By Precious Motha
Reviewing & learning: Professor Ruth Stewart at the BCURE 2015 meeting in London.
The Building Capacity to Use Research Evidence Programme (BCURE) is an initiative by the Department for International Development (DFID) launched in 2013 and ending in 2017. The aim of BCURE is to increase the capacity of policy-makers to use research more effectively through building the skills, incentives and systems required to access, appraise, and apply evidence in decision making. BCURE focuses on low and middle income countries and the programme consists of six linked projects spanning 11 countries in Africa and Asia. Each project works with government stakeholders through a range of interventions, designed and combined in different ways by different partners. As the BCURE programme ends, the Africa Evidence Network (AEN) interviewed directors leading three BCURE programmes in Africa who shared their experiences and lessons learned.
The AEN interviewed the Vaka Yiko Consortium lead Ms Clara Richards of the Evidence-Informed Policy-Making (EIPM) team at the International Network for the Availability of Scientific Publications (INASP) in the United Kingdom; Prof Ruth Stewart, Director of the University of Johannesburg-led programme (UJ-BCURE) based in South Africa; and Dr Rose Oronje, Director of Science Communications and Evidence Uptake at the African Institute for Development Policy (AFIDEP) based in Kenya.
What did your programme set out to do?
Clara: VakaYiko is a three-year programme working on capacity development for the use of evidence in policy making through a consortium of five organizations led by INASP’s Evidence-Informed Policy Making (EIPM) team. VakaYiko is funded by DFID’s BCURE programme and involved exploratory programmes which aimed to test different approaches to capacity development, and learn from one another as they went along. INASP and its VakaYiko partners worked with all parts of the research-to-policy system, including think tanks, universities, non-governmental organizations (NGOs), ministries, parliaments, and training colleges. VakaYiko trialled a wide range of approaches, from training civil servants and parliamentary staff to coordinating department-wide change strategies and facilitating policy dialogues with civil society organizations. Throughout, the programme aimed to take an open and thoughtful approach to allow Consortium partners to reflect together on what they were learning.
Ruth: Our aim in UJ-BCURE was to increase the use of research evidence in decision-making, contributing to reductions in poverty and inequality in the region. Our target audience was senior decision-makers and technical staff within government departments, focusing on pro-poor policy areas. We set out to produce country-specific workplans that were developed in a participatory way, were needs-led and responsive. We then delivered workshops and seminars to a) raise awareness and b) build capacity in research use, and had a linked mentorship programme to enhance application of learning, including individual and team mentorships. These were complemented with what we called ‘mentorship-plus’ visits to enable experiential learning, and build individual and organisational relationships. Finally, we aimed to embed all our activities within the Africa Evidence Network, building local institutional capacity, disseminating capacity building resources through the region, facilitating knowledge exchange and establishing relationships.
Rose: The Strengthening Capacity to Use Research Evidence in Health Policy (SECURE Health) programme was set up to optimize individual and institutional capacity in accessing and utilising research evidence in decision-making in Kenya and Malawi. The programme has been implemented within the Ministry of Health and Parliament in the two countries by a consortium of five institutions led by AFIDEP. The programme had two overarching objectives: a) optimizing institutional leadership and capacity to enhance evidence use and b) enhancing individual skills and capacity of policymakers in the ministry of health and the legislature in accessing, appraising and using evidence. We implemented a range of interventions to realize these objectives including sustained high-level advocacy with top leaders to tackle institutional bottlenecks hindering evidence use, development of institutional guidelines for evidence use, review of existing health research agenda in Malawi to draw lessons on this can be effectively implemented and in Kenya we developed a national research for health policy and priorities to guide evidence generation and use in decision-making, hosted regular evidence-to-policy dialogues on urgent health issues, and designed and delivered a comprehensive training and mentorship programme for technical staff in Ministry of Health and Parliament on evidence-informed decision-making. SECURE Health consortium partners include FHI360, the East, Central and Southern Africa Health Community (ECSA-HC), the College of Medicine at the University of Malawi, and the Consortium for National Health Research in Kenya (CNHR); UK Parliamentary Office of Science and Technology was a collaborator on the programme.
