Integrating evidence from research into decision-making for controlling endemic tropical diseases in South East Nigeria: perceptions of producers and users of evidence on barriers and solutions

Abstract

Background: Endemic tropical diseases (ETDs) constitute a significant health burden in resource-poor countries. Weak integration of research evidence into policy and practice poses a major challenge to the control of ETDs. This study was undertaken to explore barriers to the use of research evidence in decision-making for controlling ETDs. It also highlights potential strategies for addressing these barriers, including the gaps in research generation and utilisation in the context of endemic disease control. Methods: Information on barriers and solutions to integrating research evidence into decision-making for controlling ETDs in Anambra State, Nigeria, was collected from 68 participants (producers and users of evidence) during structured discussions in a workshop. Participants were purposively selected and allocated to groups based on their current involvement in endemic disease control and expertise. Discussions were facilitated with a topic guide and detailed notes were taken by an appointed recorder. Outputs from the discussions were synthesised and analysed manually. Results: Cross-cutting barriers include a weak research linkage between producers and users of evidence and weak capacity to undertake health policy and systems research (HPSR). Producers of evidence were purported to conceptualise and frame their research questions based on their academic interests and funders' focus without recourse to the decision-makers. Conversely, poor demand for research evidence was reported among users of evidence. Another user barrier identified was moribund research units of the Department of Planning Research and Statistics within the State Ministry of Health. Potential solutions for addressing these barriers include creation of knowledge networks and partnerships between producers and users of evidence, institutionalisation of sustainable capacity-building of both parties in HPSR and revival of State research units.

Does improving the skills of researchers and decision-makers in health policy and systems research lead to enhanced evidence-based decision making in Nigeria?—A short term evaluation

“…This engagement afforded an opportunity to reinforce producer-user dialogue, the absence of which is known in the literature to constrain GRIPP. Weak linkages between producers and users of evidence have been reported severally in literature [37][38][39] as a constraint to knowledge translation, and we also found this to be a factor in our study context as reported in the baseline assessment [36]. Studies have shown that when producers of evidence engage end users early enough in the evidence production process, that it facilitates decision making in policy and practice [37,40] In 2003, a study showed strategies to improve stakeholder engagement in LMICs were either not undertaken, or where they were undertaken, were not successful [6], so successfully carrying out this producer-user engagement servers to improve on the necessary task of building a critical mass of producers and users of HPSR evidence for the control of endemic diseases, and for overall health system strengthening in LMICs.…”

“…Details of the process and findings from the quantitative and qualitative situational analysis have been published and are available as open access. [35,36]…”

“…In their various groups, they proposed activities they were going to carry out in their various organizations in the short term (three months), medium and long term, after the workshop. Although, three-month post intervention evaluation may be considered a short period, given other competing responsibilities of participants [36], a longer period would have fallen out of the project duration. Bearing this in mind, participants were advised to propose realistic activities that they could undertake within this time frame.…”

“…Lack of authority reported by users, is a concern, because it was felt that, given the higher position of some of the participants, they would be able to implement some proposed changes, even if not all, and for this reason, were purposively allocated to be present in each thematic group during the capacity building workshop. Although, these were not tested for statistical significance because of small sample sizes, the finding forms an initial step to interrogating an implied narrow or non-existent decision space, which is being explored in the qualitative component of this project [36].…”

Policy learning and Universal Health Coverage in low- and middle-income countries

“…Yet, in many countries, challenges remain. Research findings are not always properly integrated into policy and practice [5]. Above all, UHC is a complex endeavour at the crossroads of technique and politics, applied to health systems that are themselves complex and, thus, to some extent unpredictable [6,7].…”