This new paper in Health Research Policy and Systems raises the question of whether and how civil society organisations are given a voice in determining research priorities. Citation, abstract, extract and a comment from me below.
CITATION: Strategies to promote evidence use for health programme improvement: learning from the experiences of embedded implementation research teams in Latin America and the Caribbean
N. Ilona Varallyay, Caitlin Kennedy, Sara C. Bennett & David H. Peters
Health Research Policy and Systems volume 20, Article number: 38 (2022)
ABSTRACT
Background: To achieve global health targets, innovative approaches are needed to strengthen the implementation of efficacious interventions. New approaches in implementation research that bring together health system decision-makers alongside researchers to collaboratively design, produce and apply research evidence are gaining traction. Embedded implementation research (EIR) approaches led by decision-maker principal investigators (DM PIs) appear promising in this regard. Our aim is to describe the strategies study teams employ in the post-research phase of EIR to promote evidence-informed programme or policy improvement.
Methods: We conducted a prospective, comparative case study of an EIR initiative in Bolivia, Colombia and Dominican Republic. Guided by a conceptual framework on EIR, we used semi-structured key informant interviews (n = 51) and document reviews (n = 20) to examine three decision-maker-led study teams (“cases”). Focusing on three processes (communication/dissemination, stakeholder engagement with evidence, integrating evidence in decision-making) and the main outcome (enacting improvements), we used thematic analysis to identify associated strategies and enabling or hindering factors.
Results: Across cases, we observed diverse strategies, shaped substantially by whether the DM PI was positioned to lead the response to study findings within their sphere of work. We found two primary change pathways: (1) DM PIs implement remedial measures directly, and (2) DM PIs seek to influence other stakeholders to respond to study findings. Throughout the post-research phase, EIR teams adapted research use strategies based on the evolving context.
Conclusions: EIR led by well-positioned DM PIs can facilitate impactful research translation efforts. We draw lessons around the importance of (1) understanding DM PI positionality, (2) ongoing assessment of the evolving context and stakeholders and (3) iterative adaptation to dynamic, uncertain circumstances. Findings may guide EIR practitioners in planning and conducting fit-for-purpose and context-sensitive strategies to advance the use of evidence for programme improvement.
SELECTED EXTRACT [from Colombia case study]
While a formal public presentation on findings was made, more intensive “dissemination” and “engagement” processes targeting external stakeholders were largely circumvented; within the health network, findings were incorporated into existing staff communication channels. Other stakeholder engagement strategies, such as deliberative consultations or joint problem-solving, were not deemed necessary—key informant interviews from the IR study already elicited stakeholders’ views on remedial measures.
COMMENT (NPW): The extract above is the only reference I could find to (lack of) civil society engagement.
Question 1 of our discussion asks: What does civil society participation in health policy mean and why is it important to have civil society participation in health policy processes? The above paper is a reminder that civil society has the potential to have a meaningful impact not only in creating new evidence and highlighting existing evidence, but also in prioritising what research needs to be done, and how. An example of an organisation working in this space is the Council on Health Research for Development. The COHRED website notes: 'In many countries, a weak link in the health research system is between population needs and the research and policy-making processes. COHRED works with civil society organisations and community groups to find ways to bring real population needs into the research and policy processes.' I invite comment from COHRED representatives and other organisations supporting health research to share their experience.
Best wishes, Neil
Joint Coordinator, HIFA SUPPORT-SYSTEMS
https://www.hifa.org/projects/new-support-systems-how-can-decision-makin...
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HIFA profile: Neil Pakenham-Walsh is global coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in official relations with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information.
Twitter: @hifa_org neil@hifa.org