In which countries have you been working?
Clara: VakaYiko, led by INASP worked in three countries: in partnership with the Ghana Information Network for Knowledge Sharing (GINKS) in Ghana; in Zimbabwe with Evidence-Informed Policy Network (ZeipNET) and with the Overseas Development Institute (ODI), Human Sciences Research Council (HSRC) and Council for Scientific and Industrial Research (CSIR) in South Africa. Work in a fourth country, Uganda, began during the third year of the programme in partnership with the Ugandan National Academy of Science. In addition to its core partners, the VakaYiko Consortium included seven grantees in Argentina, Ethiopia, Kenya, Nigeria, Peru, the Philippines, and Sudan.
Ruth: We’ve been working with the governments in Malawi and South Africa, and then working more broadly across the continent through our support to the Africa Evidence Network.
Rose: We have implemented the programme in Kenya and Malawi, and used the regional platforms provided the East, Central and Southern Africa Health Community to share lessons every year with other African countries.
What has been the biggest challenge in delivering your programme?
Clara: One of the key challenge has been a combination of supporting partners in country to implement the work with less support and at the same time respond to the needs of the public institutions we were ultimately trying to support to incorporate evidence in their work. By taking a ‘learning by doing’ approach we could bring both strands together, responding to needs from public institutions together with partners rather than working unilaterally. And in the end this was not only a very rewarding approach but also one that ensured sustainability, the countries where we worked in now have strong local organisations promoting EIPM and contributing to a culture of evidence use.
Ruth: I think this was actually that our job was to encourage government colleagues to use research evidence – essentially ‘demanding demand’ for evidence. This isn’t always easy when government colleagues have many other priorities. First, we had to establish our own credibility and build trust with our government colleagues. Only after doing that were they going to pay attention to what we had to say.
Rose: We embedded SECURE Health within the annual work plans of the Ministry of Health and Parliament in order to ensure the programme’s interventions were responsive to the needs of these institutions as well as ensure sustained institutional support for programme implementation. While this was great in entrenching the programme in these institutions and implementing it as a partnership, it presented one of the main challenges during implementation, which was delays in the delivery of programme activities. As MoH/Parliament activities, all programme interventions had to be implemented with inputs and approval of these two institutions, and this often occasioned long delays in the delivery of interventions.
What have been the highlights / biggest successes of the programme?
Clara: The biggest success is the operating organisations that remain in country now to continue promoting EIPM. Ginks in Ghana and Zeipnet in Zimbabwe are now playing a role taking this agenda forward, working with multiple stakeholders, from other government departments requiring support to other practitioners wanting to get involved and mainstream the use of evidence in their work. As for the success stories related to evidence use in government and parliament, we saw small but sustainable changes, like reallocation of resources to support evidence use in some public institutions. These meant for example allocating people to coordinate evidence needs for policy, include researchers in fact-finding visits in the Parliament of Zimbabwe, the institutionalisation of relationships with research institutes. These are small but important changes in contexts where resources are very scarce. I think it’s very important to be realistic about the type of change that these programmes are willing to achieve.
For a full analysis of our reflections and lessons: http://www.inasp.info/uploads/filer_public/63/97/6397dfb9-5003-4fe4-8603-f0ef6f758415/vy_-_impact_report-digital.pdf
Ruth: This links back to our biggest challenge, as I think our greatest success has been in the relationships we have built, particularly with government colleagues but also across the wider EIDM community. It has been because of these trusting relationships, and the fact we have been able to establish credibility, that all our other highlights have been possible: the large number of workshop places delivered and mentees supported, the application of learning, and the increases in the use of evidence.
