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      National policy-makers speak out: are researchers giving them what they need?

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          Abstract

          The objective of this empirical study was to understand the perspectives and attitudes of policy-makers towards the use and impact of research in the health sector in low- and middle-income countries. The study used data from 83 semi-structured, in-depth interviews conducted with purposively selected policy-makers at the national level in Argentina, Egypt, Iran, Malawi, Oman and Singapore. The interviews were structured around an interview guide developed based on existing literature and in consultation with all six country investigators. Transcripts were processed using a thematic-analysis approach. Policy-makers interviewed for this study were unequivocal in their support for health research and the high value they attribute to it. However, they stated that there were structural and informal barriers to research contributing to policy processes, to the contribution research makes to knowledge generally, and to the use of research in health decision-making specifically. Major findings regarding barriers to evidence-based policy-making included poor communication and dissemination, lack of technical capacity in policy processes, as well as the influence of the political context. Policy-makers had a variable understanding of economic analysis, equity and burden of disease measures, and were vague in terms of their use in national decisions. Policy-maker recommendations regarding strategies for facilitating the uptake of research into policy included improving the technical capacity of policy-makers, better packaging of research results, use of social networks, and establishment of fora and clearinghouse functions to help assist in evidence-based policy-making.

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          Most cited references36

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          The utilisation of health research in policy-making: concepts, examples and methods of assessment

          The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies.
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            Bridging the implementation gap between knowledge and action for health.

            There is widespread evidence of failure to implement health interventions that have been demonstrated to be cost-effective by high-quality research; this failure affects both high-income and low-income countries. Low-income countries face additional challenges to using research evidence including: the weakness of their health systems, the lack of professional regulation and a lack of access to evidence. There is a need to strengthen institutions and mechanisms that can more systematically promote interactions between researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The concept of public engagement with health research requires a public that is both informed and active. Even when systematic reviews are available further work is needed to translate their findings into guidelines or messages that are understandable to patients and health professionals. Many of the commonly used approaches for keeping health professionals' knowledge up-to-date appear to have small or inconsistent effects. The evidence-base is more extensive for interventions directed towards professionals, such as education, reminders or feedback, than for those directed at organizations or patients. The effect of interventions varies according to the setting and the behaviour that is targeted. Case studies in low-income settings suggest that some strategies can result in increased coverage of evidence-based interventions, but there is a lack of evidence from systematic reviews of rigorous research. Given the potential for near-term improvements in health, finding more effective ways of promoting the uptake of evidence-based interventions should be a priority for researchers, practitioners and policy-makers.
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              Pathways to “Evidence-Informed” Policy and Practice: A Framework for Action

              Bowen and Zwi propose a new framework that can help researchers and policy makers to navigate the use of evidence.
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                Author and article information

                Journal
                Health Policy Plan
                Health Policy Plan
                heapol
                heapol
                Health Policy and Planning
                Oxford University Press
                0268-1080
                1460-2237
                January 2011
                14 June 2010
                14 June 2010
                : 26
                : 1
                : 73-82
                Affiliations
                1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2Development Studies Institute (DESTIN) and LSE Health, London School of Economics and Political Science, UK, 3Advisor to the Minister of Investment for Research and Information, Arab Republic of Egypt, 4Department of Behavioral Medicine, Sultan Qaboos University, Sultanate of Oman, 5Director, Public Health Research Institute, Tehran Medical University, Islamic Republic of Iran, 6Department of Community, Occupational & Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 7Center for Bioethics in Eastern and Southern Africa, University of Malawi College of Medicine, Malawi, 8Senior Investigator of CONICET, National Institute of Parasitology ‘Dr M. Fatala Chaben’, ANLIS, Ministerio de Salud, Buenos Aires, Argentina and 9Health Policy & Systems Specialist, Global Forum for Health Research, Geneva, Switzerland
                Author notes
                *Corresponding author. Associate Professor, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E-8132, Baltimore, MD 21205, USA. Tel: +1 410 955 1253. Fax: +1 410 614 1419. Email: ahyder@ 123456jhsph.edu
                Article
                czq020
                10.1093/heapol/czq020
                4031573
                20547652
                0a463d7e-a3ca-4e2d-bf92-f1814f3c0882
                The Author 2010; all rights reserved.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine

                Categories
                Original Articles

                Social policy & Welfare
                research to policy,evidence-based policy,health policy,argentina,egypt,iran,malawi,oman,singapore

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