An Assessment of National Maternal and Child Health Policy-Makers’ Knowledge and Capacity for Evidence-Informed Policy-Making in Nigeria

Document Type: Original Article

Authors

1 Knowledge Translation Platform, African Institute for Health Policy and Health Systems Studies, Ebonyi State University, Abakaliki, Nigeria

2 Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso

3 Hopital Central Yaounde, Yaoundé, Cameroon

Abstract

Background
There is increasing interest globally in the use of more rigorous processes to ensure that maternal, newborn, and child health (MNCH) care recommendations are informed by the best available research evidence use. The purpose of this study was to engage Nigerian MNCH policy-makers and other stakeholders to consider issues around research to policy and practice interface and to assess their existing knowledge and capacity on the use of research evidence for policy-making and practice.
 
Methods
The study design is a cross-sectional evaluation of MNCH stakeholders’ knowledge as it pertains different dimensions of research to practice. This was undertaken during a national MNCH stakeholders’ engagement event convened under the auspices of the West African Health Organization (WAHO) and the Federal Ministry of Health (FMoH) in Abuja, Nigeria. A questionnaire was administered to participants, which was designed to assess participants’ knowledge, capacity and organizational process of generation, synthesis and utilization of research evidence in policy-making regarding MNCH.
 
Results
A total of 40 participants signed the informed consent form and completed the questionnaire. The mean ratings (MNRs) of participants’ knowledge of electronic databases and capacity to identify and obtain relevant research evidence from electronic databases ranged from 3.62-3.68 on the scale of 5. The MNRs of participants’ level of understanding of a policy brief, a policy dialogue and the role of researchers in policy-making ranged from 3.50-3.86. The MNRs of participants’ level of understanding of evidence in policy-making context, types and sources of evidence, capacity to identify, select, adapt, and transform relevant evidence into policy ranged from 3.63-4.08. The MNRs of the participants’ organization’s capacity to cover their geographical areas of operation were generally low ranging from 3.32-3.38 in terms of manpower, logistics, facilities, and external support. The lowest MNR of 2.66 was recorded in funding.
 
Conclusion
The outcomes of this study suggest that a stakeholders’ engagement event can serve as an important platform to assess policy-makers’ knowledge and capacity for evidence-informed policy-making and for the promotion of evidence use in the policy process.

