Assessment of public health organization capacity to use research evidence in decision making processes in Kenya

Abstract

INTRODUCTION
There is need for the governments to apply research evidence to improve decisions making that requires access and capacity for use. For evidence in informed decision making (EIDM) capacity initiatives is important to assess local capacity needs associated with local decision-making or policy making. The objective of the survey was to evaluate public health institutions capacity to demand and use research evidence in decision making processes in selected counties in Kenya.
MATERIALS AND METHODS
The study adopted mixed method (parallel convergence) design where both qualitative and quantitative data was obtained. Phenomenology involved exploration of causation (events, decisions, periods and policies) to understanding the EIDM. The study population was from service departments of Bungoma, Isiolo, Kitui, Makueni, Nyandarua and Taita Taveta public health facilities in six counties. County Directors of health, CHMT and Heads of departments in level 4 and 5 public hospitals were selected for the survey/ IDIs. 6 to 11 departments’ heads were recruited from each health facility. Permission for participants and audio recordings was obtained from study participants prior to interviews. IDIs data was transcribed and thematic analysis done. The final themes in analysis were: challenges in decision making for research evidence, sharing findings with staff, documents supporting research engagements, budget allocation for capacity building and lack of computer software for data analysis. Scientific and ethical approval was sought and obtained from KEMRI.
RESULTS
A total of 79 respondents participated in the survey. County health management teams and health facilities departmental heads accounted for 48.0% and 52% respectively. Of these, 57 (76%) of the respondents had previously research exposure. CMHT reported that County Assembly (MCAs) health committee usually requested for research evidence to support budget proposal and allocation of health program funding. The requests included routine data summaries (37.3%), monthly reports (37.3%) and national government documents (15.3%). Some of the key research partners who assist counties in research generation include NGOs/ FBO (20.5%), national government (21.8%) and regional partners (21.8%).
Respondents were aware of supportive infrastructures or research evidence access which included stable internet (16.7%), information technology (IT) (26.7%), electricity connection (29.3%) and community engagement (16.0%).
CONCLUSION
The survey findings suggest there exists limited capacity among public health organizations to adopt and adapt research evidence to inform decision making processes in Kenya. This calls for enhancing institutionalized platforms and structures that promote research engagement. This can be done through motivating staff; provision of highly summarized evidence policy briefs through proper identification of knowledge brokers to support research synthesis; and creation of awareness of locally accessible infrastructure, support tools and equipment.
RECOMMENDATIONS
Build sustainable relationships and trust among public healthcare workers and at organizational level through customized interventions for each county in Kenya.