Introduction
Methodology
Search strategy
Inclusion and exclusion criteria
Screening
Quality assessment
Data extraction and analysis
Results
Search results
Characteristics of included studies
Subcategory | No. | Overall quality ratinga | |||
---|---|---|---|---|---|
25% | 50% | 75% | 100% | ||
KT capacity and practice | 38 | 4 | 6 | 19 | 9 |
KT support | 5 | 0 | 0 | 2 | 3 |
Total | 43 | 4 | 6 | 21 | 12 |
Reported findings
KT capacity of researchers’ and research institutions
Emphasis on research production
Inadequate institutional links and interaction with target audience institutions
Inadequate capacity to communicate to non-scientific target audiences
Mismatch between reported and demonstrated KT competency
Influence of country income status, institutional culture, and research topic and type
Improvement in institutional KT capacity
LMIC researchers’ KT practice
KT activities undertaken by LMIC researchers
Factors influencing LMIC researchers’ KT practice
Papers citing issue | |
---|---|
Research use | |
Research not always used to inform policy and practice decisions | |
Examples of LMIC researchers successfully getting evidence used | |
Factors influencing KT | |
Researchers’ reputation/credibility/contextual understanding | |
Relevance and credibility of research evidence | |
Contrasting views, demands and incentives among researchers and policy-makers in relation to research, its use, policy actor roles and policy-making | |
Nature of policy issues (technical versus contested versus interest of policy-maker) | |
Political context | |
Decision-makers’ research background | |
Donor influence | |
International influence, e.g. WHO |
Barriers to LMIC researchers’ KT practice
Barriers | Papers citing issue |
---|---|
Political context | |
Short window for responding to policy demands | |
High turnover of government officials and politicians | |
Unfavourable political environment | |
Policy implementation challenges | |
KT knowledge and skills of target audiences | |
Target audiences lack knowledge/understanding and skills related to research and policy development | |
Research availability, accessibility and relevance | |
Limited access to and/or inadequate relevant evidence | |
Researcher/target audience collaboration and networking | |
Inadequate interaction between researchers and policy-makers | |
Researchers’ KT knowledge, attitudes and skills | |
Researchers’ inadequate research and KT skills | |
Researchers’ fear of, or limited engagement of, media | |
Challenges with simplifying research findings | |
Researcher not interested in KT | |
Research institutional support | |
Inadequate institutional support and incentives for KT | |
Funding | |
Limited funding for production of relevant research and KT activities |
Facilitators of LMIC researchers’ KT practice
Facilitators | Papers citing issue |
---|---|
Political context | |
Political and institutional requirements to the use of evidence | |
Favourable political environment | |
KT knowledge and skills of target audiences | |
Training/sensitisation of target audiences, e.g. policy-makers, communities, media etc. | |
Technical support to policy-makers and implementers | |
Research availability, accessibility and relevance | |
Timely research | |
Availability of policy-relevant research | |
Researcher/target audience collaboration and networking | |
Researchers collaborating with policy-makers and other stakeholders | |
Researchers interacting with target audiences through existing networks or strategic alliances and championing issues | |
Researcher interacting with research users through informal networks and personal relationships | |
Trust between policy-makers and researchers | |
Target audiences involved at various stages of the research process | |
Researchers involved in policy formulation and implementation | |
Researchers placed in key decision-making positions in government or in close proximity with national programmes | |
Research communication | |
Targeted dissemination of research findings | |
Tailored messages for various audiences | |
Framing of research findings in context | |
Media engagement activities, e.g. newspaper articles, TV and radio shows | |
Use of credible messengers/knowledge intermediary | |
Use of policy windows | |
Funding | |
Funding available for research and KT |
Strategies recommended or used to improve LMIC researchers’ KT practice
Strategies | Papers citing issue |
---|---|
KT knowledge and skills of target audiences | |
Sensitise and train target audiences on the value of research use in decision-making and research methods | |
Research availability, accessibility and relevance | |
Rapid response service, strategic consultancy and research commissions for policy institutions and donors/funders | |
Produce a mix of research evidence, including operations research, systematic reviews, effectiveness and cost-effectiveness research, develop low cost innovations to improve practice, etc. | |
Researcher/target audience collaboration and networking | |
Establish strong links with institutions involved in the decision-making process in research | |
Involve target audiences in the research process | |
Establish KT platforms or participatory workshops for discussing research findings | |
Research communication | |
Tailor and target the dissemination of research | |
Stakeholder analysis/analysis of policy-making process | |
Identify and seize windows of opportunity | |
Develop communication strategy | |
Researchers’ KT knowledge, attitudes and skills | |
Strengthen research and KT capacity | |
Forge strategic partnerships with international research institutions | |
Forge strategic partnerships with influential people, media and knowledge brokers | |
Research institutional support | |
Strengthening institutional support and incentives for KT | |
Funding | |
More funding allocated to KT and production of policy-relevant research |
KT capacity development for LMIC researchers and research institutions
Intervention level/paper | Intervention and evaluation aims, design and results/recommendations |
---|---|
Systems level | |
