Prof Anthony Costello, Professor of International Child Health, Institute of Child Health & Great Ormond Street Hospital
David Grzywacz, Head, Agriculture, Health and Environment Group, Natural Resources Institute, University of Greenwich
Nicola Jones, Research Fellow, RAPID Programme, ODI
Nicola Jones, in the chair, opened the meeting, explaining that this seminar constituted the fourth in a series co-hosted by ODI and DFID, entitled 'Linking research and development.'
Prof Anthony Costello
Anthony Costello started his presentation by outlining a number of issues to bear in mind when thinking about translating research into policy and practice. These included issues relating to both evidence and populations and policy. He explained that we are currently way off track in achieving MDGs 4 and 5 in Africa and South Asia, which relate to maternal and child health (MCH).
He explained that a randomised controlled trial involving 2 one-to-one sessions of health education showed very little impact. This indicated that telling people what to do does not work. Instead, a strategy of spreading health messages through womens' groups, to both educate and empower them was adopted. This started with a large project in Nepal over a huge, remote area. Training and equipment was provided to the womens' groups and the district was divided into clusters. One woman per cluster was nominated to be a member of the group. Although this meant that only 8% of the target population would be reached, sociologists advised that this would not matter as each member of the group would have a wide circle of influence.
The womens' group has a cycle of 12 meetings. In year two of the project, researchers realised that women were linking the solutions to their problems rather than the other way around, so a picture game was developed with different shaped cards representing different problems and corresponding solutions.
The initial results showed a 30% reduction in neo-natal mortality rates (NNMR) in the clusters. This was interesting, especially given the low cost of the intervention, as worked out by health economists and subsequently published in the Lancet. It was observed that the wide circle of influence each individual facilitator had within their own cluster, could eventually result in an 'epidemic of behaviour change'. The context of these results was also important - the same results may not have been achieved in a Muslim community in Bangladesh or with certain tribal populations, for example.
Policymakers remained sceptical of the findings however and it was realised that a body of evidence consisting of several studies with positive results would be needed before the intervention could hope to be translated into policy. To this end, new projects were launched in Bangladesh, India, Nepal and Malawi. For these, qualitative as well as quantitative data will be collected.
All these trials are expected to report in the next 18 months. If the results are positive, this will make for a stronger evidence base to present to policy makers. In conclusion, Prof Costello reminded the audience once again to be mindful of the issues he outlined at the start of his presentation when thinking about translating research into policy.
David Grzywacz explained at the start of hispresentation that Kenya has a very large and successful horticultural industry. In recent years, farmers have come under pressure from developed world consumers and supermarkets to decrease the use of pesticides.
The diamond back moth (DBM) is a major worldwide pest which has the potential to cause up to US$1bn of crop damage annually to growers. In Kenya in particular, it was able to develop a high degree of resistance to chemical pesticides and so threaten the livelihoods of smallholder (peasant) farmers.
DFID decided to fund research into biological pest control options which would not leave either a chemical residue on, nor cause cosmetic damage to crops, meaning they could still be sold into EU or Japanese markets. Biological control agents (BCA) include fungi, nematodes, bacteria and viruses. There were a number of both push and pull factors around the uptake of BCA research by policymakers. Constraints included the lack of appropriate policy, legislation, registration procedures and expertise concerning BCAs. A way forward was identified, consisting of an outcome-driven workshop which would aim to resolve these issues.
The elements which contributed to the success of this initiative included:
the agenda and initiative were Kenyan-driven
there were effective local champions in place to take the initiative forward
decision-making involved a balance of stakeholders
both Northern (where needed) and proven Southern technical expertise and models were used
The resulting outcomes were that legislation was put into place, allowing the registration and use of BCA research. New Southern companies and South-South networks have grown up as a result, and this experience has provided a model which has since been used successfully in other African countries.
Questions and points raised by the audience in the discussion which followed included:
Was the requirement for relevant legislation and registration procedures considered at the start of the BCA research?
How do researchers tackle the issue of vested interests and resistance to the uptake of their research findings by policymakers? What is the role of the external researcher with regard to this?
What is the role of the media in translating research into policy, and broadening the impact of research generally?
How should researchers handle the current demand for communicating research from the start of a project when the outcomes/results remain unknown until much further into the life of a project?
There is much attention on policymakers, but what about 'policyshapers' (peers) in the development community - could they play a bigger role?
Would it be beneficial to identify the optimal amount of research for reaching the 'tipping point' and how to get there faster? What strategies might be relevant for this?
What incentive systems exist, and what systems should exist, to encourage researchers to play a bigger role in influencing policy?
