TY - JOUR
T1 - Research translation to inform national health policies
T2 - Learning from multiple perspectives in Uganda
AU - Ssengooba, Freddie
AU - Atuyambe, Lynn
AU - Kiwanuka, Suzanne N.
AU - Puvanachandra, Prasanthi
AU - Glass, Nancy
AU - Hyder, Adnan Ali
N1 - Funding Information:
“the male circumcision studies were funded by NIH and WHO. We were called to Geneva to join research teams from Kenya and South Africa to guide the policy development by WHO and UNAIDS. […] we also developed a dissemination strategy for the results and engaged the (Ugandan) Ministry of Health. […] but let us face the facts - the Ministry of Health will not proceed with male circumcision without the funds from PEPFAR or Global Fund. So our dissemination in Geneva had all these agencies represented.” (Research Scientists). Demand for feasibility research At the time of this research, a Ugandan national SMC taskforce had been formed comprising MOH officials, and surgeons to advise about the implementation of the program. A striking similarity with PMTCT policy evolution was the demand for a series of additional research studies regarding feasibility of SMC implementation. As the Ministry of Health started to discuss the translation of the SMC evidence into policy, feasibility questions emerged that demanded additional operations research. The text below from a policy maker highlights this view: ”The issue of feasibility is very important. SMC should be simple and user friendly to our health providers because they are the ones who are going to implement it. [...] at the end of the day we are going to choose what is most user friendly to health care providers. Secondly, is the issue of acceptability to the general public. We are also looking at cultural sensitivity. We have been implementing HIV prevention strategies already - the ABC +. So the way we are introducing circumcision must not kill the good things which are already in HIV prevention. So those are some of the considerations to make sure that our SMC policy becomes more feasible and more acceptable” (Policy Maker).
Funding Information:
The team is grateful for the support of the Bill and Melinda Gates Foundation for funding this work through the “Partnership for Building the Capacity of Makerere University to Improve Health Outcomes in Uganda”, a Collaborative Learning Initiative with Johns Hopkins University (Grant # 49504). We would like to thank Professor Nelson Sewankambo, David Peters, and David Serwadda and George Pariyo for helpful comments on earlier drafts of the paper. We would also like to thank all participants for sharing their time and observations. This article has been published as part of BMC International Health and Human Right Volume 11 Supplement 1, 2011: An innovative approach to building capacity at an African university to improve health outcomes. The full contents of the supplement are available online at http://www.biomedcentral.com/1472-698X/11?issue=S1.
PY - 2011
Y1 - 2011
N2 - Background: Research and evidence can have an impact on policy and practice, resulting in positive outcomes. However, research translation is a complex, dynamic and non-linear process. Although universities in Africa play a major role in generating research evidence, their strategic approaches to influence health policies and decision making are weak. This study was conducted with the aim of understanding the process of translating research into policy in order to guide the strategic direction of Makerere University College of Health Sciences (MakCHS) and similar institutions in their quest to influence health outcomes nationally and globally. Methods. A case study approach using 30 in-depth interviews with stakeholders involved in two HIV prevention research project was purposively selected. The study sought to analyze the research-to-policy discourses for the prevention of mother-to-child transmission (PMTCT) and safe male circumcision (SMC). The analysis sought to identify entry points, strengths and challenges for research-to-policy processes by interviewing three major groups of stakeholders in Uganda - researchers (8), policy makers (12) and media practitioners (12). Results: Among the factors that facilitated PMTCT policy uptake and continued implementation were: shared platforms for learning and decision making among stakeholders, implementation pilots to assess feasibility of intervention, the emerging of agencies to undertake operations research and the high visibility of policy benefits to child survival. In contrast, SMC policy processes were stalled for over two years after the findings of the Uganda study was made public. Among other factors, policy makers demanded additional research to assess implementation feasibility of SMC within ordinary health system context. High level leaders also publicly contested the SMC evidence and the underlying values and messages - a situation that reduced the coalition of policy champions. Conclusions: This study shows that effective translation of PMTCT and SMC research results demanded a 360 degree approach to assembling additional evidence to inform the implementation feasibility for these two HIV prevention interventions. MakCHS and similar institutions should prioritize implementation research to guide the policy processes about the feasibility of implementing new and effective innovations (e.g. PMTCT or SMC) at a large scale in contexts that may be different from the research environments.
AB - Background: Research and evidence can have an impact on policy and practice, resulting in positive outcomes. However, research translation is a complex, dynamic and non-linear process. Although universities in Africa play a major role in generating research evidence, their strategic approaches to influence health policies and decision making are weak. This study was conducted with the aim of understanding the process of translating research into policy in order to guide the strategic direction of Makerere University College of Health Sciences (MakCHS) and similar institutions in their quest to influence health outcomes nationally and globally. Methods. A case study approach using 30 in-depth interviews with stakeholders involved in two HIV prevention research project was purposively selected. The study sought to analyze the research-to-policy discourses for the prevention of mother-to-child transmission (PMTCT) and safe male circumcision (SMC). The analysis sought to identify entry points, strengths and challenges for research-to-policy processes by interviewing three major groups of stakeholders in Uganda - researchers (8), policy makers (12) and media practitioners (12). Results: Among the factors that facilitated PMTCT policy uptake and continued implementation were: shared platforms for learning and decision making among stakeholders, implementation pilots to assess feasibility of intervention, the emerging of agencies to undertake operations research and the high visibility of policy benefits to child survival. In contrast, SMC policy processes were stalled for over two years after the findings of the Uganda study was made public. Among other factors, policy makers demanded additional research to assess implementation feasibility of SMC within ordinary health system context. High level leaders also publicly contested the SMC evidence and the underlying values and messages - a situation that reduced the coalition of policy champions. Conclusions: This study shows that effective translation of PMTCT and SMC research results demanded a 360 degree approach to assembling additional evidence to inform the implementation feasibility for these two HIV prevention interventions. MakCHS and similar institutions should prioritize implementation research to guide the policy processes about the feasibility of implementing new and effective innovations (e.g. PMTCT or SMC) at a large scale in contexts that may be different from the research environments.
UR - http://www.scopus.com/inward/record.url?scp=79952508555&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952508555&partnerID=8YFLogxK
U2 - 10.1186/1472-698X-11-S1-S13
DO - 10.1186/1472-698X-11-S1-S13
M3 - Article
C2 - 21411000
AN - SCOPUS:79952508555
SN - 1471-2458
VL - 11
JO - BMC International Health and Human Rights
JF - BMC International Health and Human Rights
IS - SUPPL. 1
M1 - S13
ER -