Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches

Area of Science:

• Health Policy and Systems Research
• Implementation Science
• Global Health

Background:

• Growing global emphasis on evidence-informed health policymaking to enhance health system performance.
• Need for collaborative strategies to integrate research knowledge into real-world policy and practice.
• Implementation of multi-site, evidence-to-policy interventions in low-resource settings.

Purpose of the Study:

• To reflect on the implementation and impact of two distinct evidence-to-policy interventions.
• To assess the effectiveness of collaborative approaches in bridging the research-policy gap.
• To provide insights for developing and supporting future evidence-to-policy initiatives.

Main Methods:

• Intervention 1: Implementation research using communities of practice (CoP) in Mexico and Nicaragua for maternal health.
• Process evaluation of CoPs assessing stakeholder capacity to acquire, analyze, adapt, and apply research.
• Intervention 2: Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES) in South Africa and Cameroon, using a 'buddying' process for systematic review use.
• Realist evaluation of the Policy BUDDIES initiative.

Main Results:

• CoP-supported research in Mexico led to local health organizations monitoring maternal healthcare quality.
• Professionals in Mexico and Nicaragua reported enhanced capacity to identify and use evidence for implementation challenges.
• Policy BUDDIES in South Africa informed a policy framework for chronic disease medication adherence.
• Policymakers in Policy BUDDIES reported increased recognition of research value and demand for policy-relevant knowledge.

Conclusions:

• Collaborative evidence-to-policy approaches require iterative engagement and continuity between researchers and policymakers.
• Fit-for-purpose strategies are crucial, adapting processes and knowledge to different policymaking cycle needs.
• Approaches embedding research use in real-world policymaking are better suited to complex, adaptive health systems.