Kalbarczyk Anna, Rodriguez Daniela C, Mahendradhata Yodi, Sarker Malabika, Seme Assefa, Majumdar Piyusha, Akinyemi Oluwaseun O, Kayembe Patrick, Alonge Olakunle O
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Bulaksumur Yogyakarta, Indonesia.
Health Policy Plan. 2021 Jun 3;36(5):728-739. doi: 10.1093/heapol/czaa188.
The barriers and facilitators of conducting knowledge translation (KT) activities are well-established but less is known about the institutional forces that drive these barriers, particularly in low resource settings. Understanding organizational readiness has been used to assess and address such barriers but the employment of readiness assessments has largely been done in high-income countries. We conducted a qualitative study to describe the institutional needs and barriers in KT specific to academic institutions in low- and middle-income countries. We conducted a review of the grey and published literature to identify country health priorities and established barriers and facilitators for KT. Key-informant interviews (KII) were conducted to elicit perceptions of institutional readiness to conduct KT, including experiences with KT, and views on motivation and capacity building. Participants included representatives from academic institutions and Ministries of Health in six countries (Bangladesh, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria). We conducted 18 KIIs, 11 with members of academic institutions and 7 with policymakers. KIIs were analysed using a deductive and inductive coding approach. Our findings support many well-documented barriers including lack of time, skills and institutional support to conduct KT. Three additional institutional drivers emerged around soft skills and the complexity of the policy process, alignment of incentives and institutional missions, and the role of networks. Participants reflected on often-lacking soft-skills needed by researchers to engage policy makers. Continuous engagement was viewed as a challenge given competing demands for time (both researchers and policy makers) and lack of institutional incentives to conduct KT. Strong networks, both within the institution and between institutions, were described as important for conducting KT but difficult to establish and maintain. Attention to the cross-cutting themes representing barriers and facilitators for both individuals and institutions can inform the development of capacity building strategies that meet readiness needs.
开展知识转化（KT）活动的障碍和促进因素已为人熟知，但对于推动这些障碍的制度力量却知之甚少，尤其是在资源匮乏的环境中。理解组织准备情况已被用于评估和应对此类障碍，但准备情况评估主要是在高收入国家进行的。我们开展了一项定性研究，以描述低收入和中等收入国家学术机构在知识转化方面的制度需求和障碍。我们对灰色文献和已发表文献进行了综述，以确定国家卫生重点以及已确定的知识转化障碍和促进因素。进行了关键信息人访谈（KII），以了解对开展知识转化的机构准备情况的看法，包括知识转化的经验以及对动机和能力建设的看法。参与者包括来自六个国家（孟加拉国、刚果民主共和国、埃塞俄比亚、印度、印度尼西亚、尼日利亚）学术机构和卫生部的代表。我们进行了18次关键信息人访谈，其中11次访谈对象是学术机构成员，7次访谈对象是政策制定者。使用演绎和归纳编码方法对关键信息人访谈进行了分析。我们的研究结果支持了许多有充分记录的障碍，包括开展知识转化缺乏时间、技能和机构支持。围绕软技能和政策过程的复杂性、激励措施与机构使命的一致性以及网络的作用，出现了另外三个制度驱动因素。参与者反思了研究人员与政策制定者互动所需的常常缺乏的软技能。鉴于时间需求相互竞争（研究人员和政策制定者都面临时间压力）以及缺乏开展知识转化的机构激励措施，持续互动被视为一项挑战。机构内部和机构之间强大的网络被描述为开展知识转化的重要因素，但难以建立和维持。关注代表个人和机构障碍及促进因素的交叉主题，可以为制定满足准备情况需求的能力建设战略提供参考。
