What Shapes Research Impact on Policy? Understanding Research Uptake in Sexual and Reproductive Health Policy Processes in Resource Poor Contexts

"...[T]here is scope for greater cross-fertilisation of concepts, models and experiences between public health researchers and political scientists working in international development and research impact evaluation...."

This paper reviews existing literature to address the following two questions: What are the factors that typically influence the impact of public health research evidence on policy? And what are the specificities of research impact on policy - sexual and reproductive health (SRH) policy, in particular? Throughout this paper, the term SRH encompasses HIV and AIDS, as well as other SRH issues such as sexuality, reproductive services, and sexually transmitted infection (STI) treatment. The authors identify aspects of the policy landscape and drivers of policy change commonly occurring across multiple sectors and studies to create a framework that researchers can use to examine the influences on research uptake in specific settings, in order to guide attempts to ensure uptake of their findings through their policy engagement actions and strategies. They apply this framework to examples from case study papers that are also part of this journal supplement, Strengthening the Research to Policy and Practice Interface: Exploring Strategies Used by Research Organisations Working on Sexual and Reproductive Health and HIV/AIDS, with specific discussion about the dynamics of SRH policy processes in resource-poor contexts.

In the introductory section of the paper, the authors stress that "'researchers' are not the only group interested in research uptake and evidence-based policy making. Such guidelines and recommendations may also be of use to lobbyists, advocates and even potential policy beneficiaries. For example, at the Paulo Longo Research Initiative (PRLO), sex workers, alongside scholars and policy analysts, are demanding an improved evidence base and more attuned policy process in order to improve their health and wellbeing. The appeal of strengthened analytical work on research uptake and impact is therefore not limited to the formal researcher community."

Section 2 highlights the complexity in defining research impact, as well as the diversity in the range of theories and approaches found in the literature to explain policy change. The authors observe that studying the impact of research on policy requires conceptualising outcome measures and that non-academic research instrumental and conceptual impact may be intricately entwined in policy processes. An example that is included illustrates how changing attitudes around SRH issues amongst specific sub-populations, such as sex workers or young people, can affect how health services are designed and targeted, which in turn may affect the behaviour and practice of health workers.

Next, they synthesise key elements from this literature that researchers can use to understand their role in policy processes, and they introduce a framework to analyse the factors shaping the impact of research on policy. As reported here, policy change is seen to be driven by the interaction of 3 dimensions, which can be combined to produce a synthesis approach: (i) Policy ideas/narratives - including how evidence and the health issue are conceptualised and the way their relevance is understood with regard to policy agendas. (ii) Policy actors/networks - including work emphasising the importance of actor interests, key decision makers and policy entrepreneurs, or networks and groups who are influential in decision making. (iii) Political context/institutions. Possible actions might include packaging the research to have resonance with prevailing debates or increasing the researcher's involvement in policy and practice communities and networks. Researchers can also work towards establishing a conducive environment in terms of organising regular meetings and consultations with key policy bodies. Table 1 summarises these pre-conditions for research impact on policy and how researchers and communications specialists can act or strategise within these to support research to policy engagement.

The paper concludes by highlighting the need for continued multi-sectoral work on understanding and measuring research uptake and for prospective approaches to receive greater attention from policy analysts. The authors write that, "when considering factors enabling research impact, it is helpful to distinguish between those that are 'pre-existing' (part of the policy context) and the actions and strategies ('interventions') deployed by researchers and communications specialists. While the latter group are less focused on more traditionally retrospective policy analysis, there are increasing examples of frameworks and approaches which take more prospective approaches, looking at what researchers can do to improve the uptake of research results....We argue that the second set of factors deserve increased attention from policy analysts..."