Research Article: Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study

Date Published: January 26, 2017

Publisher: Public Library of Science

Author(s): Madeleine Ballard, Jenny Tran, Fred Hersch, Amy Lockwood, Pamela Hartigan, Paul Montgomery, Shuby Puthussery.

http://doi.org/10.1371/journal.pone.0170367

Abstract

While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1) beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2) approaches to evidence generation and evaluation used in systems and policy change, and (3) how better evidence-generation can be undertaken and supported within social innovation in health.

Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs). Data were analysed using a Framework Analysis Approach.

While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers.

How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

Partial Text

In recent years, there has been a proliferation of projects, organizations, businesses, and research studies aimed at solving problems stemming from the inaccessibility or lack of health care facing millions of people around the world. These efforts have developed ‘social innovations,’ defined by the editors of the Stanford Social Innovation Review as “the process of inventing, securing support for, and implementing novel solutions to social needs and problems.”[1] Most studies examining how evidence is used to advance social innovations in health have found discrepancies between ideal and actual practice. Milat et al. found that while research evidence is used in decision-making, its contribution was limited by the lack of research on effectiveness and cost-effectiveness [2]. These findings were echoed by Yamey et al. who interviewed implementation experts purposively selected for their expertise in scaling-up health interventions in low- and middle- income countries (LMICs), and found that a major barrier to effective implementation was inadequate research [3]. A systematic review of barriers and facilitators of evidence usage by policymakers in any field found that the primary barrier was poor access to quality, relevant and timely research [4].

14 practitioners, 12 funders, and 5 policymakers working in eight LMICs were interviewed (Table 1). There were no notable discrepancies in data interpretation between co-researchers.

Thirty-two one-on-one interviews were conducted with purposively selected practitioners, policymakers, and funders from LMICs to explore (a) beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (b) approaches to evidence generation and evaluation used in systems and policy change, and (c) how better evidence-generation can be undertaken and supported within social innovation in health.

 

Source:

http://doi.org/10.1371/journal.pone.0170367

 

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