Promoting evidence informed policymaking for maternal and child health in Nigeria: Lessons from a knowledge translation workshop

  • Health Promotion Perspectives, Volume 8, No. 1, Year 2018

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Study Justification:
The study aimed to improve the knowledge translation (KT) competence of an implementation research team (IRT), policymakers, and stakeholders in maternal and child health in Nigeria. The justification for this study is that research evidence often does not make its way into the policymaking process in Nigeria, primarily due to a lack of KT capacity enhancement mechanisms.
Highlights:
– A three-day KT training workshop was organized in Bauchi, Nigeria.
– The workshop covered 15 modules, including integrated and end-of-grant KT, KT models, measures, tools and strategies, priority setting, managing political interference, advocacy and consensus building/negotiations, inter-sectoral collaboration, policy analysis, contextualization, and legislation.
– Pre- and post-workshop questionnaires were administered to evaluate the impact of the training.
– A total of 45 participants attended the workshop.
– There was a significant improvement in participants’ understanding of KT processes and strategies.
– The range of the pre-workshop mean of participants’ knowledge of modules taught was from 2.04-2.94, while the range for the post-workshop mean was from 3.10-3.70 on a 4-point Likert scale.
– The range of percentage increase in mean for participants’ knowledge at the end of the workshop was from 13.3%-55.2%.
Recommendations:
– Promote further KT capacity building programs, such as workshops, for health researchers, policymakers, and other stakeholders to facilitate evidence-to-policy linkages.
– Encourage the integration of KT strategies and processes into policymaking and practice in maternal and child health in Nigeria.
– Support ongoing research and implementation efforts to improve access to quality maternal and child healthcare in rural areas of Bauchi State.
Key Role Players:
– Bauchi State MNCH IRT members
– Project management team members
– Project steering committee members
– State primary health care development agency (SPHCDA) staff
– Ministry of Health (MOH) staff
– Health board members of Federation of Muslim Women Association of Nigeria (FOMWAN)
– Officials of non-governmental organizations (NGOs)
– Local government authority (LGA) health personnel
Cost Items for Planning Recommendations:
– Workshop venue and logistics
– Training materials and handouts
– Facilitators’ fees and travel expenses
– Pre- and post-workshop questionnaires
– Data collection and analysis
– Evaluation and monitoring of the impact of the training
– Follow-up activities to ensure sustained knowledge translation efforts

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study employed a ‘before and after’ design with a training workshop and used a Likert scale questionnaire to evaluate the impact of the training. The study included 45 participants and showed a noteworthy improvement in their understanding of knowledge translation processes and strategies. The range of the preworkshop mean was from 2.04-2.94, and the range for the postworkshop mean was from 3.10-3.70 on the 4-point Likert scale. The range of percentage increase in mean for participants’ knowledge at the end of the workshop was from 13.3%-55.2%. However, the abstract does not provide information on the specific methodology used for data collection and analysis, and it does not mention any potential limitations of the study. To improve the evidence, the abstract should include more details on the methodology, such as the sampling method and statistical tests used. Additionally, it would be helpful to mention any limitations or potential sources of bias in the study.

Background: Knowledge translation (KT) is a process that ensures that research evidence gets translated into policy and practice. In Nigeria, reports indicate that research evidence rarely gets into policymaking process. A major factor responsible for this is lack of KT capacity enhancement mechanisms. The objective of this study was to improve KT competence of an implementation research team (IRT), policymakers and stakeholders in maternal and child health to enhance evidence-informed policymaking. Methods: This study employed a “before and after” design, modified as an intervention study. The study was conducted in Bauchi, north-eastern Nigeria. A three-day KT training workshop was organized and 15 modules were covered including integrated and end-of-grant KT; KT models, measures, tools and strategies; priority setting; managing political interference; advocacy and consensus building/negotiations; inter-sectoral collaboration; policy analysis, contextualization and legislation. A 4-point Likert scale pre-/post-workshop questionnaires were administerd to evaluate the impact of the training, it was designed in terms of extent of adequacy; with “grossly inadequate” representing 1 point, and “very adequate” representing 4 points. Results: A total of 45 participants attended the workshop. There was a noteworthy improvement in the participants’ understanding of KT processes and strategies. The range of the preworkshop mean of participants knowledge of modules taught was from 2.04-2.94, the range for the postworkshop mean was from 3.10–3.70 on the 4-point Likert scale. The range of percentage increase in mean for participants’ knowledge at the end of the workshop was from 13.3%–55.2%. Conclusion: The outcome of this study suggests that using a KT capacity building programme e.g., workshop, health researchers, policymakers and other stakeholders can acquire capacity and skill that will facilitate evidence-to-policy link.

