Decision-making of knowledge brokers in moving evidence to action along pathways in global health

Theresa Canova Norton

‘An e-mail never made me change the way I do things’, a colleague once said. Implicit in this statement is the idea that passively receiving information alone is unlikely to motivate change. How might this observation inform the way we approach disseminating the best available evidence? This is what we explore in our Evidence & Policy article, ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries’.

Knowledge brokers are intermediaries who provide a potentially vital role galvanising change. Studies of knowledge brokers have mostly taken place in high-income countries, so we know much less about knowledge brokers in LMICs. To help address this gap, a global health focused research team conducted three studies following up with knowledge broker participants of international conferences in 2012, 2013 and 2015. The aim was to identify whether evidence from the conferences was shared with others and led to actions such as changes in health policy and practice, and what factors influenced decisions to share and act on evidence.

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Social science that improves people’s lives: what strategies should social science and humanities researchers use to foster greater social impact?

Emilia Aiello, Claire Donovan, Elena Duque, Serena Fabrizio, Ramon Flecha, Poul Holm, Silvia Molina, Esther Oliver and Emanuela Reale

Scientific research has the potential to improve people’s lives, but the translation of scientific evidence into social impact is not always easy. According to the Expert report of the European Commission ‘Monitoring the impact of EU Framework Programmes’, ‘social impact is the improvement of society and citizens in relation to their own goals (like the United Nations Sustainable Development Goals)’. How can social science and humanities research achieve this?

Governments and society increasingly demand that scientific research demonstrates social impact and benefit. In this context, scientists are encouraged to reach out to their communities, share their research and its impact on people’s everyday lives, listen to communities and consider their research from the perspective of the people they serve. Social Sciences and Humanities (SSH) research has been challenged in this regard and has been at risk of being eliminated from the European Union’s Framework Programme for Research and Innovation ‘Horizon 2020’. In response, it is necessary to identify and promote the use of effective strategies for enhancing the social impact of research, so that it can inform evidence-based policies and the actions of professionals, citizens and civil society organisations.

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What can academics do to improve evidence-informed policymaking in the UK Parliament?

David Christian Rose and Chris Tyler

The UK Parliament performs key democratic functions holding the government to account by scrutinising policy, debating legislation and providing a venue for the public to air their views through elected representatives. Despite the key role of the UK Parliament in shaping government policy, for example in recent times on Brexit and COVID-19 (though many argue Parliament should have a greater role on the latter), scholars of science-policy interfaces have rarely explored how evidence is sourced and used in legislatures.

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Rapid responsive evidence synthesis to inform decision-making and research

Evidence is power

Duncan Chambers

An evidence synthesis programme commissioned by the UK’s National Institute for Health Research from two academic teams produced a diverse range of outputs and methodological insights in its first three years of operation. The programme was subsequently re-commissioned for two further cycles. Scoping the topic and involving stakeholders were key to its success.

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Why we must work toward a recognised international standard in evaluation of upstream interventions

Feather

Matthew Johnson, Elliott Johnson, Laura Webber and Kate Pickett

The COVID-19 pandemic has increased interest in Universal Basic Income (UBI) as a means of addressing a range of socio-economic insecurities. While previous trials of cash transfer schemes have often focused on low-level transfers inadequate to satisfy the needs for which the policy was originally developed, emerging pilots are moving toward a position of increasing generosity. Our multidisciplinary project, Examining the Health Case for UBI, has brought together colleagues in behavioural science, public health, epidemiology and economics to establish pathways to health impact outlined in Figure 1 below. Our work suggests the potential for significant health impact and attendant economic benefit via reduced healthcare costs and increased economic activity. The model suggests that elements of impact may only be felt if payment is set at a more generous level. This could create greater return on investment and, ironically, a more cost-effective system.

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Is evidence-based policymaking driven by Machiavellianism or altruism in US states?

