Beyond evidence: how actor dynamics and power shape knowledge translation for health policy in Kenya

Efforts to strengthen knowledge translation (KT) for policy-making often call for greater engagement with the policy process and its actors. Yet, existing KT approaches often focus on communication and dissemination of evidence and undertheorise the role and influence of policy actors on KT. As such, this study examines how, why, and to what effect policy actors shape KT. Our findings address a critical gap in the KT literature regarding the relational dimensions of KT for policy-making in low-middle-income countries. We utilised purposive and snowball sampling to identify participants who are involved in health policy-making and KT in Kenya. This included policy-makers, academics/researchers, knowledge intermediaries, and external partners (development and implementation partners). Data were collected through in-depth interviews (n = 32), observations (n = 52 h), and document reviews (n = 34). Data analysis was informed by a theoretical framework that combined perspectives from actor-centred institutionalism, Gaventa's PowerCube, boundary work, and coproduction. Our findings reveal how actor influence in KT is shaped by institutional mandates and roles, which, in turn, shape how actors perceive their position and authority in KT processes. While some actors viewed themselves as constrained to the role of evidence provision, others acted as boundary spanners across policy spaces, enabled by their institutional flexibility and financial resources. In addition, actor interests shaped when and how they exercised power to support or resist KT. Furthermore, access to policy spaces determined whose evidence was visible and perceived as legitimate, reflecting deeper power structures. These dynamics frame KT as a relational process mediated by political and institutional structures. As such, this study highlights the need to reconceptualise KT to integrate relational and structural dimensions, moving beyond evidence dissemination to addressing actor and power dynamics. It contributes novel insights into the interplay between actors, context, and power in shaping KT outcomes.