Keywords

Main Subjects


  1. Gonzalez-Block MA. Health policy and systems research agendas in developing countries. Health Res Policy Syst. 2004;2:6. doi:10.1186/1478-4505-2-6
  2. World Health Organization (WHO). Everybody’s business: strengthening health systems to improve health outcomes. WHO’s Framework for Action. Geneva: Who; 2007
  3. Innvaer 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(4):239-244. doi:10.1258/135581902320432778
  4. 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. doi:10.1186/1478-4505-1-2
  5. Dobrow MJ, Goel V, Upshur RE. Evidence-based health policy: context and utilization. Soc Sci Med. 2004;58(1):207-217. doi:10.1016/s0277-9536(03)00166-7
  6. 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:10.1186/1743-8462-6-21
  7. World Health Organization (WHO). World Report on Knowledge for Better Health-Strengthening Health Systems. Geneva: WHO; 2004.
  8. Alliance for Health Policy and Systems Research (AHPSR). Briefing Note Number 1: What Is Health Policy and Systems Research and Why Does It Matter? Geneva: World Health Organization; 2007.
  9. Federal Ministry of Health (FMoH). National Health Management Information System policy document. Abuja, Nigeria: FMoH; 2006.
  10. Nigeria Evidence-based Health System Initiative (NEHSI). Project implementation plan November 2007 – March 2013. https://www.idrc.ca/sites/default/files/sp/Documents%20EN/NEHSI-process-document.pdf. Accessed May 21, 2016.
  11. Nigeria Evidence-based Health System Initiative (NEHSI). Overview of the project. https://www.idrc.ca/sites/default/files/sp/Documents%20EN/NEHSI-Update-English.pdf. Accessed May 21, 2016. Published 2007.
  12. Kana MA, Doctor HV, Peleteiro B, Lunet N, Barros H. Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014. BMC PublicHealth. 2015;15:334. doi:10.1186/s12889-015-1688-3
  13. Inter-agency Group for Child Mortality Estimation (IGME). Levels and Trends in child mortality. http://www.who.int/maternal_child_adolescent/documents/levels_trends_child_mortality_2012.pdf. Accessed July 31, 2016. Published 2012.
  14. Fawole AO, Shah A, Tongo O, et al. Determinants of perinatal mortality in Nigeria. Int J Gynaecol Obstet. 2011;114(1):37-42. doi:10.1016/j.ijgo.2011.01.013
  15. Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2014;14:521. doi:10.1186/1471-2458-14-521
  16. Federal Ministry of Health (FMoH). Integrated Maternal, Newborn and Child Health Strategy. Abuja: FMoH; 2007.
  17. United States Agency for International Development (USAID). Working Toward the Goal of Reducing Maternal and Child Mortality: USAID Programming and Response. Washington, DC; 2008. http://pdf.usaid.gov/pdf_docs/PDACL707.pdf. Accessed July 31, 2016.
  18. Galandanci H, Ejembi C, Iliyasu Z, Alagh B, Umar U. Maternal health in Northern Nigeria— a far cry from ideal. BJOG. 2007;114:448-452. doi:10.1111/j.1471-0528.2007.01229.x
  19. Ebonyi State Mother and Child Care Initiative (MCCI) Nigeria. Documentation commissioned by The United Nations Population Fund (UNFPA). Final Report, October 2010.
  20. Federal Ministry of Health (FMoH). The Maternal Newborn Roadmap. Abuja: FMoH; 2005.
  21. Garba AM, Bandali S. The Nigeria independent accountability mechanism for maternal, newborn, and child health. Int J Gynaecol Obstet. 2014;127(1):113-116. doi:10.1016/j.ijgo.2014.07.004
  22. Uneke CJ, Ezeoha A, Ndukwe CD, Oyibo PG, Onwe F. Development of health policy and systems research in nigeria: lessons for developing countries’ evidence-based health policy making process and practice. Healthc Policy. 2010;6(1):48-65.
  23. Uneke CJ, Ezeoha A, Ndukwe CD, et al. Individual and organisational capacity for evidence use in policy making in Nigeria: an exploratory study of the perceptions of Nigeria health policy makers. Evidence Policy. 2011;7(3):251-276. doi:10.1332/174426411x591744
  24. Uneke CJ, Ezeoha AE, Ndukwe CD, Oyibo PG, Onwe F, Ogbonna A. Assessment of organizational capacity for evidence-based health systems operations in Nigeria. Soc Work Public Health. 2013;28(2):97-108. doi:10.1080/19371918.2011.555639
  25. Dawad S, Veenstra N. Comparative health systems research in a context of HIV/AIDS: lessons from a multi-country study in South Africa, Tanzania and Zambia. Health Res Policy Syst. 2007;5:3. doi:10.1186/1478-4505-5-13
  26. Green A, Bennett S, eds. Sound Choices: Enhancing Capacity for Evidence-Informed Health Policy. Geneva: World Health Organization; 2007
  27. Deans F, Ademokun A. Investigating capacity to use evidence. http://www.inasp.info/uploads/filer_public/2013/07/04/investigating_capacity_to_use_evidence.pdf. Accessed May 21, 2016.
  28. 28.   Canadian Health Services Research Foundation (CHSRF). Validating the Foundation’s Self-assessment tool: A summary. Ottawa, ON: CHSRF; 2008.
  29. 29.   González-Block MA, Mercado FJ, Ochoa H, Rivera H, Idrovo AJ. Research utilization by health managers: validating a self-assessment tool (Spanish). Salud Publica Mex. 2008;50(6):490-497.
  30. Kothari A, Edwards N, Hamel N, Judd M. Is research working for you? Validating a tool to examine the capacity of health organizations to use research. Implement Sci. 2009;4:46. doi:10.1186/1748-5908-4-46
  31. Thornhill J, Judd M, Clements D. CHSRF knowledge transfer: (re) introducing the self-assessment tool that is helping decision-makers assess their organization’s capacity to use research. Healthc Q. 2009;12(1):22-24.
  32. 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.
  33. Gathoni N, Godbolt S.  Working together to achieve HIFA 2015: a perspective from two HIFA 2015 supporting organisations. AHILA Congress. http://ecommons.aku.edu/cgi/viewcontent.cgi?article=1024&context=libraries.
  34. Nchinda TC. Research capacity strengthening in the South. Soc Sci Med. 2002;54:1699-1711.
  35. Hrynkow SH, Primack A, Bridbord K. Paradigms and Progress in Building Research Capacity in International Environmental Health. Int J Hyg Environ Health. 2003;206(4-5):413-422.
  36. Chetley A. Improving Health, Connecting People: the Role of ICTs in the Health Sector of Developing Countries. A Framework. Paper Working paper No. 7. https://www.infodev.org/infodev-files/resource/InfodevDocuments_84.pdf. Accessed May 21, 2016. Published 2006.
  37. Dzenowagis J. Bridging the digital divide: linking health and ICT policy. In: Wootton R, Patil NG, Scott RE, Ho K, eds. Telehealth in the Developing World. London, UK: Royal Society of Medical Press; 2009.
  38. United Nations Educational, Scientific and Cultural organization (UNESCO). Towards Knowledge Societies. Paris: UNESCO; 2005.
  39. Pablos-Mendez A, Chunharas S, Lansang MA, Shademani R, Tugwell P. Knowledge translation in global health. Bull World Health Organ. 2005;83(10):723.
  40. Haines A, Kuruvilla S, Borchert M. Bridging the implementation gap between knowledge and action for health. Bull World Health Organ. 2004;82:724-731.
  41. DeRoeck D. The importance of engaging policy-makers at the outset to guide research on and introduction of vaccines: the use of policy-maker surveys. Journal of Health Population & Nutrition 2004;22:322-330.
  42. Hargreaves S. Time to right the wrongs: improving basic health care in Nigeria. Lancet 2002;359(9322):2030. doi:10.1016/s0140-6736(02)08826-8
  43. Lavis JN, Posada FB, Haines A, Osei E. Use of research to inform public policymaking. Lancet. 2004;364:1615-1621. doi:10.1016/s0140-6736(04)17317-0
  44. Brownson RC, Royer C, Ewing R, McBride TD. Researchers and policymakers: travelers in parallel universes. Am J Prev Med. 2006;30(2):164-172.
  45. Haahr JH, Shapiro H, Sørensen S. Defining a Strategy for the Direct Assessment of Skills. Danish Technological Institute; 2004. http://www.pedz.uni-mannheim.de/daten/edz-b/gdbk/04/defining_strategy_final.pdf. Accessed July 30, 2016.