Systematic Review: What are the effects of interventions to improve the uptake of evidence from health research into policy in low and middle-income countries?
This review aims to identify the barriers to the uptake of research evidence from intervention and non-intervention studies
Abstract
Background
The evidence-base for improving health continues to grow. However,
concerns remain that the translation of this evidence into appropriate
policies is partial and slow. Facilitating such translation is
particularly important in low and middle-income countries that bear a
disproportionate share of the global burden of ill-health.
Objectives
The primary objective of this review was to assess the effects of
interventions to improve the uptake of research into health policies in
low and middle-income countries. A secondary objective was to identify
the barriers and facilitators to the uptake of research evidence derived
from intervention and non-intervention studies.
Results
The final analysis included 25 intervention studies and 29
non-intervention studies describing barriers and facilitators to
evidence-uptake either from observations of policy-making processes or
from stakeholders' views. Most of the intervention studies were
descriptive case-studies with inadequate detail on methodology and
intervention design. The interventions were complex and many encompassed
the whole cycle of research, policy development and implementation. All
interventions had some positive effects in terms of policy-related
outcomes. The most frequently cited components of interventions
reporting positive effects on policy development included carrying out
local research (e.g. for contextualisation), ensuring intensive
stakeholder engagement and collaboration, including training and
capacity-building activities, and fostering community participation.
These elements were also identified in the non-intervention studies as
common factors in the analysis of barriers and facilitators to evidence
uptake. Few differences were seen between studies from low and
middle-income countries in terms of barriers and facilitators. However,
one important distinction cited was that low income countries tended to
depend more on the support of large multilateral organisations, and that
this dependence was also seen as a barrier to focussing on local
priorities.
Conclusions
Although the intervention studies from low and middle-income countries
included in this review were not of sufficient quality to provide strong
recommendations, the findings are broadly consistent with the findings
from high-income countries on the need for multi-faceted, tailored
interventions and on the importance of contextual influences,
particularly organisational. Effective interventions to increase uptake
of evidence are likely to be those tailored to the context and include
local research, extensive stakeholder engagement, and community
participation. High-quality comparative studies reporting on a range of
outcomes, with clear and comprehensive descriptions of methodology and
of context, are still needed to strengthen understanding on how to
improve uptake specifically in low and middle-income countries.
There is a protocol for this systematic review
Citation
University of Aberdeen, Aberdeen, UK, 107 pp.
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