Blogs

This is the second of a series of three blogs discussing the Kenya Health Knowledge Translation Platform (KTP). The first blog analyses the model adopted by the Kenya Health KTP in the context of the evidence-base on KTPs. The final blog in the series highlights how the Kenya Health KTP builds on recent efforts to improve evidence-informed decision-making in Kenya’s health sector.

These reflections on critical factors that should be considered in the establishment of the Kenya Health KTP are drawn from consultative deliberations, particularly one held on 1 March 2018, where the Ministry of Health (MoH) convened a stakeholder meeting to discuss the establishment of the Kenya Health and Research Observatory (KHRO). The KHRO aims to promote evidence-informed decision-making (EIDM) in the health sector by improving access and use of research and health information. These reflections will also draw on the evidence-base on KTPs in Cameroon (a);(b), Malawi, Nigeria, Uganda (a);(b) and Zambia.

Critical factors for consideration in the establishment of the Kenya KTP

The evidence-base reveals that KTPs improve the technical capacity to promote evidence-informed decision-making (EIDM), the interaction between research producers and users, production of relevant evidence and evidence-informed deliberations. However, the meeting deliberations and evidence-base raise a number of issues and challenges for consideration in the establishment of the Kenya KTP.

Strong leadership encompass unique qualities

One of the reasons the Regional East African Community Health Policy Initiative (REACH-PI) KTP, comprising of Burundi, Kenya, Rwanda, Tanzania, and Uganda ceased to be active, was its weak leadership. The Zambia KTP found that few individuals have the essential qualities for leading a KTP i.e. « ˜a combination of skills in both the research and policy communities and carrying sufficient respect among those communities to be an effective broker bringing both together’.

Increase and train KTP staff

A cross-cutting challenge of the existing national KTPs is inadequate staff. KTPs in Africa tend to be under-staffed and often rely on individuals that volunteer to help implement activities. Activities implemented by volunteers tend to stall since they are often full-time employees elsewhere. The Malawi KTP found that hosting KTP staff and volunteers in residential meetings away from the city to complete activities such as the development of policy briefs addressed this challenge. Nevertheless, it is recommended that KTPs need to hire more dedicated staff. In addition, running a KTP requires staff who understand research as well as the policymaking process and who have the skills and motivation to navigate between the two communities (researchers and policymakers). There is still no critical mass of such individuals in Africa (although it’s increasing), therefore, KTPs need to invest in training staff as well as other stakeholders involved in the KTP activities.

Increase funding for KTPs

Limited funding was also highlighted as a major challenge among the existing national KTPs. In particular, KTPs that are housed in public institutions (Cameroon, Uganda, and Nigeria) reported receiving only in-kind contributions from their host institutions. The Malawi KTP was the only platform to report that the country’s Ministry of Health (MoH), where it is housed, pays a salary for a full-time coordinator. Funding for KTPs is largely sourced from development partners but is not always consistently available leading to disrupted activities. In addition, funders are reluctant to provide core support, which is crucial for KTPs that must maintain an office and visibility and convene dialogues. There is a need for advocacy for knowledge translation (KT) to be integrated as a core health-system activity to enable KTPs to attract government funding. The Malawi KTP’s location in the MoH is reported to have benefited the KTP as it is viewed as a government initiative and this has « ˜opened doors for in-country funding’. It is hoped that the Kenya KTP will enjoy similar benefits at the very least.

Motivate KTP users to participate

Web-based KTPs rely on motivated users, which is difficult to generate particularly in the absence of regular awareness raising/communication activities. The coordinator for Maisha Maarifa Research Hub highlighted the low use of the platform as a key challenge.

Improve KTP evaluation methods

Understanding the extent of the impact of KTPs on EIDM and health systems is critical to increasing support for them. However, the evidence-base points to limitations in the methods used to evaluate the effectiveness of the KTPs. There is a call for the development and validation of robust evaluation methods and tools.

Context matters

Finally, the evidence-base indicates that context influences the performance of national KTPs. There is need to understand the context and tailor KTP activities to suit it. For example, a comparative evaluative reflection of the Cameroon and Uganda KTPs revealed that KTPs may implement comparatively similar activities but the outcomes may differ considerably due to « ˜diversity of grant arrangements and differences in institutional arrangements and planning cycles as well as the stability of health technocrats‘.

In conclusion, a KTP requires strong leadership and adequate funding and staff to realise its full potential. Engagement and communication activities that sensitise stakeholders about the benefits of the KTP and how to get involved will improve participation. Understanding the context and tailoring KTP to align with the context is also critical to the success of KTPs.