CONCEPTUAL FRAMEWORK
2.11 FIVE CRITICAL ENTRY POINTS FOR RESEARCH INTO ACTION LINKAGE
2.11 FIVE CRITICAL ENTRY POINTS FOR RESEARCH INTO ACTION
The sand glass in Figure 11 shows the major steps of the research process from the choice of a policy issue to be studied to the publication of a scientific paper. Only the narrow middle section is governed by strict scientific rules, depicted as tight and rigid. By contrast, the beginning and end points of the research process are not strictly governed by those rules, but accommodate judgement and wider options, hence the less-defined borders. The upper part of the sand glass indicates that health system researchers need to communicate with other stakeholders in order to be acquainted with the agenda and to identify relevant research questions.
Once the research questions are defined the researcher adheres to the scientific research rules. Thereafter researchers need to discuss the interpretation and conclusion with relevant stakeholders.
Figure 11: Sand Glass
Source: Sauerborn et al, 1999:833
The interaction between political imperatives and research evidence will continue to present challenges, but that is not a reason for researchers to shrink from the important part they can and should play in the process. The situation at eThekwini Municipality Health Unit at present is not conducive to a sand glass style of operation as proposed by Sauerborn et al
(1999:833). There seems to be less communication with stakeholders by researchers throughout the research process and this is contrary to the sand glass scenario.
2.11.2 M E D I A T I N G M E C H A N I S M S
The researchers, research users and research funders tend to work in isolation from one another and adhere to their own mandates. Within the framework of strengthening the
research-to-policy link, interaction among all the stakeholders needs to be intensive and to take place at multiple,
overlapping stages of the research and policy making processes. An effective mediator is needed to encourage the various stakeholders to work together. A coordinating mechanism with funding authority, if possible, would be relevant for fulfilling this role.
The eThekwini Municipality Health Unit currently has an internally-focused Research Committee which plays a
coordinating role. A co-ordinating body, or mechanism, which takes care of the interests of both internal and external
stakeholders should be established (eThekwini Health Department Annual Report, 2002).
2.11.3 RESEARCH MANAGERS
The research manager's responsibilities need to include ensuring better linkages between research and action. They must ensure that research work has the best chance of being utilised by potential users by identifying and involving all stakeholders. Sauerborn et al (1999:833) argues that research managers require skills such as facilitating the process, multi-
stakeholder priority-setting, building coalitions around specific problems, seizing opportunities to identify relevant research questions and ensuring that available research is utilised.
The performance of the research managers should be assessed according to the relevance of the research questions or projects formulated, the extent of the involvement of key stakeholders, the sense of ownership by key users and researchers, the effectiveness of research dissemination, the relationship between subsequent actions and available research studies and the impact of research on service delivery. Currently research managers are only at research institutions or
institutions of higher learning. At the eThekwini Health Unit there is no dedicated research manager (Research Committee minutes, 2003:7).
2.11.4 POLITICAL LEADERS
According to Sauerborn et al (1999:834) political commitment sets the political dimension for listening and responding to the concerns of people, conducting the affairs of government in an open and transparent fashion and asking for evidence to support decision making. Political leaders, including councillors, must also be assisted in understanding that investing in science and technology, for both short and long- term purposes, is an investment towards enhancing the wellbeing of the people.
2.11.5 T H E INTERNATIONAL RESEARCH COMMUNITY
The international research community includes research funding agencies (such as the European Union), international research institutes and individual researchers as noted by Sauerborn et al (1999:834). The international research
community includes the provision of additional channels for the international exchange of results and provides assistance to developing-country researchers in order to share results with colleagues in other countries.
Making the best use of available research studies is a priority goal in both developed and developing countries. Most efforts in this regard have adopted a simple conceptual framework which focuses on linking the final stage of the research process with the initial stages of the decision making process.
A more logistic-orientated approach is needed. The Council on Health Research for Development, World Health Organisation (WHO) (2000:8) argues that improving the research policy and action link requires not only introducing new tools and
techniques, but also a paradigm shift among many of the key stakeholders, especially research and research founders. This paradigm shift calls for a better balance between research supply and demand. It requires new skills and mechanisms to create this balance as well as new partnerships within and between countries and at the international level. The eThekwini Municipality already has existing partnerships
with international organisations, especially the donor agencies (e.g. USAID) and most of these organisations have research divisions. (eThekwini Municipality Integrated Development Plan, 2002:8). The eThekwini Municipality Health Unit should, therefore, engage with the research divisions of these
organisations with a view to collaboration and capacity building in health research.