integrating local civil society perspectives throughout the policymaking process can enhance the legitimacy, acceptability, and effectiveness of policy decisions.
COMMENT (NPW)
'The dominance of medical and public health professionals in decision-making spaces led to the prioritization of evidence on vaccines’ public health benefits over socio-political considerations. Local civil society’s influence in vaccine policymaking was limited, with its community-based experiential knowledge primarily informing advocacy, communication, and social mobilization, rather than vaccine prioritization and policy decisions. We conclude that strengthening evidence-informed policymaking requires more inclusive approaches that value diverse evidence types.'
I have not been able to read the full text, but the policymaking process appears to have been a lot more effective than we have seen in the United States, where evidence in favour of maintaining vaccine regimens has been dismissed. For me, it makes sense to prioritise p0ublic health benefits and issues such as advocacy, communication and social mobilisation. I would be interested to learn from the authors about which aspects of community-based experiential knowledge were believed to be underrepresented.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org