Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on Infectious Diseases of Poverty in Nigeria

Document Type : Original Article

Authors

1 Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria

2 Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria

3 Department of Banking & Finance, Ebonyi State University, Abakaliki, Nigeria

4 National Obstetrics Fistula Centre, Abakaliki, Nigeria

5 Department of Paediatrics, Ebonyi State University, Abakaliki, Nigeria

6 Department of Applied Microbiology, Ebonyi State University, Abakaliki, Nigeria

7 Department of Sociology/Anthropology, Ebonyi State University, Abakaliki, Nigeria

8 Catholic Relief Services (Nigeria Program), Abakaliki, Nigeria

Abstract

Background
The lack of effective use of research evidence in policy-making is a major challenge in most low- and middle-income countries (LMICs). There is need to package research data into effective policy tools that will help policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP). The objective of this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian health policy-makers to develop evidence-informed policy brief on the control of IDP.
 
Methods
A modified “before and after” intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the degree of adequacy; 1 = “grossly inadequate,” 4 = “very adequate” was employed. The main parameter measured was participants’ perceptions of their own knowledge/understanding. This study was conducted at subnational level and the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A oneday evidence-to-policy workshop was organized to enhance the participants’ capacity to develop evidence-informed policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy briefs; policy dialogue; ethics in health policy-making; and health policy and politics.
 
Results
The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean ranged from 3.42–3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 20.10%–45%. Participants were divided into 3 IDP mentorship groups (malaria, schistosomiasis, lymphatic filariasis [LF]) and were mentored to identify potential policy options/recommendations for control of the diseases for the policy briefs. These policy options were subjected to research evidence synthesis by each group to identify the options that have the support of research evidence (mostly systematic reviews) from PubMed, Cochrane database and Google Scholar. After the evidence synthesis, five policy options were selected out of 13 for malaria, 3 out of 10 for schistosomiasis and 5 out of 11 for LF.
 
Conclusion
The outcome suggests that an evidence-to-policy capacity enhancement workshop combined with a mentorship programme can improve policy-makers’ capacity for evidence-informed policy-making (EIP).

