Knowledge into action: using research findings to inform policies in maternal and newborn health

Background: Many interventions found to be effective in research studies on maternal and newborn health and survival, fail to translate into policies and health service delivery models in settings with high maternal and newborn morbidity and mortality. IDEAS is a 5-year project funded by Bill & Melinda Gates Foundation, in three areas with high burden of maternal and neonatal mortality: Ethiopia, North-Eastern Nigeria and Uttar Pradesh in India. The project is a multi-method evaluation of complex interventions in maternal and newborn health (MNH), and is implemented by the London school of Hygiene & Tropical Medicine. One of the objectives of the project is to assess the extent to which innovative MNH care models are scaled up and to identify enabling and inhibiting factors to scale up. As part of this assessment we have undertaken a qualitative study to explore how research findings and knowledge generated in pilot projects are used by policy makers in developing policies and strategies for MNH.

Methods

Building on frameworks for transferring knowledge into action (Lavis et al 2009; Darmschroder et al 2009), we developed a topic guide seeking to explore views of researchers, policy makers and other stakeholders on translating research findings into policy. A total of about 75 in-depth interviews are being undertaken in Ethiopia, Nigeria and India. The topic guide is used as a flexible tool allowing participants to express opinions and raise issues that are most relevant to them. The interviews are recorded and transcribed verbatim. The transcripts are analysed by a team of researchers from London and the three countries, using framework analysis for policy research. This abstract presents emerging findings from pilot interviews in Ethiopia and India.

Findings

Willingness of policy makers to consider research findings depends to a great extent on how they perceive the quality of the evidence: whether it is conducted by an independent organisation, whether it is statistically significant and whether health outcomes could be attributed to particular components of complex, multi-layered programmes. The way evidence is disseminated influences the likelihood of its uptake into policy. It is more likely to be considered if it is presented by people who had legitimacy (experts in the field); if the audience included high level decision makers and donors who had the authority to act on the data; and if it included demonstartion sites (taking decision makers to the field to get emotional buy-in.

Interpretation

Translation of research evidence into policy depends on 1) the nature of the evidence and how the strength and validity (independence) of the evidence is perceived; 2) the way research is communicated: by whom (messenger), to whom (audience) and how (vehicle); 3) the ability and willingness of decision-makers to use evidence depending on capacity and context.

References

Damschroder LJ, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009 Aug 7;4:50.

Lavis JN, et al. SUPPORT Tools for evidence-informed health Policymaking (STP). Introduction. Health Research Policy and Systems 2009, 7(Suppl 1):I1