Getting research into policy and practice

Experiences from sexual and reproductive health, HIV and AIDS

The true test of the effectiveness of health and development research is whether people use it – for decision-making, influencing, referencing, or most importantly, to bring about change.

Development actors are paying increasing attention to the question of how research, despite barriers, can fulfil its potential to improve policy and practice.

Researchers and communications experts are using innovative approaches to communicate their research but they do not often share their experiences and achievements. This issue of insights sets out to redress this, focusing on their experiences of working on sexual and reproductive health, HIV and AIDS globally. The articles are all based on case studies presented during a meeting at the Liverpool School of Tropical Medicine, in the UK, in May 2009.

Politics influences how open decision-makers are to using evidence-based research in formulating policy or making decisions. For example, in the field of sexual and reproductive health, social or religious attitudes and interest groups play a powerful role in politics and can encourage decision-makers to ignore new research evidence. The role of research in policy processes can also be hampered by weak capacity to assess and use research evidence or a lack of appreciation of how research can identify health problems and unmet needs, develop effective interventions, and improve the accessibility and targeting of services.

Trial and error
At the community level, Sinead Delany-Moretlwe describes how some trials achieved a positive impact even though the study did not find a genital herpes treatment drug, acyclovir, effective for preventing HIV. The process of engaging with different community groups throughout the trials increased the understanding of health research in communities where previously few people trusted biomedical research.

At the national level, Eleanor Hutchinson reveals how the same evidence on the effectiveness of Cotrimoxazole resulted in different kinds of uptake in Malawi and Zambia. This was because of the different policy processes in each country and the different roles that individual ‘champions’ of the policy and moments of opportunity can play in promoting the use of research evidence.

Building partnerships
Academics and research institutions will have different attributes that can help them influence policy and practice. The challenge is to identify opportunities and partnerships and use these to get people’s attention and persuade them that the research is important for their work.

Johnny Gyapong describes how the Research and Development Division, by being part of Ghana’s Ministry of Health, can play a critical role in policy development processes by participating in key fora. Others establish formal partnerships: Wambura Mwita and his colleagues in Tanzania helped create a Taskforce Committee and Technical Working Group that brought policymakers, researchers, donors and non-government organisations (NGOs) together to design policy on male circumcision.

Building relationships with individuals and establishing a personal touch can be crucial. Rose Oronje describes how the African Population and Health Research Center holds regular meetings and lunches for journalists, communications experts and researchers to build mutual understanding and stronger working relationships between the media and academia.

Talking things through
Sabina Rashid tells us how a BRAC workshop on sexuality raised awareness about the rights of homosexuals and transgendered people, marginalised in Bangladeshi society and neglected by policymakers. The workshop provided a platform to highlight their experiences, needs and rights, by bringing together diverse groups and creating a space for discussion, and by associating the workshop with the credibility and legitimacy that academics hold among key stakeholders in Bangladesh.

Strategic partnerships, writes Nana Ole Lithur, between researchers, legal activists and parliamentarians have helped develop and draw on different strengths to improve the law on gender-based violence in Ghana. Kate Hawkins discusses the diversity of organisations seeking to influence policy with research and the need to work with networks such as parliamentary committees and civil society coalitions to harmonise messages and communicate them through multiple channels.

The discussions at the Liverpool workshop showed that good influencing strategies are based on critical consideration of the specific policy context, the characteristics and purpose of a research project, and whether the research issue is neglected, contested or mainstreamed. Some researchers or communications staff are using policy analysis methods when developing their research strategies or tools for evaluating the impact of their research. There may be a need to bring policy analysis into the skills set of research and communication teams.

Donor pressure
The climate for policy processes and for research projects is constantly changing and researchers and communicators need to continually adapt their strategies in response to this, which of course takes energy and resources – human and financial. The current economic crisis has increased scrutiny of research impact as donors are under increasing pressure to justify their spending. Rapid shifts in policy such as the US administration’s stance on sexual and reproductive health provide opportunities and challenges that researchers and communication experts need to address.

Changing attitudes
Ensuring that research findings impact on policy and practice can be challenging and time-consuming. It requires careful consultation, negotiation and partnership building. Policy engagement is not just about communicating results. It is about communicating and building partnerships at all stages of the research process, during project design, fieldwork and analysis as well as at the end.

It can also be about contributing to longer-term social processes, such as changing attitudes to sexual rights. This takes time and energy but is a necessary investment: the growing attention on the research-to-policy-and-practice interface will continue to gather momentum. There is a need to continue to build the capacity of everyone involved – individuals and communities, policymakers, researchers, and intermediaries – to engage with research-to-policy processes and to increase the funding available to take this work forward and further share experiences of what works, what does not and why.

Jo Crichton and Sally Theobald

Sally Theobald
Senior Lecturer in Social Science and International Health
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
+44 (0) 151 7053197
sjt@liverpool.ac.uk
www.liv.ac.uk/lstm