Keywords

Main Subjects

References

  1. Deans F, Ademokun A. Investigating capacity to use evidence. International Network for the Availability of Scientific Publications (INASP). http://www.inasp.info/uploads/filer_public/2013/07/04/investigating_capacity_to_use_evidence.pdf. Accessed February 14, 2015.
  2. Oxman AD, Lavis JN, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 1: What is evidence-informed policymaking? Health Res Policy Syst. 2009;7 Suppl 1:S1. doi:10.1186/1478-4505-7-s1-s1
  3. Bowen S, Zwi AB. Pathways to “evidence-informed” policy and practice: a framework for action. PLoS Med. 2005;2(7):e166. doi:10.1371/journal.pmed.0020166
  4. Campbell DM, Redman S, Jorm L, Cooke M, Zwi AB, Rychetnik L. Increasing the use of evidence in health policy: practice and views of policy makers and researchers. Aust New Zealand Health Policy. 2009;6:21. doi:10.1371/journal.pmed.0020166
  5. Dobrow MJ, Goel V, Upshur RE. Evidence-based health policy: context and utilisation. Soc Sci Med. 2004;58:207-217. doi:10.1016/s0277-9536(03)00166-7
  6. Hanney SR, Gonzalez-Block MA, Buxton MJ, Kogan M. The utilization of health research in policy-making: concepts, examples and methods of assessment. Health Res Policy Syst. 2003;1:2-29.
  7. Innvær S, Vist G, Trommald M, Oxman A. Health policy-makers perceptions of their use of evidence: a systematic review. J Health Serv Res Policy. 2002;7:239-244. doi:10.1258/135581902320432778
  8. Oxman AD, Lavis JN, Fretheim A. The use of evidence in WHO recommendations. Lancet 2007;369:1883-1889. doi:10.1016/s0140-6736(07)60675-8
  9. Lavis JN, Davies HT, Oxman A, Denis JL, Golden-Biddle K, Ferlie E. Towards systematic reviews that inform healthcare management and policymaking. J Health Serv Res Policy. 2005;10:35-48.
  10. Lavis JN, Ross SE, Hurley JE, et al. Examining the role of health services research in public policymaking. Milbank Q. 2002;80:125-154.
  11. Moat KA, Lavis JN, Clancy SJ, El-Jardali F, Pantoja T. Evidence briefs and deliberative dialogues: perceptions and intentions to act on what was learnt. Bull World Health Organ. 2014;92(1):20-28. doi:10.2471/blt.12.116806
  12. El-Jardali F, Lavis J, Moat K, Pantoja T, Ataya N. Capturing lessons learned from evidence-to-policy initiatives through structured reflection. Health Res Policy Syst. 2014;12:2. doi:10.1186/1478-4505-12-2
  13. Lavis JN, Panisset U. EVIPNet Africa’s first series of policy briefs to support evidence-informed policymaking. Int J Tech Assess Health Care. 2010;26(02):229-232.
  14. World Health Organization (WHO). World Health Organization 2012: Global Report for Research on Infectious Diseases of Poverty. http://whqlibdoc.who.int/publications/2012/9789241564489_eng.pdf. Accessed February 14, 2015.
  15. World Health Organization (WHO). World Malaria Report 2014. Geneva: Switzerland; 2014:242.
  16. Okorie PN, Ademowo GO, Saka Y, et al. Lymphatic filariasis in Nigeria; Micro-stratification Overlap Mapping (MOM) as a prerequisite for cost-effective resource utilization in control and surveillance. PLoS Negl Trop Dis. 2013;7(9):e2416. doi:10.1371/journal.pntd.0002416
  17. World Health Organization (WHO). Global programme to eliminate lymphatic filariasis: progress report. Wkly Epidemiol Rec. 2011;87:346-356.
  18. Hotez PJ, Asojo OA, Adesina AM. Nigeria: ‘‘Ground Zero’’ for the High Prevalence Neglected Tropical Diseases. PLoS Negl Trop Dis. 2012;6:e1600. doi:10.1371/journal.pntd.0001600
  19. Adenowo AF, Oyinloye BE, Ogunyinka BI, Kappo AP. Impact of human schistosomiasis in sub-Saharan Africa. Braz J Infect Dis. 2015;19(2):196-205. doi:10.1016/j.bjid.2014.11.004
  20. Adam T, Moat KA, Ghaffar A, Lavis JN. Towards a better understanding of the nomenclature used in information-packaging efforts to support evidence-informed policymaking in low- and middle-income countries. Implement Sci. 2014;9:67. doi:10.1186/1748-5908-9-67
  21. Lavis JN. How can we support the use of systematic reviews in policymaking? PloS Med. 2009;6(11):e1000141. doi:10.1371/journal. pmed.1000141
  22. Rosenbaum SE, Glenton C, Wiysonge CS, et al. Evidence summaries tailored to health policy-makers in low- and middle-income countries. Bull World Health Organ. 2011;89(1):54-61.
  23. Lavis JN, Lomas J, Harnid M, Sewankambo NK. Assessing country-level efforts to link research to action. Bull World Health Organ. 2006;84:620-628.
  24. Feldman PH, Nadash P, Gursen M. Improving communication between researchers and policy makers in long-term care or “researchers are from Mars; policy makers are from Venus”. Policy Brief (Cent Home Care Policy Res). 2001;(5):1-6. doi:10.1093/geront/41.3.312
