Levels of research evidence in health policy assessment in Malawi

Abstract

Purpose-The paper examines 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%) 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%) of the health policies they searched for grey literature and other government documents. In only 6 (20%) 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%) of the health policy documents research evidence played a minimal role and had very little influence on the policy documents. Research limitations/implications-The empirical evidence in the health policy documents are limited due to 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 paper 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 paper 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.

The Use of Research for Health Systems Policy Development and Implementation in Mozambique: A Descriptive Study

“…Some authors have noted that, despite the growing production of scientific evidence for public health decision making globally, a great gap remains between the appropriate courses of action suggested by scientific evidence and what is actually implemented (the so-called “know-do gap”). 7 We found this gap in Mozambique: political decisions are often made without reference to, and not in line with, evidence from research. 7 , 13…”

“… 7 We found this gap in Mozambique: political decisions are often made without reference to, and not in line with, evidence from research. 7 , 13…”

“…Researchers, as well as government and nongovernmental institutions working in these areas, have been gaining experience and raising the quality of research, while narrowing their areas of focus. 7 , 8 …”

“…This issue is reportedly caused by the lack of support and skills in interpreting research, and it results in the lack of policies based on evidence and even inconsistent policies. 7 …”

“…Researchers, as well as government and nongovernmental institutions working in these areas, have been gaining experience and raising the quality of research, while narrowing their areas of focus. 7,8 The volume of scientific production in Mozambique, combined with the viewpoints of the majority of interviewees, suggest that research on health in general and on health systems in particular has generated robust evidence. However, the evidence frequently has not been disseminated systematically and comprehensively, nor has it been directed to the appropriate audiences.…”