3.RAFORRC (RESEARCH ACTIVITIES FOR THE RIGHTS AND RESPONSIBILITIES OF CITIZENS)
(Getting Research into Policy and Practice GRIPP)
GRIPP is a process of going from research evidence to decisions and action. To integrate research findings into the policy making process and to communicate research findings to policymakers is a key challenge world-wide.
The results are represented in a model with the four GRIPP strategies found: i) stakeholders’ request for evidence to support the use of certain strategies or to scale up health interventions; ii) policymakers and stakeholders seeking evidence from researchers; iii) involving stakeholders in designing research objectives and throughout the research process; and iv) facilitating policy maker-researcher engagement in finding best ways of using research findings to influence policy and practice and to actively disseminate research findings to relevant stakeholders and policymakers.
The challenges to research utilization in health policy found were to address:
1.the capacity of policy makers to demand and to uptake research,
2. the communication gap between researchers, donors and policymakers,
3. the management of the political process of GRIPP,
4. the lack of willingness of some policy makers to use research,
5. the limited research funding and
6. the resistance to change.
Conclusions: Country based Health Policy and Systems Research groups can influence domestic policy makers if appropriate strategies are employed. The model presented gives some direction to potential strategies for getting research into policy and practice in the health care sector in Nigeria and elsewhere.
Misunderstandings between the evidence production and the policy-making effort have been identified:
- researchers and policy makers consider each other’s activity as generating products instead of engaging in processes;
- scientific research attempts to focus the question so that a clear and crisp answer can be provided whereas policy making takes other variables such as interests, ideology, values, or opinions into account.
- decision makers are not sensitive to the incentives that drive researchers like attracting grant money and publishing in peer-reviewed journals and not responding to a current issue before the government policy makers.
- researchers rarely take into account the different audiences that would be audiences for their research [20].
- policy makers rarely convey clear messages about the policy challenges they face in their specific context to allow for timely and appropriate research agendas
- researchers on the other hand often produce scientific evidence that is not always tailor-made for application in different contexts [21].
- centralized decision making
- a policy making culture that gives little importance to evidence based.
- lack of communication between researchers and policy makers,
- lack of involvement of policy makers and the community in determining the research to be done.
- Also, the research-to-policy linkages have been generally described as weak.
- lack of high-quality research,
- generally weak and unreliable research institutions and think tanks
- apparent disconnect between researchers and policymakers. There is little interaction between policymakers and researchers, thus meaningful discussion of available research findings, their suitability to policy-related problems, and identification of other policy areas requiring research attention is severely lacking.
- Research organizations serve a useful function of linking policy makers, yet the work of these organizations is sometimes not fully appreciated by policymakers either because researchers do not fully understand the policy process or do not know how to communicate effectively their research findings to policymakers.
Challenges to research utilization
1. Capacity to use HPSR
This is in terms of decision-makers demand for and uptake of HPSR; their research uptake skills and its practical implications for evidence-based policy making. It was noted that some decision makers lacked research uptake skills and in the word of a researcher. The quote below illustrates this:
“One of the problems of demanding evidence and uptake of results is that the policy makers hardly appreciate the importance of this and they simple lack the skills to do so. They don’t even know whom to turn to if they need information to underpin a policy decision …..hence there is need to train them on this”
(Researcher Lagos State)
This was further echoed by a policy maker: “if we are trained on a regular basis on the need to recognise when to ask for the results and how to interpret them, things will go on smoothly” (Policy maker Lagos State)
- Communication gap between researchers, donors and policymakers.
Communication gap between researchers, donors and policy makers seem to present a challenge to research utilization. In the words of one of the respondents:
“There is also a communication problem between the donors and the researchers because the donors want a particular thing to be researched which might not be the crux of the problem” (Researcher Lagos State)
- Managing the political process of GRIPP.
According to the respondents, if work is commissioned, then results need to be made available in a timely way. But if work is not commissioned it is pure luck if a study being done is relevant to the topic of focus and completed on time to influence a particular debate. Respondents captured this thus:
“I think researchers themselves need to be politically minded to know when to produce evidence and how to get it across to the users, given the various interests of policy makers and their disposition”. (HPRG Researcher).
“A researcher must have knowledge of the most pressing political and policy questions that they would need to make their research more relevant and be connected to the politicians and policy makers in one way or the other” (HPRG Researcher ).
- Lack of willingness of some policy makers to use research.
This is greatly influenced by the political context within country and not always easy to change. This is captured by a respondent
“I think the biggest problem is the resistance to change. This is because, we will do some surveys and you try to tell people that this is what we found in this survey and people will say no, no, this is how we have been doing it.” (Researcher 1 Enugu)
- Limited research funding and resistance to change
Limited research funding and resistance to change were some of the constraining factors offered by respondents which would affect GRIPP. This was captured by several quotes from the respondents. “..from the local point of view, governments of states are not always interested in research. In most cases little or no budgets are made for research. Even where there are fiscal releases they are hardly used for research”- (Researcher/stakeholder Enugu State) “Well when you look at the cost, at times the state will say these people who are proposing this are they going to fund it? Once they start like that, putting cost before effect, you know you are not going to get anywhere.”-(Policymaker, Enugu State)
Conclusions: With the right level of interaction between researchers and decision-makers, the translation of research findings into actionable policy and programmatic guidance is an achievable goal. Country HPSR groups can influence domestic policy makers if appropriate strategies are employed. This paper has tried to bring together in the Nigerian context a preview of positive features and challenges in the process of getting research findings into policy and practice through the investigation of seven cases and how the involved policy makers and researchers of an institutional-based HPSR group experienced these cases. Our experience suggests that four strategies converge to create pathways through which research can get into policy and practice. Depending on the policy under consideration, any of the strategies or a combination of them can be employed. Much of the work undertaken by the HPRG was driven by requests from government or donors and the primary outputs were research reports, journal publications, policy briefs and verbal briefings through feedback workshops and one-on one briefing. The integration of research findings into policy and communicating research findings to Nigerian policymakers is necessary if improved policy decisions are to be adopted, especially within the context of universal health coverage. It requires a deep understanding of how to interact with policymakers, what information they require, and in what form and with whom to establish interactions
It is necessary to educate decision makers and practitioners about the relevance of evidence produced, as exemplified in some of the strategies. It is also necessary to develop context specific sub-strategies and activities that can explain how the findings can be utilized in practice. Interpersonal relationship and trust, and good networks are helpful ways of strengthening the relationship between researchers, policy makers and practitioners.
Respondents uniformly agreed that research findings need to be timely, i.e. to be made available when they are needed to influence policy and practice. In addition a majority also felt that if the research question was a topical issue in a given context, that it would also positively influence GRIPP. Some of the challenges to research utilization in health policy found to be important was the capacity of policy makers to demand for and uptake research, communication gap between researchers, donors and policymakers, managing the political process of GRIPP, lack of willingness of some policy makers to use research and limited research funding and resistance to change.