  25. Coburn A. The role of health services research in developing state health policy. Health Affairs. 1998;17(1):139-151. doi:10.1377/hlthaff.17.1.139
  26. Lomas J. Using “linkage and exchange” to move research into policy at a Canadian foundation. Health Affairs 2000;19:236-240.
  27. Roos NL, Shapiro E. From research to policy: What have we learned? Med Care. 1999;37:JS291-JS305.
  28. Lavis JN, Permanand G, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Res Policy Syst. 2009;16;7(suppl 1):S13. doi:10.1186/1478-4505-7-S1-S13
  29. Brownson RC, Dodson EA,Stamatakis KA, et al.Communicating evidence-based information on cancer prevention to state-level policy makers. J Natl Cancer Inst. 2011; 103(4):306-316. doi:10.1093/jnci/djq529
  30. International Development Research Centre, Swiss Agency for Development and Cooperation. Chapter 8: The Two-Pager: Writing a policy brief. In: The RM Knowledge Translation Toolkit: A Resource for Researchers. Ottawa, Canada: IDRC and SADC; 2008.
  31. Stamatakis K, McBride T, Brownson R. Communicating prevention messages to policy makers: the role of stories in promoting physical activity. J Phys Act Health. 2010;7(suppl 1):S99-S107.
  32. Green A, Bennett S, eds. Sound choices: enhancing capacity for evidence-informed health policy. Geneva: World Health Organization; 2007.
  33. DeMarco R, Tufts KA. The mechanics of writing a policy brief. Nurs Outlook. 2014;62(3):219-224. doi:10.1016/j.outlook.2014.04.002
  34. Jones JA. Political science? strengthening science-policy dialogue in developing countries. London: ODI; 2008.
  35. The SURE Collaboration. SURE Guides for Preparing and Using Evidence-Based Policy Briefs: 1. Getting started. Version 2.1. http://global.evipnet.org/sure/. Published 2011. Updated November 2011.
  36. Purdon S, Lessof C, Woodfield K, Bryson C. Research methods for policy evaluation. National Centre for Social Research. http://www.academia.edu/1967742/Research_methods_for_policy_evaluation. Published 2001. Accessed  February 14, 2015.
  37. Bammer G, Strazdins L, McDonald D, et al. Expanding the deliberations about the research-policy gap: useful lessons from the literature. In: Bammer G, Michaux A, Sanson A, eds. Bridging the ‘know-do’ gap: Knowledge brokering to improve child wellbeing. Canberra, Australia: ANU E-Press; 2010:135-155.
  38. Canadian Coalition for Global Health Research (CCGHR). Module Three: Why Mentorship? http://www.ccghr.ca/wp-content/uploads/2013/05/Mentoring_Module3_Why-Mentorship_e.pdf. Published 2001. Accessed February 14, 2015.
  39. Johnson NA, Lavis JN. Procedures Manual for the ‘Evaluating Knowledge Translation Platforms in Low- and Middle-Income Countries’ Study. Hamilton, Canada: McMaster University Program in Policy Decision-Making; 2009.
  40. Tusting LS, Thwing J, Sinclair D, et al. Mosquito larval source management for controlling malaria. Cochrane Database Syst Rev. 2013;8:CD008923. doi: 10.1002/14651858.CD008923.pub2
  41. Gamble CL, Ekwaru JP, ter Kuile FO. Insecticide-treated nets for preventing malaria in pregnancy. Cochrane Database Syst Rev 2006;2:CD003755. doi:10.1002/14651858.CD003755.pub2
  42. Poirot E, Skarbinski J, Sinclair D, Kachur SP, Slutsker L, Hwang J. Mass drug administration for malaria. Cochrane Database Syst Rev 2013;12:CD008846. doi:10.1002/14651858.CD008846.pub2
  43. Odaga J, Sinclair D, Lokong JA, Donegan S, Hopkins H, Garner P. Rapid diagnostic tests versus clinical diagnosis for managing people with fever in malaria endemic settings. Cochrane Database Syst Rev 2014;4:CD008998. doi:10.1002/14651858.CD008998.pub2
  44. Abuya TO, Mutemi W, Karisa B, Ochola SA, Fegan G, Marsh V. Use of over-the-counter malaria medicines in children and adults in three districts in Kenya: implications for private medicine retailer interventions. Malar J 2007;6:57. doi:10.1186/1475-2875-6-57
  45. Ogbonna A, Uneke CJ. Artemisinin-based combination therapy for uncomplicated malaria in sub-Saharan Africa: the efficacy, safety, resistance and policy implementation since Abuja 2000. Trans R Soc Trop Med Hyg. 2008;102(7):621-627.
  46. Amoa Onguéné P, Ntie-Kang F, Lifongo LL, Ndom JC, Sippl W, Mbaze LM. The potential of anti-malarial compounds derived from African medicinal plants. Part I: A pharmacological evaluation of alkaloids and terpenoids. Malar J 2013;12:449. doi:10.1186/1475-2875-12-449
