Open Access Research article

Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda

Juliet Nabyonga Orem1*, David Kaawa Mafigiri2, Bruno Marchal3, Freddie Ssengooba4, Jean Macq5 and Bart Criel3

Author Affiliations

1 WHO Uganda office, Health systems and services cluster, P. O. Box 24578, Kampala, Uganda

2 Makerere University School of Social Sciences, P.O Box 7072, Kampala, Uganda

3 Institute of Tropical Medicine Antwerp-Belgium, Nationalestraat 155, 2000 Antwerp, Belgium

4 School of Public Health, Makerere University, P.O. Box. 7072, Kampala, Uganda

5 Université Catholique de Louvain, Boite 3058; Clos Chapelle aux champs, 30, 1200 Bruxelles, Belgium

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BMC Public Health 2012, 12:109  doi:10.1186/1471-2458-12-109

Published: 9 February 2012

Abstract

Background

Use of evidence in health policymaking plays an important role, especially in resource-constrained settings where informed decisions on resource allocation are paramount. Several knowledge translation (KT) models have been developed, but few have been applied to health policymaking in low income countries. If KT models are expected to explain evidence uptake and implementation, or lack of it, they must be contextualized and take into account the specificity of low income countries for example, the strong influence of donors. The main objective of this research is to elaborate a Middle Range Theory (MRT) of KT in Uganda that can also serve as a reference for other low- and middle income countries.

Methods

This two-step study employed qualitative approaches to examine the principal barriers and facilitating factors to KT. Step 1 involved a literature review and identification of common themes. The results informed the development of the initial MRT, which details the facilitating factors and barriers to KT at the different stages of research and policy development. In Step 2, these were further refined through key informant interviews with policymakers and researchers in Uganda. Deductive content and thematic analysis was carried out to assess the degree of convergence with the elements of the initial MRT and to identify other emerging issues.

Results

Review of the literature revealed that the most common emerging facilitating factors could be grouped under institutional strengthening for KT, research characteristics, dissemination, partnerships and political context. The analysis of interviews, however, showed that policymakers and researchers ranked institutional strengthening for KT, research characteristics and partnerships as the most important. New factors emphasized by respondents were the use of mainstreamed structures within MoH to coordinate and disseminate research, the separation of roles between researchers and policymakers, and the role of the community and civil society in KT.

Conclusions

This study refined an initial MRT on KT in policymaking in the health sector in Uganda that was based on a literature review. It provides a framework that can be used in empirical research of the process of KT on specific policy issues.

Keywords:
Research; Policy; Practice; Implementation gap; Uganda; Low income countries