The proposed Kenya Health Knowledge Translation Platform: its adopted model is designed to position it for success

This is the first in a series of three blogs discussing the Kenya Health Knowledge Translation Platform (KTP). The follow-up blog will highlight lessons from existing KTPs for consideration in the establishment of the Kenya Health KTP. The final blog highlights how the Kenya Health KTP builds on recent efforts to improve evidence-informed decision-making in Kenya’s health sector.

Background

A Knowledge Translation Platform (KTP) brings together policymakers, researchers and other stakeholders, including the civil society, for evidence-informed deliberations on identified health priorities. It creates and nurtures links that draw the research and policy communities closer together to ultimately create cycles of policy-informed evidence and evidence-informed policy. The concept of the KTP was initiated and promoted by the World Health Organization beginning in 2005, resulting in numerous national and regional KTPs across the globe. By 2012, twelve countries in Africa either had a national KTP (Cameroon, Malawi, Nigeria, Uganda and Zambia) or were part of a regional KTP e.g. the Regional East African Community Health Policy Initiative (REACH-PI) comprising of Burundi, Kenya, Rwanda, Tanzania and Uganda, although only active for two years from 2006 to 2008.

On 1 March 2018, 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. It is thought of as “a web-based portal designed to facilitate multi-stakeholder collaboration and partnership in accessing and using information for strengthening national health information systems, as well as serving as a repository of the best available information, and provide tools to strengthen monitoring of health status and trends”.

One of three platforms being proposed to be hosted on the KHRO is the Kenya Health Knowledge Translation Platform (KH-KTP), which will “consolidate all health research conducted on Kenya and facilitate discussions and translation of this research by key policy actors to enable its uptake in decision-making in the health sector”.

As part of the deliberation on what to consider when establishing a KTP, AFIDEP was invited to provide insights on the role of KTP in promoting EIDM in the Kenya health sector. What follows is my analysis of the model adopted by the Kenya Health KTP and its potential for success in the context of the evidence-base on KTPs in Cameroon (a);(b), Malawi, Nigeria, Uganda (a);(b) and Zambia.

Proposed structure/model of the Kenya KTP in relation to existing models

A KTP may take several different forms, each with their advantages and disadvantages. It may be a web-based entity or it may be located in a conventional office. Web-based KTPs rely on motivated users, which is difficult to generate in the absence of regular awareness raising/communication activities. On the other hand, KTPs operated from an office and engaged in implementing knowledge translation activities incur high costs, but promote and improve interaction and collaboration among researchers and policymakers and evidence-informed discussions.

The Kenya KTP is adopting a combination of the two as it is proposed to have:

  1. an online repository of local health research; and
  2. a non-online component focused on creating and nurturing links among policymakers, researchers and academic institutions, and other research-users to enable the translation and use of data and research evidence in decision-making.

The combined model is common among the other national KTPs in the African region.

KTPs can also either be health sector-wide as is being proposed for the Kenya KTP or they can be issue-focused. For example, Kenya’s National AIDS Control Council (NACC) runs a web-based knowledge sharing platform, called the Maisha Maarifa Research Hub, which focuses on HIV & AIDS, Sexual and Reproductive Health (SRH) as well as co-morbidities such as Tuberculosis. The Maisha Maarifa Research Hub collates locally generated research findings as well as best practices in programming to inform HIV-related policy and decision-making. To ease its management and enhance performance, health sector-wide KTPs can be organised into communities of practice, which focus on identified priority issues as was done in Cameroon, Malawi and Zambia. The Kenya KTP will adopt this model.

Finally, KTPs can either be housed in a government institution e.g. MoH or other relevant parastatal, academic or research institution (public or private) or a Civil Society Organisation. The Kenya KTP will be housed in the MoH, within the Department of Policy, Planning & Healthcare Financing. The evidence-base on KTPs point to a preference for KTPs to be housed in government or public institutions arguing that due to their close proximity to government policymakers, they tend to have higher buy-in and participation by stakeholders. On the other hand, there is need to take extra steps to ensure the neutrality of KTPs housed in government, the absence of which would compromise its purpose of promoting EIDM.

 The Kenya Health KTP is poised for success, but only if it is adequately funded and staffed. It has adopted the best elements of existing KTPs, in terms of its model:

  • It will be housed in the MoH, which will increase buy-in and chances for securing government funding commitment in addition to other sources of funding
  • It will have both an online repository of local health research as well as organise events that bring together researchers and policymakers to promote EIDM

Read the follow-up blog (Wednesday 14 March 2018) to appreciate some of the soft issues that must be considered in the establishment of the Kenya Health KTP if it is to realise its full potential.