Majdzadeh 2010 [94] | - Intervention: In 1985, the Iranian government integrated medical schools into the Ministry of Health resulting in the creation of the Ministry of Health and Medical Education (MOHME) - Aim: To enhance translation of evidence into policy and practice - Evaluation: Qualitative study involving interviews and focus group discussions with decision-makers, non-medical professionals, researchers (from intervention and control settings) and practitioners to assess impact on MOHME decision-making processes - Results: Increased operations research but institutional policy-making culture remained unchanged; time for teaching and research compromised because of over-emphasis on service delivery - Recommendations: Need for establishment of clear regulations and incentives to guide and promote the integration |
Sriram 2018 [90] | - Intervention: Processes to form National Knowledge Platform (NKP) initiated in 2013, in India, by the Ministry of Health and Family Welfare (MOHFW) - Aim: To enhance dialogue and exchange between policy-makers and health policy and systems researchers to inform the generation of policy-relevant evidence and decision-making - Evaluation: Qualitative case study involving interviews with researchers and policy-makers and document reviews in 2016 to analyse the policy-making process - Results: NKP initially established as embedded within MOHFW but evolved into an independent platform; researchers network at the forefront, pushing formation of NKP, including leading proposal development; researcher network initially considered as secretariat but later involved as Steering Committee member |
Institution level | |
Mijumbi 2014 [91] | - Intervention: University-based (Makerere University) rapid response service (RSS), implemented from 2010 to present, targeting state and non-state decision-makers, including mid- and top-level officials at Ministries of Health, civil society organisations and legislators - Aim: Timely (within 28 days) development of four-page evidence briefs with clear key messages to support health systems policy development and planning - Feasibility assessment: Case study involving RSS service data and interviews with service users covering the period 28 months from start of the service - Results: Among nearly half of the policy-makers, the intervention resulted in a change in the course of action based on the evidence provided in the rapid response briefs |
Mijumbi-Deve 2017 [92] | - Intervention: University-based (Makerere University) RSS implemented from 2010 to present targeting state and non-state decision-makers, including mid- and top-level officials at Ministries of Health, civil society organisations and legislators - Aim: Timely (within 28 days) development of four-page evidence briefs with clear key messages to support health systems policy and planning decision-making - Evaluation: Qualitative case study entailing interviews with researchers involved in its implementation and policy-makers who used or were conversant with the service, to explore the contextual factors associated with the how and why an RRS may be taken up by users in Uganda in the period 2010 to 2014 - Findings: Buy-in from Ministry of Health, consultation during design and implementation of the service, ongoing sensitisation and reminders, follow-up interviews with users, sustainable funding to run the service, including paying and training full time staff, and RSS research staff maintaining a balance between an institutionalised system and a personal relationship |
Syed 2008 [72] | - Intervention: Development and application of the Future Health Systems (FHS) evidence–policy interface conceptual framework based on document review and iterative discussions among FHS research consortium; framework considers four key factors, including the developmental context, research characteristics, decision-making processes and stakeholder engagement - Aim: Tool for assessing research plans’ potential for strengthening research–policy links in LMICs and opportunities for improvement - Evaluation: Applied to six health system research plans - Results: Identified gaps in research plans, including limited focus on the following: nurturing links with institutions involved in decision-making processes, identification and participation on formal and informal networks, and stakeholder analysis to inform the design of engagement strategies - Recommendation: Wide application and evaluation |
Individual level | |
Mbuagbaw 2014 [93] | - Intervention: 2-day training workshop targeting Cameroonian health researchers’ (university-based and independent) and policy-makers on pragmatic KT trials including distinguishing pragmatic trials from other types of trials, and key concepts in KT, important steps in clinical trial design - Aim: Improve knowledge - Evaluation: Structured pre–post training test survey administered before start of training and immediately after end of training - Finding: Statistically significant short-term improvement in the participants’ mean score (standard deviation) from 14.7 (3.75) in the pre-test to 18.27 (4.21) in the post-test |
Activity level | |
Lavis 2009 [96] | - Intervention: SUPPORT Tools for evidence-informed health Policymaking (STP) #13: Preparing and using policy briefs to support evidence-informed policymaking - Aim: Guiding questions for preparing policy briefs for use in decision-making processes - Evaluation: not evaluated |
Lavis 2009 [95] | - Intervention: SUPPORT Tools for evidence-informed health Policymaking (STP) #14: Organising and using policy dialogues to support evidence-informed policymaking - Aim: Guiding questions for organising policy dialogue - Evaluation: not evaluated |
Young 2018 [69] | - Intervention: The Policy BUDDIES Project in Western Cape Province, South Africa, implemented in 2014 for 6 months. Paired/matched provincial policy-makers one-to-one with local researchers skilled in KT skilled and knowledgeable about health policy and systems issues - Aim: To build relationships (termed buddying) between researchers and policy-makers to increase the use of evidence in provincial health policy decisions - Evaluation: External mixed methods evaluation using interviews with policy-makers participating in the programme, focus group discussions with researcher buddies and document reviews - Results: Various uses of evidence observed; evidence presented by researchers not always align with policy-maker evidence needs; researchers’ improved understanding of complexity of policy process, communication of evidence and flexibility; and policy-maker champions and reputation of researchers facilitated programme success |