Luke Yingling and Daniel J. Mallinson

We find that the adoption of evidence-based policies in US states is driven more by Machiavellianism than altruism. Although engagement with evidence-based policymaking (EBP) can produce more efficient and effective government, it can also supply new levers of control to politicians and bureaucrats, which can be used to produce electoral benefits. An appeal to EBP can be used to centralise control of executive functions, as well as to manipulate budgets, that incentivise adoption. Further, the construction, purpose and outcomes of these laws are influenced by the institutions, parties and officeholders who craft them. Our study finds that Democratic governors, Republican legislatures and state innovativeness are significant predictors of EBP adoption in the American states. 

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Exchanging international perspectives to enhance evidence for policymakers

Tomas van den Broeke

Especially in times of crisis, the relationship between evidence and policymaking may change dramatically. The current Covid-19 crisis generated manifestations of ‘evidence informed policymaking’ in an unprecedented way, both nationally and locally. It also showed that the need to use internationally organised, reliable data for effective policy interventions has never been more urgent in times of peace. This information needs to be both profound and directly available.

In the processes of shaping evidence informed policymaking, scientists from all kinds of disciplines play a crucial role to substantiate the development of policies. An international, virtual conference taking place 15–18 December 2020 will treat the outcomes of the current crisis as input for the challenge of professionalising the structured interaction between evidence and policymaking. The current learning processes will be analysed in the context of the existing knowledge infrastructure for policymakers. Instruments for creating evidence for policymakers have recently grown with the introduction of Big Data and the development of algorithms. Another widespread trend is the use of innovative evaluation processes in order to enhance the effectiveness of policy instruments and the growth of new standards for experimental policies.

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Beyond ‘context matters’: learning from the African evidence community

Using Evidence cover

Ruth E. Levine

‘Wouldn’t it be great if the evidence-to-policy work we’re seeing on the rise in Africa could be visible to a wider audience?’ That was the question my colleagues at the William and Flora Hewlett Foundation and I had on our minds in 2017, seeing the creativity and resourcefulness of a host of organisations and champions from the region as they advanced a complex agenda. Now, just a few years later, the opportunity to learn from African experiences is realised in the volume Using Evidence in Policy and Practice: Lessons from Africa, edited by Ian Goldman and Mine Pabari (Routledge, 2020). The book, which both articulates a conceptual framework for thinking about the elements of a contextually-determined evidence ecosystem and presents eight case studies about diverse experiences, adds immeasurably to the literature on evidence-informed decision making.

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Implementation during a time of crisis: the critical role of trusting relationships

Trust

Allison Metz

Are there lessons we can learn from the current response of service systems which have galvanized into action to meet the needs of children and families during the COVID-19 pandemic?  How does the response of service systems affect our hypotheses about how change happens at scale?

In my professional role providing implementation support to public service systems, I’ve observed these systems responding to the COVID-19 pandemic with urgency and agility.  The urgency is to be expected, but the agility has inspired me. 

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Evidence, medicine and art – lived experience completing the picture

This blog is the first of a series of blogs linked to the Evidence & Policy special issue (Volume 16, Issue 2) on Opening up evidence-based policy: exploring citizen and service user expertise. Guest Edited by Ellen Stewart, Jennifer Smith-Merry, and Marc Geddes.

Laila Hallam

Recently I came upon this photo in a post in Twitter[1].  I have seen it before.  It’s a powerful image by Sir Luke Fields.  The child and doctor at the centre, in the glow of the lamp.   The child ill and exhausted.  The doctor earnestly observing.  Watching.  Sitting.  Waiting.  Thinking.  Previously, and again this time, I absorb this painting as a statement on the medical profession.  A reminder of the solemness of their work.  The gravity of life and death.  The role of the family in the background, secondary and in the dark.

But then I was challenged to really look at the image.  The Dad wasn’t simply in the background, he was standing in the shadows, he was stoic, he was purposefully and intently studying the doctor for signals.  Only after considerable prodding, did I notice Dad’s hand comforting his distraught wife.  The Mum collapsed in prayer, or distress, or both.  Dad’s hand gently on her shoulder, reassuring her, or maybe channelling his energy into her prayer.  Her faith.  Their hope.

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