With regard to HIV/AIDS, there are particular challenges in terms of bridging research and policy, and there are both incentives and disincentives. There is also a role for CSOs to be involved in research partnerships, as they play a key role as service-providers. It is therefore important to remember that CSOs are obvious local champions.
Regarding the 'demand side' - what happens to the womens' groups and cluster groups after the research finishes? Can NGOs use the research and/or carry on the initiatives which have been started as a result of the research?
What possibilities are there for partnerships with local and national NGOs, for example those which are already involved with womens' groups and/or share the same strategic objectives?
Research funding is normally provided for 3 years at a time, however a much longer-term presence is required if any real progress is to be made on these issues. How does this affect research outcomes?
'Policy' is often very different from 'practice' - how can these be connected?
What/who informs the research questions and ethics of a research project? Local NGOs and CSOs have an important role to play and should be involved.
Is there a case for more funding for knowledge management (KM) in order for knowledge to be stored and shared more easily, to help avoid the short-termism which currently affects research?
David Grzywacz responded as follows:
with regard to relevant legislation and registration procedures, the BCA researchers did not predict the success, nor know there was a need for such legislation at the beginning of the project
with regard to vested interests, finding effective, local champions is paramount. Researchers then act purely as information-providers to the champions
the media is extremely important, even at the start of a project, to communicate what the project hopes to achieve in commonly-understood language. For this, the BCA team relied much on their Kenyan colleagues and DFID provided funding specifically for media work
the 'tipping point' theory is the sociology of science and is only sometimes applicable. The DBM is a relevant example however, as there was no possibility that it would develop resistance to BCAs
disincentives for researchers to engage with policy included vested interests in certain elements of the research community itself, which may want guaranteed research funding for certain number of years
local champions must be end-point (i.e. policy) driven, researchers are often not the best-placed to carry an entire project through from research to policy - the work should be shared between researchers, the media, policy people and social scientists
regarding an information/KM strategy for research results - this should be a complex, multi-layered strategy
womens' groups are good for delivering both health and agriculture messages, however some internal actors in Kenya decided to marginalise NGOs in the BCA work. In other countries and contexts, however, this approach could work
the short-termism of research funding is a real problem - an intermediate option, offering funding for periods of longer than 3 years is required, together with intelligent management and active monitoring
where there is no relevant national system/industry in place, CSOs should be called upon. This will depend upon local partners. CSOs should be competent and/or prepared to adapt to become competent in this arena
with regard to policy and practice - in this case, a new policy did result in changes in practice
although there was relatively little participation by farmers' groups, Kenyan farmers did participate directly, as the companies involved in the initiative had very active growers networks
data is often abandoned and/or inaccessible in Africa due to its project by project nature, so a KM project to pool research would aid greatly
the involvement of social scientists with natural science research is a great eye opener. Generally there is a good dialogue between the two, and projects which succeed are often strong on social science, although good social scientists are rare!
Prof Costello responded as follows:
the media must be used with caution, especially when attempting to challenge the status quo. Community radio however, as an intervention itself, can be very useful
local champions form part of the partnership approach which should always be used, as local partners will always know better than researchers from the North how to open policy doors
scientists shouldn't try to be GRIP ('getting research into policy') people too - other professionals should be involved to help with this. Incentives which exist include funding - for example, in DFID programmes, a large percentage of funding is reserved for communications - this has meant that researchers often start talking to policymakers much earlier on in the research projects than previously
with regard to HIV/AIDS, the group approach could work - the membership of groups and the outcome monitoring methods would need to be looked at carefully, but this is a very important and under-researched subject
issues of how to scale projects up and hand them over are critical. Replicating the project in Nepal for example, has involved using volunteers from parts of the national health service, but this depends on an enabling political context. It is definitely necessary for social scientists and policy specialists to help with scaling projects up
the three year structure of research funding is a problem but there is still an ethical responsibility on researchers to do the research in the best and most efficient way. Longer term funding is definitely required
research questions for ICH projects are initially set by the ICH itself, but as local partners become involved, these questions evolve as a result of collaboration
with regard to KM, there is an ethical responsibility on all researchers to disseminate their findings. Spin-off research often constitutes 90% of findings but this often does not get written up. At ICH, all data must go into open access journals. There is also some debate as to whether massive datasets should go on the web for meta comparative analysis
social science work is interesting and social scientists often ask interesting questions, however there is a real shortage of talented social scientists
This event, the fourth in a series co-hosted by ODI and DFID, entitled 'Linking research and development', discussed what need to be considered when translating research into policy and practice.
MDGs 4 and 5 are not on track to be fulfilled in Africa and South Asia, which relate to maternal and child health (MCH).