Promoting evidence informed policymaking for maternal and child health in Nigeria: lessons from a knowledge translation workshop

Abstract

Background: Knowledge translation (KT) is a process that ensures that research evidence gets translated into policy and practice. In Nigeria, reports indicate that research evidence rarely gets into policymaking process. A major factor responsible for this is lack of KT capacity enhancement mechanisms. The objective of this study was to improve KT competence of an implementation research team (IRT), policymakers and stakeholders in maternal and child health to enhance evidence-informed policymaking. Methods: This study employed a “before and after” design, modified as an intervention study. The study was conducted in Bauchi, north-eastern Nigeria. A three-day KT training workshop was organized and 15 modules were covered including integrated and end-of-grant KT; KT models, measures, tools and strategies; priority setting; managing political interference; advocacy and consensus building/negotiations; inter-sectoral collaboration; policy analysis, contextualization and legislation. A 4-point Likert scale pre-/post-workshop questionnaires were administerd to evaluate the impact of the training, it was designed in terms of extent of adequacy; with “grossly inadequate” representing 1 point, and “very adequate” representing 4 points.Results: A total of 45 participants attended the workshop. There was a noteworthy improvement in the participants’ understanding of KT processes and strategies. The range of the preworkshop mean of participants knowledge of modules taught was from 2.04-2.94, the range for the postworkshop mean was from 3.10–3.70 on the 4-point Likert scale. The range of percentage increase in mean for participants’ knowledge at the end of the workshop was from 13.3%–55.2%.Conclusion: The outcome of this study suggests that using a KT capacity building programme e.g., workshop, health researchers, policymakers and other stakeholders can acquire capacity and skill that will facilitate evidence-to-policy link.

A literature review of knowledge translation and partnership research training programs for health researchers

“…Lectures and interactive discussions were held around the following topics: 1) Introduction to health policy and systems research/building evidence-informed policy environments; (2) Capacity development and enhancement for evidence-informed health policy-making; (3) Acquisition, assessment, adaptation & application of evidence in health policy-making and (4) Building effective linkage, partnership & exchange between health policy-makers and researchers in Nigeria. Participants in the workshop were also broken up into six focus groups to discuss the topic ‘Bridging the gap between health policy-makers & researchers’Uneke et al (2018) [34]Nigeria10 researchers and 10 senior policy staffPart-time secondment, up to 2 working days per week over a period of 6 monthsTwo-way secondment (policy-makers working in research teams and researchers working within government health programs)Researchers seconded to policy teams provided research expertise to several projects, including the State Malaria Elimination program, reproductive health services, and primary healthcareResearch secondees were instructed to (1) build trust and understand policy-maker’s evidence needs; (2) play an expert advisory role and provide scientific evidence to guide on policy issues; and (3) provide capacity enhancement for policy-makersPolicy-maker experiences (in research organisations) were also reported; however, this is out of scope for the present reviewUltimately, the two-way secondment aimed to increase collaboration between policy-makers and researchers in Nigeria and build capacity for ongoing evidence-informed policy-makingFollowing the secondments, all participants (both researchers and policy-makers) attended a policy dialogue event where they received training on preparing a policy brief; the event was used to produce national guidelines on malaria control using insecticide-treated nets in Ebonyi StateUneke et al (2018) [35]Nigeria45 participants: researchers from the Implementation Research Team, policy-makers (from the Ministry of Health, Local Government Area, state primary healthcare development agency) and representatives from non-governmental organisations3 daysTraining course (face-to-face)The aim of the training program was to increase the capacity of policy-makers and researchers to undertake KT and promote evidence-based policy; the 3-day training workshop included 15 modules (5 per day)The 15 modules wereIntroduction to health policy and health systems; Introduction to KT (IKT and End-of-Grant KT); Research priority setting; Leadership capacity development and managing political interference; Getting research into policy and practice; KT models measures; Research evidence in health policy-making and health policy implementation; Health policy advocacy, demand creation, consensus-building and negotiations; KT tools and strategies for stakeholders and end users engagement; Policy formulation and implementation process. Modules were taught each day by way of lectures and group work sessions; lecture sessions used learning tools such as PowerPoint slides and handouts; group work consisted of focus group discussion, question/answer sessions and group workPapers emerging from the KTSI run by the Canadian Institutes of Health ResearchKho et al (2009) [36]CanadaPrimarily doctoral students or PhDs (early career researchers)4 daysTraining course (face-to-face)The aims of the KTSI in relation to health services, p...…”

“…The identified capacity-building initiatives all included researchers as participants; however, a range of other professionals were also included. Gerrish and Piercy’s [30] secondment program included clinical nurses, while Uneke et al [33–35] included policy-makers, healthcare managers, directors of NGOs and other stakeholders alongside researchers in their initiatives. Participants in the Canadian Summer Institute, from which three papers emerged [36–38], were all researchers or graduate students interested in KT research.…”

“…The duration of the training initiatives varied from part time secondments, which lasted between 6 months [34] and up to 2 years [30], to Santacroce et al’s [32] program, which was embedded into existing training programs for nurse scientists over several years (pre- and post-doctoral coursework). The other programs [31, 33, 35, 36] were brief (between 1 and 4 days) face-to-face courses or were delivered during a single session [37, 38].…”

“…The program reported by Gerrish and Piercy [30] aimed to build skills in applying KT frameworks in practise, evidence appraisal, skills to facilitate practice change and evaluation. Jones et al [31], Kho et al [36] and Uneke et al [35] all focused on theory of KT and planning for KT. Santacroce et al [32] proposed a framework of six research translation themes (dissemination oriented) embedded into an existing research curriculum.…”

“…All the training initiatives identified included skills-building elements in their programs. The most common focus of skills development was KT intervention planning, included in Jones et al [31], Kho et al [36], Gerrish and Piercy [30], Uneke et al [35], and Santacroce et al [32].…”