This study employed a “before and after” design, modified as an intervention study as described in previously.22 The study was designed as a three-day KT training workshop organized into fifteen modules including: integrated and end-of-grant KT; KT models, measures, tools and strategies; priority setting; managing political interference; advocacy and consensus building/negotiations; inter-sectoral collaboration; policy analysis, contextualization and legislation. A 4-point Likert scale pre-/post-workshop questionnaires were administered to evaluate the impact of the training, it was designed in terms of extent of adequacy; with “grossly inadequate” representing 1 point, and “very adequate” representing 4 points. The workshop took place in November 2016 in Bauchi the capital of Bauchi State located in the northeastern Nigeria. The improvement of the health of women of child bearing age and children is a topmost agenda in the Nigerian State of Bauchi, because maternal and child health outcomes in the State are among the poorest in Nigeria. According to available report, the maternal mortality ratio (MMR) in Bauchi is 1540 per 100 000 live births, while the infant mortality rate (IMR) is 78 per 1000 live births.23 A total of 45 individuals took part in the workshop. Table 1 presents the profile of the attendees. These included members of Bauchi State MNCH IRT, members of the project management team, project steering committee, State primary health care development agency (SPHCDA) staff, Ministry of Health (MOH) staff, health board members of Federation of Muslim women association of Nigeria (FOMWAN), officials of non-governmental organizations (NGOs) and Local government authority (LGA) health personnel. The IRT is undertaking an implementation research in which edutainment strategy is employed as a tool for the improvement of access to quality maternal and child health care in rural areas of Bauchi State. Abbreviations: IRT, implementation research team; SPHCDA, state primary health care development agency; NGO/CSO, non-governmental organization/civil society organization; FOMWAN, Federation of Muslim Women Association of Nigeria; LGA, local government area. The workshop was developed as a 3-day training event. The workshop package consisted of 15 modules, designed to enhance the KT competence of the IRT and other stakeholders closely associated with the research undertaken by the IRT. Five modules were taught each day (Tables ​(Tables11-​-3).3). The workshop consisted of lecture sessions and group work sessions. Power-point presentation was used for the teachings and handouts were provided for participants on each module treated. Focus group discussions, dialogues, question/answer sessions and group work were held. A pre-workshop questionnaire was administered before the commencement of the training each day. The questions contained in the pre-workshop questionnaire were designed to evaluate the extent of participants’ initial knowledge/understanding of the modules. At the end of each day’s training a similar questionnaire was given to the participants to evaluate the post workshop understanding of the modules taught. The data collection questionnaires used for the pre/post workshop assessment were designed as structured questionnaires. They scale, number of items, title of domains, and scoring mode were modified from the evaluation tool by Johnson and Lavis24 and the Canadian Health Services Research Foundation (CHSRF) (http://www.chsrf.ca/other_documents/working_e.php). Our choice of the self-assessment tool of CHSRF was because several previous studies showed that the tool is very useful and reliable in the evaluation of health stakeholders’ capacity to use evidence from research for policymaking and practice.25-27 The questionnaires were pre-tested and validated in our previous evidence-to-policy training workshops for policymakers and other stakeholders in the health sector and found to be relaible.20,28-30 The final version of the validated questionnaire was used for the present study. We employed the Johnson and Lavis24 method in the analysis of the completed questionnaires, which stipulates the use of mean rating (MNR). Details of the methods is provided in our previous studies.20,28-30 The percentage differences in the MNR of the pre-workshop and post-workshop were calculated and used as indicator of the extent of improvement in the participants knowledge after the training.

