Stories from the ground: how integrated knowledge translation affected non-communicable disease policy and practice in five African countries

Article type
Authors
Jessani N1, Delobelle P2, Balugaba B3, Mpando T4, Ayele F5, Ntawuyirushintege S6, Rohwer A7
1Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Institute for Development Studies, United Kingdom
2Department of Public Health, Vrije Universiteit Brussels, Brussels, Belgium; Chronic Disease Initiative for Africa, University of Cape Town, Cape Town, South Africa
3Department of Disease control and Environmental Health, Makerere University School of Public Health, , Makerere, Uganda
4School of Global and Public Health. Kamuzu University of Health Sciences, Malawi
5Non-communicable Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
6School of Public Health of the University of Rwanda, Kigali, Rwanda
7Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Abstract
Background: Integrated knowledge translation (IKT) aims at continuous engagement between researchers and decisionmakers to guide evidence-informed decision making (EIDM). IKT was critical to the Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+), which conducted research on preventing and treating non-communicable diseases in sub-Saharan Africa.

Aim: To describe CEBHA+ IKT journeys through illustrative stories.

Methods: Within CEBHA+, the IKT component included capacity building and mentoring of teams from Malawi, Ethiopia, Rwanda, Uganda and South Africa and resulted in identifying priority stakeholders, developing tailored stakeholder engagement strategies, and developing and disseminating issue briefs to inform EIDM. We reflected on the IKT process and how this affected policy and practice in different contexts.

Results: In South Africa, structured and ad hoc stakeholder engagement was used. Results were disseminated using different media formats and an NCD symposium convened with the National Department of Health. In Uganda, stakeholder meetings were held with local and national policymakers and civil society and a symposium hosted to address the daily mobility challenges faced by people living with disability. In Ethiopia, stakeholder engagement with policymakers, community members, and healthcare providers was guided by a citizen science approach. In Malawi, a Knowledge Translation Platform with policymakers, researchers, and implementers was used to facilitate a coordinated approach for EIDM, which acted as a platform for engagement during the COVID-19 pandemic and resulted in a policy workshop co-hosted by CEBHA+. In Rwanda, researchers engaged with government, traffic police, and healthcare providers. Interventions were discussed during the pandemic, including animated television sessions, mobile phone applications, and physical presence at community meetings.

Conclusion: By actively involving researchers, policymakers, practitioners, and community members, IKT fostered collaboration, improved understanding, and facilitated the translation of research findings into EIDM. We found that grounding IKT in a deliberate and structured process of stakeholder mapping and engagement was important for value and coownership, especially during the COVID-19 pandemic, where the demand from governments in Malawi, Uganda and Rwanda was key to sustainability. Ad hoc engagement through personal networks and opportunities was equally indispensable, especially in South Africa and Ethiopia.