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Table 2 Factors facilitating and those hindering the production, dissemination and utilisation of research evidence to guide policy formulation process

From: Research influence on antimalarial drug policy change in Tanzania: case study of replacing chloroquine with sulfadoxine-pyrimethamine as the first-line drug

Factor Barrier Factors Facilitating Factors
Contextual -Poverty: (i) Possibility that the drug proposed to replace the existing one may not be cost-effective given the poverty situation facing the majority of the residents (ii) Resource poor government – meagre health budget, high national debt crisis -UN agencies e.g. WHO and bilateral agencies e.g. DFID, SDC, USAID, DANIDA etc. readiness to assist technically and financially
-Other countries in the Region also changing their national treatment policy
Actors/Institutional -Fear by drug manufacturers and traders mainly when they still have huge stocks of the drug proposed to be replaced
-Perceptions by doctors/clinicians based on their experiences with prescription/use of alternative antimalarial drugs
-Perceptions of some biomedical researchers and national level policy decision makers
Sometimes contrasting/overlapping research evidence about drug resistance and cure rates of various drugs (lack of/delayed consensus)
-Anticipated repercussions about (i) drug's side effects (ii) poor compliance by drug users and sometimes by drug administrators
-Sustainability in government health budget should donors pull out/terminate assistance or when external assistance is not guaranteed
-Involvement of key stakeholders in research
-Formation and operation of credible Regional organizations such as EANMAT
-Presence formal interface between researchers and policy-makers i.e. institutional and policy frameworks such as TANHERF and professional associations such as national Drug Task Policy Force, MAT, TPHA, and NMAC
-Strong local and biomedical research capacity supported by Northern Institutions, bilateral organisations such as DANIDA, DFID, SDC, USAID and multilateral agencies such as TDR
Content -Cost of alternative drugs
-Cost of implementing national policy change
-Some studies carried out on too small scale in terms of population sample size and area coverage to justify representation of the national picture
-Delay in reporting/disseminating research evidence
-Delay in policy-makers to make informed decisions based on research evidence and recommendations
-Poor communication of research evidence: some reports being too long, some being too technically/professionally written
-Availability of local research evidence on drug resistance
-Detailed research reports (i) e.g. Abdulla et al. [1] on cost-effectiveness analysis of alternative treatment policy options and Research synthesis (ii) e.g. brief reports to feedback policy-makers