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Research to practice: Need for knowledge translation in palliative care in Africa

Author: Eve Namisango, the writer is a Sir Halley Stewart Scholar for the MSc in Palliative Care, Cicely Saunders Institute, King’s College London, and currently the Research Manager at the African Palliative Care Association
13 February 2015
  • Research and academia fellows from across Africa attend a course on systematic review and meta-analyses of health systems research in Uganda, sponsored by Africa Centre for systematic Reviews and Knowledge Translation

I read with interest the e-hospice article by Professor Xavier Gómez-Batiste, Director of the WHO Collaborating Centre, on the WHO and the development of a strategic plan for implementation of the World Health Assembly resolution ‘Strengthening of palliative care as a component of comprehensive care throughout the life course.’

I was particularly attracted to the section on anticipated challenges, with one being “To involve all WHO departments and WHO regions, Ministries of Health, and achieve consensus with the main stakeholders with the plan, and also get funding and support from donors.”

To mitigate this challenge, we need a multi-pronged approach that encompasses training, advocacy, policy, research and then research in the form of knowledge translation.  Knowledge translation (KT) is defined as “a dynamic and iterative process that includes the identification, synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products and strengthen the healthcare system …” (Canadian Institute of Health Research, 2004).  This is indeed a priority for the WHO which notes that for better health we need to research into action (World Health Organization, 2004).

Building capacity in KT will be useful one several levels; availing synthesised quality evidence makes it easy to use evidence to convince donors to fund what works, it becomes easy to  provide rapid response to major questions that might arise and to inform decision making. Lastly winning other stakeholders to endorse the strengthening of palliative care as a component of comprehensive care calls novel approaches to providing quality evidence to demonstrate value in simple terms and this is integral to KT. 

The director of the Africa Centre for systematic reviews and knowledge translation Makerere University, Professor Nelson Sewankambo made very useful remarks;

  • “Sufficient evidence, knowledge, and financial resources exist now to reduce substantially the intolerable burdens of disease in the region.
  • Rapid and efficient translation of knowledge to policy and action is weak, researchers have been relatively ineffective in pushing their evidence to policy and practice.
  • “Policy makers have been relatively inefficient in pulling evidence into policy and practice.”

Creation of new knowledge often does not on its own lead to widespread implementation or impact on health.  Now is the time for us to lay strategies for undertaking more research alongside bridging the “we-need-to-use-what-is-available”, by bridging the “know-do” gap, through KT. This moves the whole agenda beyond providing practical scientific information and focusing on academic publications as a key strategies for results dissemination and will help us ensure that evidence informs policy and decision making.    

The African Palliative Care Association is a member of the Uganda National Academy of Sciences, an organisation that strives to engage the best African scientists through the African science academies in building their capacity to provide independent, evidence-based advice to their governments and nations on all matters related to science and technology. Our collective ambition is to further this work with partners to build knowledge translation capacity for palliative care in Africa.  

References

Canadian Institute of Health Research (2004) Knowledge Translation Strategy 2004-2009: Innovation in Action.  Ottawa, Ontario: Canadian Institutes of Health Research.  www.cihr-irsc.gc.ca/e/8505.html

Davis D, Evans M, Jadad A, Perrier L, Rath D, Ryan D, et al. (2003) The case for knowledge translation: Shortening the journey from evidence to effect.  British Medical Journal, 327: 33-35

World Health Organisation (2004) World Report on Knowledge for Better Health.  Geneva: World Health Organization


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