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Based on the provided information, one potential innovation to improve access to maternal health is the implementation of knowledge translation (KT) training workshops. These workshops aim to enhance the KT competence of implementation research teams, policymakers, and other stakeholders in maternal and child health. The workshops cover various modules, including integrated and end-of-grant KT, KT models, measures, tools, and strategies, priority setting, managing political interference, advocacy and consensus building/negotiations, inter-sectoral collaboration, policy analysis, contextualization, and legislation. The workshops utilize a before-and-after design, with pre- and post-workshop questionnaires administered to evaluate the impact of the training. The workshops have shown promising results in improving participants’ understanding of KT processes and strategies, with a notable increase in knowledge after the training. This innovation can potentially contribute to evidence-informed policymaking and improve access to maternal health.
AI Innovations Description
The recommendation from the study is to implement a knowledge translation (KT) training workshop to improve the capacity and skills of health researchers, policymakers, and stakeholders in maternal and child health. The workshop consists of 15 modules covering various topics such as integrated and end-of-grant KT, KT models, measures, tools and strategies, priority setting, managing political interference, advocacy and consensus building/negotiations, inter-sectoral collaboration, policy analysis, contextualization, and legislation. The workshop uses a 4-point Likert scale pre-/post-workshop questionnaire to evaluate the impact of the training. The study found that the workshop significantly improved participants’ understanding of KT processes and strategies. By enhancing KT competence, policymakers and stakeholders can better utilize research evidence to inform policymaking and improve access to maternal health.
AI Innovations Methodology
Based on the provided description, the study aimed to improve knowledge translation (KT) competence in maternal and child health to enhance evidence-informed policymaking. The methodology used a “before and after” design, modified as an intervention study. Here is a brief description of the methodology used to simulate the impact of the recommendations on improving access to maternal health:

1. Workshop Design: A three-day KT training workshop was organized, consisting of 15 modules covering various topics related to KT and evidence-informed policymaking in maternal and child health.

2. Participants: A total of 45 individuals participated in the workshop, including members of the Bauchi State MNCH IRT, project management team, project steering committee, State primary health care development agency (SPHCDA) staff, Ministry of Health (MOH) staff, health board members of Federation of Muslim Women Association of Nigeria (FOMWAN), officials of non-governmental organizations (NGOs), and local government authority (LGA) health personnel.

3. Pre-Workshop Questionnaire: A 4-point Likert scale pre-workshop questionnaire was administered to evaluate the participants’ initial knowledge and understanding of the modules. The questionnaire was designed to assess the extent of adequacy, with “grossly inadequate” representing 1 point and “very adequate” representing 4 points.

4. Workshop Sessions: The workshop consisted of lecture sessions, group work sessions, focus group discussions, dialogues, question/answer sessions, and group work. PowerPoint presentations were used for teaching, and handouts were provided for each module.

5. Post-Workshop Questionnaire: At the end of each day’s training, a similar questionnaire was given to the participants to evaluate their post-workshop understanding of the modules taught.

6. Data Analysis: The completed questionnaires were analyzed using the mean rating (MNR) method, as stipulated by Johnson and Lavis. The MNR of the pre-workshop and post-workshop questionnaires were compared to calculate the percentage differences, indicating the extent of improvement in participants’ knowledge after the training.

By implementing this methodology, the study aimed to assess the impact of the KT training workshop on participants’ understanding of KT processes and strategies, ultimately enhancing evidence-to-policy linkages in maternal and child health.


Statistics:
Citations: 10
Identifiers:
DOI: 10.15171/hpp.2018.08
Research Areas:
Community Interventions, Health System and Policy, Maternal and Child Health, Quality of Care
Study Countries:
Nigeria
Study Design:
Grounded Theory, randomised-control-trial
Study Approach:
Qualitative
Participants Gender:
Female
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