Strengthening capacity to use research evidence in health sector policy-making: experience from Kenya and Malawi
Strengthening capacity to use research evidence in health sector policy-making: experience from Kenya and Malawi
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DOI：
10.1186/s12961-019-0511-5
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发表时间：
2019-12-19
影响因子：
4
通讯作者：
Zulu, Eliya M.
中科院分区：
文献类型：
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作者：
Oronje, Rose N.;Murunga, Violet, I;Zulu, Eliya M.
背景在决策中使用证据的许多障碍中，证据使用能力薄弱在过去十年中吸引了很多关注。该研究旨在通过介绍和讨论在肯尼亚和马拉维实施的一个项目的经验和教训，为加强卫生部（MoH）内证据使用的个人和机构能力，提供信息和丰富正在进行和未来的努力，以加强证据使用的能力。方法本文借鉴了由英国国际发展部资助的一个为期3年的项目的内部和外部评估，加强能力，利用研究证据在卫生政策（SECURE健康）。为了加强个人能力，该项目为两个卫生部的60名中级决策者实施了培训和指导方案。为了加强机构能力，该项目与最高领导人一起进行持续宣传，以加强有利于循证决策的结构，支持肯尼亚制定研究促进健康政策和优先事项，支持马拉维审查其健康研究议程的执行情况，为两个卫生部制定循证决策准则，并支持一年两次的证据对话，以改善互动并提高证据的知名度。内部评价包括基线和底线调查（93次基线访谈和92次底线访谈）、60次深入访谈和针对具体干预措施的评价（培训讲习班的前后测试、政策对话反馈表和跟踪宣传工作的效果）。外部评价与项目执行同时进行，进行了三次年度评价。结果EIDM培训和导师制项目对提高公务员胜任力有显著效果。然而，这些方案需要培训足够数量的人员，才能有效地加强卫生部的EIDM实践。在加强机构能力以促进消除贫穷和提高妇女地位方面，虽然该项目取得了一些成功，但由于其实施时间有限和对持续政治经济分析的关注有限，该项目没有实现长期效果，这意味着卫生部内部利益经常变化，对干预产生了负面影响。结论虽然培训和指导是有效的，提高EIDM能力，他们需要纳入现有的职前和在职培训方案的可持续性。加强使用证据的机构能力是一项复杂的工作，需要持续的政治承诺和长期投资。
Background Among the many barriers to evidence use in decision-making, weak capacity for evidence use has attracted a lot of focus in the last decade. The study aims to inform and enrich ongoing and future efforts to strengthen capacity for evidence use by presenting and discussing the experiences and lessons of a project implemented in Kenya and Malawi to strengthen individual and institutional capacity for evidence use within the ministries of health (MoHs). Methods This paper draws on the internal and external evaluations of a 3-year project funded by the United Kingdom's Department for International Development, the Strengthening Capacity to Use Research Evidence in Health Policy (SECURE Health). To strengthen individual capacity, the project implemented a training and mentorship programme for 60 mid-level policy-makers in the two MoHs. To strengthen institutional capacity, the project conducted sustained advocacy with top leaders to strengthen structures that enable evidence-informed decision-making (EIDM), supported Kenya to develop research-for-health policies and priorities, supported Malawi to review the implementation of its health research agenda, developed EIDM guidelines for both MoHs, and supported bi-annual evidence dialogues to improve interactions and raise the profile of evidence. Internal evaluation included baseline and endline surveys (93 baseline and 92 endline interviews), 60 in-depth interviews, and intervention-specific evaluations (pre-post tests for training workshops, feedback forms for policy dialogues and tracking effects of advocacy efforts). The external evaluation was implemented alongside project implementation, conducting three annual evaluations. Results The results show that training and mentorship programmes in EIDM were effective in improving competencies of civil servants. However, such programmes need to train a critical mass to be effective in enhancing EIDM practice at the MoHs. On strengthening institutional capacity for EIDM, while the project achieved some success, it did not realise long-lasting effects because of its limited time of implementation and limited focus on sustained political economy analysis, which meant that the intervention was negatively affected by frequently changing interests within the MoHs. Conclusions Although training and mentorship are effective in improving EIDM competencies, they need to be incorporated in existing pre-service and in-service training programmes for sustainability. Strengthening institutional capacity for evidence use is complex and needs sustained political commitment and long-term investments.