Rose: Broadly, the biggest successes of the programme are two-pronged:
a). At national level in Kenya and Malawi where the programme has been implemented, evidence shows that the programme’s interventions are stimulating & nurturing a culture of evidence use in the MoH & Parliament. This includes increased awareness and mind-set shift among top officials and technical staff in MoH and Parliament and improved skills and confidence in EIPM among technical staff. These institutions now have tools for guiding and embedding evidence use in their work – the Guidelines for Evidence Use, and EIPM Training Curriculum. These institutions are also making some little steps towards strengthening their structures and processes for enabling increased evidence use. For instance, the leadership of the Malawi Parliament has now addressed the issue of poor Internet connectivity that was always mentioned by staff as a key barrier to accessing evidence and sharing information with the institution. The Kenya MoH has started allocating resources to its internal Research Unit to enable it to support the MoH’s efforts in increased use of evidence. This unit did not have any budget at the start of our programme. We see these developments as a result of sustained engagement with top leadership and pointing out specific things they can do to continuously enable increased evidence use.
b). At regional and global level, the programme is providing thought leadership in EIPM, mainly shifting actor’s focus to tackling the ‘demand-side’ barriers to the evidence use and contributing to strengthening the EIPM movement in Africa.
What has surprised you most?
Clara: I guess the amount of work that public institutions are already doing to improve evidence use, along with the national institutional frameworks that support this work. We found pockets of good practices worth learning from and sharing with others, like the commitment and leadership of the research department within the Parliament of Uganda. These are also good windows of opportunity to expand and build on emerging practices.
Ruth: I think what has surprised me most has been how much I have learnt. I must confess that we were all quite naïve when we started this work. We believed that we had something to offer to our government colleagues. This may well be the case, but we have certainly learnt as much as we have contributed. So we now prefer to talk about ‘capacity-sharing’ for evidence-informed decision-making, rather than ‘capacity-building’.
Rose: What has surprised me most has been the interest and demand for EIPM skills and support that the programme has generated in the two countries and the region. Having worked most of my life ‘pushing’ evidence for use in decision-making, I didn’t really think the programme would generate much interest and demand. While I knew that weak individual and institutional capacity was a key barrier to evidence use, the programme has surprisingly shown me that decision-makers acknowledge this barrier and are willing to work towards tackling the barrier.
What one piece of advice would you give to someone wanting to increase the use of evidence in decision-making in the continent?
Clara: Take a holistic approach that looks at all the factors that influence how a public institution uses or doesn’t use evidence. Often the issues were not about lack of technical skills (or if they were, that’s not the most difficult challenge to overcome) but other factors, like culture, leadership, management, business processes, etc., hugely influence how people can include knowledge in their work. This interactive product can help them navigate and identify windows of opportunities. I would also suggest to take a participatory approach to identifying and prioritising these. If training was going to be conducted, take those factors into account, use methodologies that are suited to adult learners, this is hugely important to create agency and give space for leaders to emerge. This toolkit can help you do that .
Ruth: That relationship-building is key. It takes time and isn’t always straightforward, but if you don’t invest in relationships then your impact will be limited.
Rose: One word, institutionalize, institutionalize, institutionalize! Interventions that get embedded into existing institutions to continuously promote, support and enable increased evidence have the greatest chance of inculcating and sustaining a culture of evidence use in decision-making so that this becomes day-to-day norm rather than an exception.
In conclusion, these BCURE programmes in Africa have made positive strides to increase the capacity of policy-makers to use research evidence in policy-making. All BCURE programmes have shown a remarkable ability to adapt to changing circumstances and to recognize the efforts that were already made in each of the various country contexts. Furthermore, the quality of professional and personal connections that have been built between the lead programmes and the various partners has explained in part, the continued appeal of the BCURE programmes. While a lot has been achieved, there is an overriding sense that the evidence journey has just begun and that all BCURE programmes are well placed to accelerate the interest and use of evidence in decision-making in governments in Africa.
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