Investigating the process of evidence-informed health policymaking in Bangladesh: a systematic review

Abstract

Over the last four decades, Bangladesh has made considerable improvements in population health, this is in part due to the use of evidence to inform policymaking. This systematic review aims to better understand critical factors that have facilitated the diffusion of scientific evidence into multiple phases of health policymaking in Bangladesh. To do this an existing policy framework designed by Shiffman and Smith in 2007, was used to extract and synthesize data from selected policy analyses. This framework was used to ensure the content, context and actors involved with evidence-informed policymaking were considered in each case where research had helped shape a health policy. The ‘PRISMA Checklist’ was employed to design pre-specified eligibility criteria for the selection of information sources, search strategy, inclusion and exclusion criteria, and process of data extraction and synthesis. Through our systematic search conducted from February to May 2017, we initially identified 1859 articles; after removal of duplicates, followed by the screening of titles, abstracts and full-texts, 24 articles were included in the analysis. Health policy issues included the following topics: maternal and child health, tobacco control, reproductive health, infectious disease control and the impact and sustainability of knowledge translation platforms. Findings suggested that research evidence that could be used to meet key targets associated with the Millennium Development Goals (MDGs) were more likely to be considered as a political (and therefore policy) priority. Furthermore, avenues of engagement between research organizations and the government as well as collective action from civil-society organizations were important for the diffusion of evidence into policies. Through this article, it is apparent that the interface between evidence and policy formulation occurs when evidence is, disseminated by a cohesive policy-network with strong leadership and framed to deliver solutions for problems on both the domestic and global development agenda.

Assessing the impact of knowledge communication and dissemination strategies targeted at health policy-makers and managers: an overview of systematic reviews

“…Four reviews included only low-income countries [ 22 , 28 , 36 , 37 ], 12 included only high-income countries [ 6 , 20 , 21 , 25 , 26 , 30 – 34 , 39 , 40 ], one did not report [ 15 ], and the remaining 10 included low–medium- and high-income countries.…”

“…Twelve SRs mentioned or were informed by a theory or framework [ 15 , 16 , 18 – 20 , 28 , 29 , 31 , 34 , 35 , 39 , 40 ], none of which was used by more than one SR. Some examples of the theories used were the Rothman and Salovey theory, arts-based KT (ABKT) framework, the Guiding Arts-Based Research Assessment framework (GABRA), knowledge-brokering domains, policy framework (Shiffman and Smith framework), leadership theory, domains of knowledge management (Lee et al 2010), Kirkpatrick’s evaluation model hierarchy, theory-driven approach, Green’s transportation imagery model, and the SPIRIT (Supporting Policy In health with Research: an Intervention Trial) action framework.…”

“…Fourteen reviews assessed the effects of a communication strategy [ 6 , 16 – 19 , 23 , 25 , 27 , 28 , 30 , 32 , 33 , 39 , 40 ], but only two [ 23 , 30 ] provided evidence considered useful for the development of effectiveness statements (Table 1 ). Nine reviews provided some effectiveness information, which was insufficient, however, to make any definitive statements, and three reviews informed research gaps [ 16 , 28 , 33 ].…”

“…Fourteen reviews assessed the effects of a communication strategy [ 6 , 16 – 19 , 23 , 25 , 27 , 28 , 30 , 32 , 33 , 39 , 40 ], but only two [ 23 , 30 ] provided evidence considered useful for the development of effectiveness statements (Table 1 ). Nine reviews provided some effectiveness information, which was insufficient, however, to make any definitive statements, and three reviews informed research gaps [ 16 , 28 , 33 ]. The 11 reviews providing evidence of effectiveness assessed interventions focused on tailoring and targeting the message communicated to decision-makers, the use of arts-based approaches to communicate research, the use of alternative formats for presenting SRs, and multicomponent communication strategies.…”

Generating Political Priority for Primary Health Care Reform in Romania

“…27 While these conceptual frameworks are not exhaustive, they have informed analysis of health policy agenda setting in other contexts. [28][29][30][31] Kingdon's model for agenda setting overlaps significantly with the main elements of other frameworks. For example, the problem, policy, and politics streams within Kingdon's model examine similar concepts as the issue characteristics, policy ideas, and political context in the framework described by Shiffman and Smith.…”