The Journey to Enhancing Research Utilization for Family Planning: Experiences and Practical Lessons from the Field

Reana Thomas, Technical Officer, FHI 360

Trinity Zan, Associate Director, FHI 360

With contributions from Dr. Suzanne Kiwanuka, Senior Lecturer, Department of Health Policy Planning and Management, Makerere University School of Public Health and Fredrick Mubiru, Technical Advisor, FHI 360

In a world of demands, deadlines, and deliverables, the staff of the Research for Scalable Solutions (R4S) project took a moment to reflect on one of the priority project elements: research utilization. The R4S project conducts implementation science research to improve the efficiency, cost-effectiveness, and equity of family planning (FP) programs in Africa and Asia. In global health, research utilization (RU) is a cyclical process of integrating evidence into practice for better health and development outcomes in the communities we serve. RU is embedded in the planning of every activity within the R4S project with the use of several available tools. As a project, we thought it was time to come together through “pause-and-reflect” sessions to talk about the challenges we have faced, identify solutions, and celebrate successes in the spirit of improving RU in R4S.

First, we reflected on our successes. R4S staff members, who bring years of experience and successes with research utilization, noted what has been working with RU and stakeholder engagement. We celebrate:

  • The development of R4S-supported research and learning agendas for FP that informed countries’ FP2030 commitments and costed implementation plans
  • The formation of country-specific equity in FP working groups to help address relevant questions and needs in the research and learning agendas
  • The development and release of the Drug Shop Operators’ Provision of Injectable Contraception manual to support expanded access to and choice of methods within the private sector
  • A digital content review leading to improved FP content within client-facing digital tools
  • The compilation of indicators used to monitor high impact practices (HIPs) in FP helping to identify information gaps and highlight the need for harmonization

In addition to the more visible successes, we also celebrate the RU accomplishments less apparent to the public. One of the key principles of, and strategies for, RU is stakeholder engagement. R4S stakeholders are numerous; they include government officials, funders, researchers and research institutions, nonprofit organizations, civil society organizations, and, of course, the people in the communities. R4S staff bring evidence to these diverse stakeholders through a variety of strategies. R4S has hosted independent data interpretation workshops where stakeholders tell us what the data mean to them. We are regularly part of country-level FP technical working group meeting agendas. We celebrate making RU a deliberate and intentional part of regular check-ins internally and formally including it in study protocols by creating RU plans.

Though the team has had many successes, stakeholder engagement can be one of the most challenging aspects of RU. Many barriers to research uptake involve stakeholder engagement, for example stakeholders not being included from the beginning and continuously throughout the life of the research activity. Another barrier is a lack of communication between researchers and end users. R4S staff reported experiencing the following challenges:

  • Connecting with stakeholders: Connecting with stakeholders is an essential step in the process. Challenges to that include stakeholders not having adequate time for meetings or having packed schedules, the need to find alternative methods to connect through COVID-19 lockdowns, a lack of our presence in certain communities, and the need to retain consistent stakeholders.
  • Building stakeholder ownership of activities: Stakeholders often feel that their priorities are not valued by research partners, which can severely affect research uptake, so project staff must listen to and advocate for those priorities when they can. Researchers also need to think about how stakeholders can apply study findings in policy and programs.
  • Managing stakeholder feedback: Feedback from stakeholders is an important part of the RU process, but setbacks such as a delay in analyzing results, missing the right time to present materials, or certain stakeholders being unfamiliar with a topic, may disrupt feedback channels.
  • Navigating stakeholder expectations: All projects have limitations, so stakeholders may expect more from the project than is possible at the time if assumptions are not clarified. An example is when we cannot expand the study scope to include a region or district of interest due to budget limitations.

We know that successful RU requires us to implement a range of strategies systematically and continuously. These pause-and-reflect sessions confirmed that we are on the right track and generated ideas on how we can tweak and adjust our approaches. These are a few of the things we will focus on as we move ahead:

1) We will continue to conduct stakeholder analysis and mapping that allows us to understand each stakeholder’s perspective, priorities, and preferences related to a proposed study. Staff suggested creating stakeholder profiles that could help individual team members — who may not engage directly with stakeholders — to better grasp stakeholders’ positions and tailor research products and communications materials.

2) We will hear what stakeholders expect of us and clearly communicate to stakeholders at the start — prior to protocol development — what our studies can and cannot do.

3) We should not rely on our own assumptions of the right platforms needed to connect with stakeholders and when to use them. Instead, we will ask stakeholders directly how and when they want to be engaged.

4) We will not underestimate the value of a trusted messenger or an insider. We will seek out and leverage relationships with trusted individuals who can act as brokers and champions — opening doors to certain stakeholders and helping convey key concerns and considerations. We will continue to connect with those who have knowledge, or even influence over, stakeholder schedules and agendas. This is an effective way of getting necessary “airtime” with our key audiences.

5) We will explore different ways of working with stakeholders, such as engaging with champions and establishing technical advisory groups, to ensure findings are conveyed to the right people, with the right message, at the right time.

R4S is committed to continuous learning as we navigate the journey to promote RU for FP, so we plan to organize more pause-and-reflect sessions and to use what is learned to strengthen RU within the project.

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