Sepsis is a policy issue: Reshaping stakeholders’ perceptions of sepsis in Africa

Sepsis is the second biggest cause of death in the world and the leading cause of preventable death. Globally, there are an estimated 30 million cases of sepsis each year, with over 7 million ending in death. Of these deaths, at least 2 million are estimated to occur in Africa. Despite being a major killer, sepsis remains largely unknown by the general public and health care workers, and is under-prioritised by policy-makers.

From 14th – 16th June 2019, experts converged in Dar es Salaam under the African Research Collaboration on Sepsis (ARCS) initiative to discuss sepsis in Malawi, Gabon and Uganda and the need to highlight sepsis as a policy issue.The meeting saw experts identify three inter-related problems confronting sepsis in these countries.

First is the need for a standardised definition for sepsis. There are many different definitions of sepsis, even among doctors and experts, and this makes it difficult for most people to fully understand and engage with sepsis. Consequently, there is limited to no population awareness of it. Even amongst medical practitioners, there is only a presumptive diagnosis of sepsis and no point-of-care tests. As a result, practitioners put less emphasis on sepsis but rather look at other diseases associated with it, leading to the second issue of lack of data availability due to the syndromic (and not objective) diagnosis of sepsis. This is compounded by the fact that there is no public budget or private funding for sepsis research in Africa, so it is generally not prioritised. This vicious circle is completed by there being no resources for sepsis-related training or treatment and the third problem: lack of population awareness. There is no word for sepsis in vernacular, and consequently no social chatter in communities about sepsis, which would aid in engaging discussion and building pressure for government intervention. There is also no pressure on the government from the medical profession, who consider it as “small fish” secondary to “real” underlying problems associated with sepsis, such as malaria, TB or HIV.

Based on this, participants embarked on the policy-influencing objective of generating more knowledge to recognise sepsis as a priority disease and put it on the agenda. Specifically, there is a need to converge the problem with policy and politics by engaging with eleven stakeholder groups, namely: Civil Society Organisations, Ministries of Health (MoH), Laboratory personnel, Media, Health recorders, International funders, Researchers, Medical teachers, Clinicians, Ethics committees, and Regulatory bodies.

These stakeholders should be engaged in four low-cost outcome mapping approaches:

  1. Informing and translating: This policy learning process should target civil society, media, international funders, MoH, medical teachers and regulatory bodies. Various evidence products developed through sepsis research must be disseminated to these stakeholders. For example, the sepsis fact sheet must be disseminated to civil society and media, whereas the sepsis policy brief should be disseminated to MoH and international funders, and curriculum change recommendations to medical teachers and regulatory bodies.
  2. Linking: This coalition-building process should involve linking sepsis experts to target stakeholders, including MoH technical working groups (TWGs), medical teachers, regulatory bodies and media. Sepsis experts must present to these stakeholders on sepsis-related research through meetings, panel discussions and interviews.
  3. Matchmaking: This attention-focusing process will bring together ethics committees, clinicians, international funders, allied health workers and researchers. Arrangements should be made for clinical and allied health workers to communicate to ethics committees on the gaps in knowledge to accurately diagnose and report sepsis. Communication between ethics committees and international funders must be facilitated for the latter to speak on the gaps in evidence on sepsis. Finally, communication between ethics committees and researchers can be moderated for the latter to speak on the need for permission to audit patient records to generate the knowledge and evidence on sepsis needed by health workers and international funders.
  4. Capacity strengthening: This activity should involve training MoH staff on evidence-informed decision making (EIDM). A curriculum developed by the African Institute for Development Policy (AFIDEP) and their partners is a great starting point, and the training delivery can use sepsis as a case study

With sepsis having human and financial costs, these approaches could bring sepsis on the policy agenda, where it needs to be, by converging the problem with policy and politics. Re-shaping the perception of sepsis among key stakeholders and making it a policy issue is vital to reducing cases in Africa, and the world at large. This World Sepsis Day, let us play our part and spread awareness.

 

 

ARCS is a Global Health Research Group awarded by the National Institute for Health Research (NIHR grant reference number 17/63/42) and led by the Liverpool School of Tropical Medicine (LSTM). This blog presents independent research funded by the NIHR. The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

 

ICPD25 Dialogue event: What has changed in middle-income countries in southern Africa?

AFIDEP’s Senior Knowledge Translation Scientist, Dr. Bernard Onyango represented AFIDEP at a dialogue that is among the various events being held in the lead-up to the ICPD25 Nairobi Summit. The dialogue, titled, What’s Changed in Middle-Income Countries in Southern Africa? took place on 11 September 2019 in Namibia, where the First Lady of the Republic of Namibia, Monica Geingos, joined stakeholders in reflecting on the last 25 years, future opportunities, as well as challenges in driving the population and development agenda.

According to Dr Bernard Onyango, the meeting focused on the experience of five countries (Mauritius, South Africa, Botswana, Namibia, Eswatini) and one high-income country (Seychelles). These countries face varied but unique population and development challenges from the rest of sub-Saharan Africa.

