Development of a framework to improve the utilisation of malaria research for policy development in Malawi

Abstract

BackgroundThe existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world’s disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi.MethodsThe study used two approaches including: two case studies of policy analysis exploring the policy-making process in Malawi, utilisation of local malaria research, and the role of key stakeholders in policy formulation process; and the assessment of facilitating factors and barriers to malaria research utilisation for policy-making in Malawi.ResultsFrom the case studies’ lessons and elements identified during the assessment of facilitating factors and barriers, a framework is developed to promote an integrated approach to knowledge translation. In this framework the Ministry of Health is considered as the main user of knowledge from research through the demand created by the research directorate and the National Malaria Control Programme. Key documents identified as being particularly relevant to the Ministry of Health for purposes of knowledge translation include the National Health Research Agenda, Guidelines for Policy Development and Analysis, and Guidelines for Evidence Use in Policy-making. Institutions conducting academic and policy-relevant malaria research in Malawi are identified and a consolidation of their linkages with the users of research is established through the Knowledge Translation Unit, the Evidence Informed decision-making Centre, and the African Institute for Development Policy. Equally, key players in this framework are the funding partners for both research and programmes that need to see accountability and impact of their support. Independent advisors, partners, and consultants also have their vital role in the process.ConclusionThe framework offers a practical basis for the factors identified and their linkages to promote a co-ordinated approach to malaria research utilisation in policy-making. Its applicability and success hinges on its wider dissemination and ownership by the government through the National Malaria Control Programme.

A systematic review of frameworks for the interrelationships of mental health evidence and policy in low- and middle-income countries

“…Learnings can also be drawn from other public health issues with which mental health shares a number of commonalities, and which have recently gained traction on the policy agenda in LMICs, such as HIV/AIDS [ 126 ], malaria [ 127 ], tuberculosis [ 128 ] or maternal deaths [ 129 ].…”

Examining and Contextualizing Approaches to Establish Policy Support Organizations – A Critical Interpretive Synthesis

“…Health system -Availability of resources • Existence of policy-development and/or planning units within government institutions contribute to framing the expectation of informing policy using evidence. 52,54,55 Health system -Trust between researchers and policy-makers • Establishing a PSO in a health system that is highly reliant on external funding (eg, donors or external organizations) is more challenging because it is less trusted and more likely to be fragmented. 55,56 • In a tiered health system, the competition between private and public sectors might complicate the establishment of a PSO, and therefore it is important to start with identifying common priorities to minimize the fragmentation and increase the trust between the policy and research communities.…”

“…For these reasons, institutionalizing the PSO within a pre-existing structure is recommended even if initially started as an independent project. 39,51,52,54,60,63,64,70,76 • The governance approach of the hosting organization that allows for mobilizing funds for program and project implementation can facilitate the establishment of a PSO, but this requires being fully aware of the administrative formalities of the hosting organization. 39,44,50,51,55,56 • Having appropriate political support from policy-makers and stakeholders facilitates the establishment of PSOs by mobilizing needed resources and resolving any conflicts between the research and policy communities, 19,39,44,50,51 and this requires processes to identify policy-makers' interest and any potential resistance to establishing a PSO.…”

“…20 ■ Exchange: PSOs conduct deliberative dialogues to exchange ideas with partners, learn about their evidence needs, identify tacit knowledge and actions that can be taken by different groups to address health-system issues, and contextualize global evidence. 26,39,40,43,50,[52][53][54]56,59,60,63,65,66,69,70,[77][78][79][80] ■ Sustainable KT processes involve building capacity for different types of functions (eg, preparing evidence briefs, convening policy dialogues and providing a rapid response services), raising funds, and monitoring and evaluating the impact of the PSO's work on policy change. 20,[38][39][40][41]43,48,53,60,64,66,78 researchers and policy-makers and/or by building new connections where needed.…”

Phytoremediation Using Aquatic Plants

“…Therefore, given the potentially large area required, CW-based phytoremediation may be unable to compete for limited land availability with other more profitable land uses. Furthermore, in countries where vector-borne diseases, such as malaria or dengue, are a public health issue the creation of open shallow wetland environments may be undesirable as it has the potential to provide ideal conditions for the propagation of mosquitoes and other disease vectors (Mwendera et al, 2017).…”