Assessment of the barriers & capacity gaps for evidence use in health decision-making in Kenya

1. Assessment of the barriers & capacity gaps for evidence use in health decision-making in Kenya April 15, 2013 Rose N. Oronje AFIDEP 1

2. Overview Aim of Assessment Methods Findings: Major Barriers to Evidence use Findings: Priority Areas for Intervention Conclusions Support for the Programme

3. Aim of Assessment • Assess barriers to research evidence use within ministry of health & legislature: • Capacity gaps – top & mid-level policymakers • Opportunity for interventions

4. Methods Key informant interviews with top & mid-level policymakers Purposive sampling 4 top & 4 mid-level policymakers interviewed Analysis: Themes derived from interview data

5. Findings: Barriers to Evidence Use • Poor reading/research culture • Underlying problem • Lack of top leadership for evidence utilisation • Poor research culture • Poor understanding of research • Lack of support for transparency & accountability • Translated to low priority for activities & mechanisms that support evidence utilisation

6. Findings: Barriers to Evidence Use • Weak technical capacity to acquire, assess, synthesize, adapt & utilise research evidence • Identify & define research questions • Conduct critical appraisal of lit. to assess credibility & relevance/suitability • Conduct critical analyses & syntheses of different kinds of evidence & adapt these to local context/needs • Effectively package & communicate research evidence in clear & concise manner

7. Findings: Barriers to Evidence Use • Lack of institutional capacity & support systems for evidence use • Often library not well-equipped, no journals • Unreliable Internet access • HIMS est’d but ineffective • Lack of supportive institutional policies & guidelines • Lack of incentives for evidence use • Routine data & res. evidence not used

8. Findings: Barriers to Evidence Use • Lack of meaningful networking mechanisms between policymakers & researchers • No formal mechanism dedicated to the discussion of new res. evidence • On & off linkages btn policymakers & researchers • Health ministry lacks a clearly defined Research Agenda • Although some dep’ts have own res. agenda • Ministry too medical, too technical

9. Findings: Priority Areas for Intervention Demystify research Generate top level commitment to research evidence utilisation Cultivate research champions Strengthen staff’s technical skills

10. Findings: Priority Areas for Intervention • Institutionalize incentive mechanisms • Strengthen mechanisms within the ministry for promoting & supporting evidence use • Advocating for prioritization of key res. dep’ts • Strengthening skills in key res. dep’ts • Addressing HIMS challenges

11. Findings: Priority Areas for Intervention • Establish sustained networking mechanisms between policymakers & researchers • Research TWG at ministry-level

12. Conclusions • Two main factors interact to hinder the use of research evidence • Lack of top-level leadership • Weak technical & institutional capacity • Interventions should target these two • Variations in levels of priority & capacity • Between MoH & legislature • Between departments in MoH

13. Support for Programme • All the respondents indicated that they would be supportive of an initiative that seeks to generate top-level commitment, as well as, strengthen capacity for evidence use • Head of Policy Planning department, MoH, indicated that he would be willing to provide a support letter for the proposed programme • But this will only be possible once Kenya’s new gov’t is in place