Facilitating factors and barriers to malaria research utilization for policy development in Malawi

Abstract

Background:Research on various determinants of health is key in providing evidence for policy development, thereby leading to successful interventions. Utilization of research is an intricate process requiring an understanding of contextual factors. The study was conducted to assess enhancing factors and barriers of research utilization for malaria policy development in Malawi.Methods: Qualitative research approach was used through in-depth interviews with 39 key informants that included malaria researchers, policy makers, programme managers, and key stakeholders. Purposive sampling and snowballing techniques were used in identifying key informants. Interview transcripts were entered in QSR Nvivo 11 software for coding and analysis.Results: Respondents identified global efforts as key in advancing knowledge translation, while local political will has been conducive for research utilization. Other factors were availability of research, availability of diverse local researchers and stakeholders supporting knowledge translation. While barriers included: lack of platforms for researcher-public engagement, politics, researchers' lack of communication skills, lack of research collaborations, funder driven research, unknown World Health Organization policy position, and the lack of a malaria research repository. Conclusion:Overall, the study identified facilitating factors to malaria research utilization for policy development in Malawi. These factors need to be systematically coordinated to address the identified barriers and improve on malaria research utilization in policy development. Malaria research can be key in the implementation of evidence-based interventions to reduce the malaria burden and assist in the paradigm shift from malaria control to elimination in Malawi.

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

“…The basic approach involves the assessment of enablers and barriers in the utilisation of research evidence in policy. Therefore, an assessment of facilitating factors and barriers to malaria research utilisation for policy development in Malawi was conducted, the process for which is fully described elsewhere [ 24 ].…”

“…The development of the framework was based on lessons drawn from two case studies [ 22 , 23 ] and an assessment of facilitating factors and barriers to malaria research utilisation in policy development in Malawi [ 24 ]. The methodologies for these studies can be accessed from the respective publications.…”

Changing the policy for intermittent preventive treatment with sulfadoxine–pyrimethamine during pregnancy in Malawi

“…Most important was leadership by the MOH through the NMCP that showed keen interest in seeing the policy developed and implemented. Similarly, the NMCP was identified as critical in driving government efforts in engaging and collaborating with the right stakeholders such as researchers in seeking evidence for policy formulation and its implementation [ 33 ]. It is important that the motivation emanates from the government if such a process is to be realized.…”

How actors, processes, context and evidence influenced the development of Malawi's Health Sector Strategic Plan II

“…These include the strategic importance of funding (and control of resources), availability of (acceptable) evidence, stakeholder engagement, and positionality, the global health agenda, decision-making structures, and support for alignment and harmonization. 4,15,16,18,19,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] Health Sector Strategic Plans (HSSPs), often referred to by various names and associated acronyms, such as Health Sector Strategic Master Plans and National Health Policy Strategic Plans, 48,49 are high-level national health policies implemented in LMICs which define health sector agendas for set periods of time, outline key interventions for achieving health targets and serve as an important resource for attracting external support. [49][50][51] They are formulated based on the tenants of the Paris, Accra, and Busan Agreements and in conjunction with HSSP formulation guidelines defined by the World Health Organization (WHO).…”

“…Many studies document the application of evidence for decision-making, issues related to its quality and availability, and preferences for use vis à vis the hierarchy of evidence. 32,37,[40][41][42]100 The definition of "evidence" and its attributed value, as outlined by the hierarchy of evidence is important when selecting data to use during health policy discussions and recent debates have arisen about the importance of including forms of evidence, other than the "gold standard," during policy development processes. [100][101][102] As policy development aims to address complex social issues which often require a more holistic understanding, utilizing a more inclusive definition of evidence may be advantageous.…”