Turning Research into Practice: Suggested Actions from Case-Studies of Sexual and Reproductive Health Research

This document is the result of a review of case studies of utilisation of sexual and reproductive health research with a view to eliciting lessons that researchers, programme managers, and others could apply to increase the use of findings of this kind of health research. The report is the outcome of two technical consultations, convened by the Department of Reproductive Health and Research (RHR), World Health Organization (WHO), Geneva, Switzerland, in collaboration with Family Health International (FHI), the Population Council’s FRONTIERS in Reproductive Health Program, the United States Agency for International Development (USAID), the United Nations Population Fund (UNFPA), the Program for Appropriate Technology in Health, John Snow International, and EngenderHealth. Case studies were reviewed retrospectively with a view to extracting lessons learnt from the different approaches to research utilisation employed in them, and a conceptual framework was developed to elaborate the process of utilisation at various stages of research.

According to the document, "[t]he gap between knowledge generation and its use is now well recognized by many researchers, donors, policy-makers, and service providers. The challenge... is how to develop strong communication linkages between the various parties in order to facilitate the uptake of research findings. To do this effectively, stakeholders will need to identify the barriers to communication and learn from successful examples of research utilization....Findings can be used to make decisions on new policies about provision of services (e.g. instituting new procedures, practice and interventions, including those for prevention) related to reproductive health-care delivery. They can equally contribute to the strengthening of existing programmes in terms of discontinuing practices found to be ineffective or harmful. Furthermore, research findings can also be used for advocacy for reproductive health....The central component of this document is a conceptual framework which highlights a variety of issues and processes that influence the utilization of research results at various stages of the research process [pages 15-19].

...A complete chapter is devoted to guidance for researchers in using the conceptual framework to identify activities aimed at promoting research utilization [pages 20-27]. Another chapter provides a checklist for policy-makers and programme managers to help them define the potential for utilization of research [pages 28-29].... Eight key factors are discussed as important determinants of research utilisation: the research topic; the relationship between researchers and decision-makers; the political and programmatic context of research; research quality; dissemination (extent, quality, intensity, persuasive power) activities; development of study recommendations; promotion of research utilization; and sustainability of results....A pathway to promote and guide the use of sexual and reproductive health research on sensitive issues in policy formulation and service programmes" includes the following:

• Development of the research question
  
• Identification of the "target" audience(s)
  
• Identification of who is a policy-maker and who is involved in the policy process
  
• Communication strategies - including adapting messages for different audiences using the following types of communication: regular information updates (in printed format and through face-to-face meetings), research summaries, press releases, dissemination workshops (especially for less literate populations), policy briefs, and final reports (with executive summaries and policy recommendations). Additional communication concerns centre on communicating the research accurately - particularly possible if the research budget allows funding for the researcher to produce the advocacy materials - for example, posters, leaflets, press releases, and policy briefings.
• What is communicated and when
  
• Utilisation of research findings
  
• Evaluation of research findings and identification of facilitating factors and barriers in communication and utilisation.
  

Because of the sensitivity associated with sexual and reproductive health issues, they require, as indicated in the document, special communication skills and strategies to communicate results to decision makers. Collaboration with the end users of research is highlighted as a pathway (illustrated by a chart on page 10) to research utilisation. Strategies are described for researchers to develop and maintain collaborative links throughout the research process, and beyond it, to facilitate effective utilisation of results. A systems approach to analysing various components of the research-policy environment can be a useful tool for assessing the interlinkages between research, advocacy, policy, programmes, and practice, and the role of each in research utilisation. Also, identifying key concerns of all relevant stakeholders, including donors to research, knowledge brokers, health system managers, and public policy-makers, can facilitate uptake of the knowledge generated by research.

Communication activities designed to enhance utilisation of research are focused on four levels: the scientific level - through publication of an original research paper, often in a journal or online knowledge management resource; the policy and decision-making level - through policy briefs/summary releases; the programme management and service provision level - through the publication of practice guides, tools, and scientific literature; and the general public or potential ultimate beneficiaries level - mass media campaigns and community sensitisation and mobilisation. The document includes models of collaboration to enhance utilisation (beginning on page 33) and case studies of projects using research to inform project policies and practices.