“On average, they are more advanced in their demographic transition, with total fertility ranging from 1.5 in Mauritius to 3.6 in Namibia. As a result, some of the countries are at an advanced stage to capitalise on having a large working-age population relative to a dependent population and harness the demographic dividend. For example, 7 out of 10 people in Mauritius are of working age. Having said that, southern Africa countries, such as South Africa, Namibia, Botswana, and Eswatini, have very high unemployment rates. This undermines the promise that a large youthful workforce could lead to significant demographic dividends. Further, with the exception of Mauritius, the rest of these countries suffer from high levels of inequality, while economic growth in most of the countries has been quite sluggish in the last decade.” says Dr Onyango.

The #ICPD25 Nairobi Summit will be held on 12-14 November 2019 with the theme “Accelerating the promise”. Among the major highlights of the event will be a signature session on Demographic Dividend and Diversity that will give participants an opportunity to share experiences and lessons learnt from harnessing the demographic dividend. Aiming towards building an inclusive society, the session will explore how countries can seize opportunities and respond to development needs of their people.

 

Learn more about #ICPD25 Nairobi Summit on https://www.nairobisummiticpd.org/

AFIDEP’s Dr Zulu keynote speaker at 16th International Inter-Ministerial Conference on Population and Development

On 4 September 2019, AFIDEP’s Executive Director, Dr. Eliya Zulu will be the keynote speaker at the 16th International Inter-Ministerial Conference on Population and Development in Tunis, Tunisia. His keynote speech will be on “South-South Cooperation for Harnessing Demographic Dividend for Achieving the ICPD Programme of Action (POA) and the 2030 Sustainable Development Goals 2030”.

The Conference, which will run for two days between 3-4 September 2019, has been organised by the Partners in Population and Development (PPD), in collaboration with UNFPA and the National Board for Family and Population, Minister of Health, Government of Tunisia. The theme for this year’s Conference is “Consolidating the gains and reaffirming the commitments for the achievement of the ICPD Programme of Action (POA) and the SDGs 2030 Agenda”.

The Conference seeks to deliberate and clarify on how the South-South and Triangular Cooperation (SSTC) can maximise and leverage the health and demographic outcomes; contribute to addressing emerging population issues; and realize global commitment for accelerated implementation of the 1994 International Conference on Population and Development (ICPD) Programme of Action and the Sustainable Development Goals (SDGs) Agenda.

The Conference will draw Ministers, senior government officials, international development partners; eminent scientists, scholars, academics and subject experts to deliberate and reach consensus on the Conference’s topic. The outcome of this year’s conference will form the basis of a background document containing crucial elements for reflection at the ICPD25 Nairobi Summit in November 2019, a high-level meeting bringing together governments, UN agencies, civil society, private sector organisations, women and youth groups/networks to discuss and agree on the actions needed to accelerate the implementation of the 1994 ICPD Programme of Action, which is critical to achieving the UN’s Sustainable Development Goals (SDGs) by 2030.

Nurturing a culture of evidence-based reporting in the media: AFIDEP partners with the Media Council of Kenya

The media plays an invaluable role in promoting good governance and driving development in Africa. By covering stories, events and investigating issues that directly or indirectly affect the everyday lives of ordinary people, the media creates public awareness, influences behaviour, shapes public policy and opinion, and acts as a watchdog. AFIDEP appreciates the media’s contribution towards development efforts in Africa by creating healthy debates around issues of science; governance and accountability; the environment and climate change; reproductive health; population health and sustainable development, and through leveraging on partnerships with the experts on these issues to contribute to making the discussions be informed by evidence.

In this regard, AFIDEP is keen to cement a mutually beneficial relationship with the media in the various African countries that we work in. The goal is to improve how scientists and researchers view the media and media platforms, and vice versa, and to also improve the quality of journalism by nurturing a culture of evidence-based reporting. For instance, three weeks ago, AFIDEP initiated a partnership with the Media Council of Kenya (MCK), a statutory body mandated to develop and regulate the media in Kenya. The partnership was marked by AFIDEP’s involvement in the Annual Media Summit, a signature event of the MCK, in collaboration with various partners.

Taking place between 7-9 August 2019 in Nairobi, Kenya, the Media Summit brought together journalists, diplomats, governance experts, and academicians to discuss and share experiences under the theme: Media, accountability and good governance’. The 8th edition of the Annual Media Summit kicked off with a one-day pre-media training for selected journalists from across the country, and culminated into the Annual Journalism Excellence Awards (AJEA) Gala Dinner, which recognised and awarded journalistic excellence.

