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Getting health research into policy and practice: Approaches, opinions and incentives

By 12/08/2011

Most researchers and communication specialists who work on international health are passionate about their work and about making a difference and improving health and health care. Such a vision can be enshrined in institutional mission statements.

For example, the Liverpool School of Tropical Medicine (where I work as a senior lecturer) has a mission statement that highlights the importance of promoting ‘improved health, particularly for people of the less developed countries in the tropics and sub-tropics’.

Donors are also clearly concerned about ensuring the research they fund has impact and does not simply gather dust on library shelves. Research proposals increasingly need a clear impact section, and these really matter in whether grants are won or not. For example the impact section accounts for a third   of the marks for EU research proposals. A new Supplement of Health Research Policy and Systems, which I co-edited, explored the process of getting research into policy and practice, and provides useful learning for researchers grappling with research communications and the impact of their research.

Content, focus, mindset

We (myself and Joanna Crichton) conducted qualitative in-depth interviews with 22 researchers and communication specialists who work on HIV and SRH in Africa and Asia, seeStrategies and tensions in communicating research on sexual and reproductive health, HIV and AIDS: a qualitative study of the experiences of researchers and communications staff. We asked people about their views on research engagement and how this relates to topic area and context, what they thought worked well and why and where the challenges lie. Doing the interviews was a real pleasure and we both learnt a lot. Our interviewees were reflective and soul searching in their responses – clearly the why and how of engaging different stakeholders in the research endeavour to try to maximise impact took up a lot of time and energy. Joanna and I analysed research engagement in relation to the well known ODI RAPID framework and found:

  • Context is critical, and researchers and advocates within different country contexts often have in-depth knowledge of policy players and networks and know how to access them. They also have ideas on which arguments or ways of framing the messages are most likely to resonate best with different political parties or personalities.
  • Also important is the focus of research as this shapes research engagement strategies. In our analysis of the qualitative interviews we show how researchers may seek to extend mainstream issues, or highlight neglected issues (such as congenital syphilis) or reframe contested issues (such as entry points to discussing sexual debut or abortion).
  • The mind set or attitude of researchers matter. Joanna and I analysed researchers’ and advocates’ characteristics and actions and argue that who we are and how we act as researchers responds to the political and external contexts we work within, and shapes the networks and alliances we make and the ways in which we may chose to present and discuss our research findings.

So who we are as researchers, our mind sets and our motivations shape our research engagement strategies. We found this is shaped in part by discipline, some researchers saw opening doors and promoting change as part and parcel of their academic role, whereas others saw their role as providing good quality rigorous research that others could pick up and use and that they should not go further than this. For example one researcher commented that ‘A good academic is trained to […] state the […] cautions, the doubts, whereas those are fatal qualities for an advocate who has to simplify, dramatise, exaggerate.’

There is also scepticism amongst some academics about whether the experience of research uptake or communications is really appropriate for peer reviewed academic journals. This scepticism relates in part to the challenge of actually demonstrating impact from one specific piece of research, and the methodological conundrums this throws up.

What actually constitutes impact is also up for debate, and the papers in the supplement illustrate that there are a wide range of impacts that are important in SRH and HIV. These range from the more frequently discussed end product of research uptake, such as changing policies or laws (see Tulloch et al on Gender Based Violence in Ghana), to areas which are important but more challenging to measure or demonstrate such as changing discourse (see Rashid et al on opening up public spaces on representations on sexuality in Bangladesh), to raising awareness of research and capacity to understand it (see Oronje et al on developing partnerships with the media to encourage reporting on neglected SRH issues in Kenya; and Delany-Moretlwe et al on communicating results from an HIV trial to communities in South Africa).

Incentivising a focus on research uptake: Future trends

Scepticism and disciplinary leanings aside it is useful to consider the incentives in place in academia. Most of us are busy juggling teaching, admin, research, consultancy and family life and trying to keep a job in an increasingly competitive environment. In the qualitative interviews we conducted there was a clear sense that there were little academic brownie points to be gained from research engagement. But this might be set to change for academics in the UK. The Research Excellence Framework (REF), which assesses academic excellence, will take place in 2013 and is occupying all academics in the university system. The REF is important as it determines the levels of funding for university departments. A  key change from the 2008 Research Assessment Exercise (the predecessor of the REF) is the need to develop case studies on research impact as  highlighted in the guardian. This new focus on impact has brought criticisms such as increasing burden for academics and the possibility of privileging scientific subjects where impact might be easier to prove than in the humanities and social sciences. There may also be unintended consequences… might this possibly lead to research in less contested areas, where there is policy buy in and more possibility of showing impact? For example in SRH, will academics choose (operational) research on scaling up anti-retroviral therapy over abortion services?

Time will tell, but the academic incentives or brownie point landscape for considering impact is changing.

We are seeing increasing numbers of academic papers on the process and experiences of research engagement and impact from diverse fields. This supplement in the open access peer reviewed journal Health Research policy and Systems which has 14 papers on research uptake in Sexual Reproductive Health from Africa and Asia is part of this growing literature. My best guess is that this trend will continue and that critically researching research impact will become more mainstream.

Watch this space.

4 Responses to Getting health research into policy and practice: Approaches, opinions and incentives

  1. Avatar Rebecca Pointer says:

    Waves at Sally! Long time no see 🙂 Great article. My sense is that health research to policy is more advanced (effective?) than some other development sectors, e.g I’m now working in land reform/ agricultural sector and getting research ino policy is an uphill battle as the commercial farming sector seems to have more clout. Clearly we can learn some lessons from the health sector but to some extent I think the evidence of what works regarding health is more readily available e.g we know public health is more equitable. Equitable working land reform models on the other hand are not visible because globally no really good models. Similarly we know commercial agriculture doesn’t (can’t?) deliver global food security and eradicate hunger but we don’t have working models anywhere. IMO this context means while we can learn from health research to policy models other models might still be needed to tackle some other development issues – in my searches for info in other sectors the only other promising models I’ve seen are on getting global warming science into policy. Like health, this has more than just social science behind it – so I wonder to what extent you think presenting evidence as physical science (often viewed as unbiased) makes impact easier to negotiate than just having social science (often viewed as ideological) to back your inputs?

    Best wishes and regards
    Rebecca Pointer

  2. Avatar Emusungwini says:

    Thank you Sally and also believe that there is need for linking Research from Accademia with Operational Research. In this context a deliberate link between NGOs or CBOs and University and Research Centres should be explored. The accademia supports and utilises the rich experience of CBOs.

  3. Avatar Emusungwini says:

    Thank you Sally and also believe that there is need for linking Research from Accademia with Operational Research. In this context a deliberate link between NGOs or CBOs and University and Research Centres should be explored. The accademia supports and utilises the rich experience of CBOs.