  47. Pluess B, Tanser FC, Lengeler C, Sharp BL. Indoor residual spraying for preventing malaria. Cochrane Database Syst Rev 2010;4:CD006657. doi:10.1002/14651858.CD006657.pub2
  48. Yuan Y, Xu XJ, Dong HF, Jiang MS, Zhu HG. Transmission control of schistosomiasis japonica: implementation and evaluation of different snail control interventions Acta Trop. 2005;96(2–3):191-197.
  49. Hu GH, Hu J, Song KY, et al. The role of health education and health promotion in the control of schistosomiasis: experiences from a 12-year intervention study in the Poyang Lake area. Acta Trop. 2005;96(2-3):232-241. 
  50. Su J, Lu DB, Zhou X, Wang SR, Zhuge HX. Control efficacy of annual community-wide treatment against Schistosoma japonicum in China: a meta-analysis. PLoS One. 2013;8(11):e78509. doi:10.1371/journal.pone.0078509
  51. Weil GJ, Ramzy RM. Diagnostic tools for filariasis elimination programs. Trends Parasitol. 2007;23(2):78-82.
  52. Bockarie MJ, Pedersen EM, White GB, Michael E. Role of Vector Control in the Global Program to Eliminate Lymphatic Filariasis. Annu Rev Entomol. 2009;54:469-87. doi:10.1146/annurev.ento.54.110807.090626
  53. Nandha B, Krishnamoorthy K. School-based health education campaign--a potential tool for social mobilization to promote the use of DEC-fortified salt towards elimination of lymphatic filariasis. Health Educ Res. 2007;22(4):539-546.
  54. Blackburn BG, Eigege A, Gotau H, et al. Successful integration of insecticide-treated bed net distribution with mass drug administration in Central Nigeria. Am J Trop Med Hyg.2006;75(4):650-655.
  55. Hopkins DR, Eigege A, Miri ES, et al. Lymphatic  filariasis elimination and schistosomiasis control in combination with onchocerciasis control  in Nigeria. Am J Trop Med Hyg. 2002;67(3):266-272.
  56. Molyneux DH. Filaria control and elimination: diagnostic, monitoring and surveillance needs. Trans R Soc Trop Med Hyg. 2009;103(4):338-341. doi:10.1016/j.trstmh.2008.12.016
  57. Healthcare for all (HIFA). CHILD2015 Summary: Are workshops effective? http://www.hifa2015.org/wp-content/uploads/2008/09/training_workshops_are_they_effective.pdf. Published 2008. Accessed February 14, 2015.
  58. Poulos RG, Zwi AB, Lord SR. Towards enhancing national capacity for evidence informed policy and practice in falls management: a role for a “Translation Task Group”? Aust New Zealand Health Policy. 2007;31:4:6. doi:10.1186/1743-8462-4-6
  59. Bennett S, Paina L, Kim C, et al. What must be done to enhance capacity for Health Systems Research? Background paper for the global symposium on health systems research 16-19 November 2010, Montreux, Switzerland.
  60. Prewitt K. Winning the policy wars. London, UK: Global Public Policy Network, London school of economics and political sciences; 2006.
  61. Overseas Development Institute (ODI). Bridging research and policy in international development: an analytical and practical framework. Research and Policy in Development Programme Briefing Paper No. 1. London: Overseas Development Institute; 2004.
  62. Aarons DE. Issues in bioethics: ethics in health policy and guidelines in healthcare. West Indian Med J.  2006;55(2):113-119.
  63. World Health Organization (WHO). Knowledge Translation on Ageing and Health: A Framework for Policy Development.  Geneva, Switzerland: WHO; 2012
  64. Sheldon TA. Making evidence synthesis more useful for management and policy-making. J Health Serv Res Policy. 2005;10(suppl 1):1-5.
  65. Alliance for Health Policy and Systems Research (AHPSR). Sound choices: enhancing capacity for evidence-informed health policy. Geneva: World Health Organization; 2007.
  66. Uneke CJ, Ezeoha AE, Ndukwe CD, Oyibo PG, Onwe F. Promotion of evidence-informed health policymaking in Nigeria: bridging the gap between researchers and policymakers. Global Public Health 2012;7(7):750-765. 
  67. Anand K, Baridalyne N, Moorthy D, Kapoor SK, Sankar R, Pandav CS. Ethical issues in public health policy. Natl Med J India.  2002;15(2):97-100.
  68. Hyder AA,  Merritt M, Ali J, Tran NT, Subramaniam K, Akhtar T. Integrating  ethics,  health policy and health systems in low- and middle-income countries: case studies  from  Malaysia  and Pakistan. Bull World Health Organ. 2008;86(8):606-611. 
  69. Haahr JH, Shapiro H, Sorensen S, et al. Defining a Strategy for the Direct Assessment of Skills. Brussels, Belgium: European Commission, Directorate General for Education and Culture; 2004:141.

Files

History

  • Receive Date: 19 February 2015
  • Revise Date: 02 May 2015
  • Accept Date: 16 May 2015
  • First Publish Date: 01 September 2015

Share

How to cite

Statistics