Supporting evidence-based reporting on Kenya’s 2019 Census

AFIDEP’s Dr Rose Oronje and Dr Bernard Onyango facilitated training sessions during the pre-summit training, which focused on giving support and ideas to journalists on reporting on the August 2019 Census in Kenya. Highlighting the key areas journalists can focus on during the national census exercise; Dr Onyango spoke to the need for journalists to report on the census beyond the count. He urged journalists to refrain from focusing on the political angle of the numbers and rather draw the public to the importance of the census and how it will contribute to the country’s development.

The national population census is a necessary development tool because it provides a basis for adequate policy and programmatic planning. In-depth information will be generated from the census, which may reveal aspects such as population structure, fertility trends, education attainment, employment rate, housing conditions, and migration trends, among others. This information will help to inform public policy amendments as well as make projections for future development needs.

Notably, the 2019 census is the first census to be carried out under Kenya’s 2010 Constitution and its devolved system of government. County governments are set to benefit from the data collected, which can be used, for instance, to inform the county integrated development plans.

Why use evidence in journalistic reporting?

In her presentation, Dr Oronje said, “We [AFIDEP] appreciate the way the media is currently using data in their stories. The stories have been transformed by use of data and research.” She urged journalists to take advantage of academic research as sources in their reporting, drawing attention to how research findings can create powerful news stories relevant to their audiences.

The use of evidence as a basis for journalistic reporting not only enhances the accuracy and objectivity of a news story, but it also helps journalists to address issues in a more informed and impactful way. Dr Oronje noted that increased use of research and data would further strengthen the media’s role in development.

When it comes to reporting on science and research, serious concerns have been voiced regarding the current practices and capacities of journalists. Journalists often have difficulties reporting on science and research due to the technicality of content while researchers do not trust journalists to report accurately. Yet, the media is a strategic conduit that can link the public, researchers and policymakers. Researchers can use the media to advance their findings to the top of the policymakers’ agendas and on the other hand, the media can engage the public in awareness, policy development and implementation.

Engaging and working with the media, is one of the many actions that AFIDEP has taken to enhance understanding of science and research by the public, policymakers and the media itself. We endeavour to inculcate a culture of evidence-based reporting in addition to improving the way journalists write and present their information.

Evidence-based journalism calls for journalists to collect, assess and combine adequate and credible information on a given issue, ensuring that their sources are reliable and that the information is factual. It also extends to journalists being objective in their reporting as well as incorporating ‘the so what question’ which interrogates the impact or lack-of, of a news story.

As AFIDEP continues to work with journalists in Kenya and across Africa, we envision a media fraternity that can demonstrate value, is responsive, transparent, more accountable, and engages better with the society they serve with the overall goal of improving lives.

 

 

 

 

World Population Day 2019: Accelerating the Promise

On 11 July 2019, AFIDEP joined stakeholders in population to commemorate World Population Day 2019 in Kisayani High School in Kibwezi town, Makueni County. The commemoration was led by the National Council for Population and Development (NCPD) – the host of the event and the focal government agency on matters relating to population and development policies and programmes in Kenya – and the United Nations Population Fund (UNFPA) Country Office – Kenya.

The theme of this year’s commemoration is fulfilling the commitments made 25 years ago at the 1994 International Conference on Population and Development (ICPD) in Cairo, Egypt. While the Conference was a global milestone in reproductive health and rights, resulting in a revolutionary Programme of Action (PoA) that received the backing of 179 governments, the POA has yet to be realised in its entirety by national governments and the international community.

Specifically, the 1994 ICPD PoA called for all people to have access to comprehensive reproductive health care, including access to family planning, safe pregnancy and child birth services, and the prevention and treatment of sexually transmitted infections.

In the lead up to the Nairobi Summit on ICPD 25 in November 2019, this year’s World Population Day theme – Accelerating the Promise – provides a call to mobilise the political will and financial commitments we urgently need to finally and fully implement the ICPD Programme of Action.

In this video, we interview Hon Adelina Mwau, the Deputy Governor -County Government of Makueni, and Dr. Josephine Kibaru-Mbae, the Director General, NCPD, for their take on the significance of this year’s World Population Day theme, the Nairobi Summit, the teen pregnancy menace in Kenya, and why this year’s commemoration was held in Makueni County.

Our 2018 Annual Report: Evidence Drives Policy Decisions and Action

 

 

The African Institute for Development Policy (AFIDEP) is pleased to share with you the 2018 Annual report: Evidence Drives Policy Decisions and Action. Read how in 2018, evidence on demographic dividend (DD) informed programme priorities for Africa among development partners, and how various African governments moved from awareness to integration of DD in their population policies and national development plans. We also worked towards strengthening accountability and governance systems at national and sub-national levels and witnessed an increase in the demand for use of evidence and skills towards effective governance.

In 2019, we look forward to a vibrant year in which we launch our 2020-2024 strategic plan and renew our commitment and focus to having evidence transform lives in Africa.

We thank you for continued support and collaboration.