Strengthening capacity for evidence-informed decision-making in Africa: evident lessons and opportunities

Abstract

Background and objectives: Unacceptably high rates of malnutrition in Africa persists, despite considerable knowledge and technology to address its determinants. A missing link is the access to and use of quality evidence. In the African context, there is disconnect between evidence generators and users, effectively limiting uptake of knowledge for better policies and programs. The EVIDENT (Evidence-informed Decision-making in Nutrition and Health) partnership was established in 2014 to address this gap. EVIDENT aims to enhance Evidence-informed Decision-making (EIDM) by bridging linking researchers and decision-makers and strengthening their capacity to co-create solutions to address local needs. EVIDENT’s EIDM framework proposes to identify and prioritize information needs, systematically appraise existing evidence, and translate it into concrete recommendations actionable by responsible bodies. We present the findings of a project evaluation, conducted in 2016 to determine stakeholders’ perception of the added value and quality of EVIDENT, and lessons learned regarding drivers, barriers, and opportunities for EIDM in Africa. Methodology: The evaluation used mixed methods including in-depth interviews of EVIDENT partners and stakeholders; project documentation including partner meeting minutes, protocols, and annual reports; and an online survey administered to partners and stakeholders. The evaluation focused on i) the implementation of activities with regard to EVIDENT’s goal, expected out- puts, and milestones; ii) barriers, challenges and opportunities for a future EVIDENT; and iii) lessons learnt for EIDM. Results: EVIDENT achieved the goals of championing EIDM in Africa through: capacity strengthening (delivering courses in evidence synthesis and contextualisation; n=70 persons), tool development (Evidence synthesis guidance and process tools developed), understanding EIDM landscape in different contexts (four country case-studies explored current country-specific EIDM procedures), and responded to local priorities (5 systematic reviews on various topics currently being conducted). EVIDENT has also recognized the need to en sure good Africa-based leadership and coordination; Ghana and South Africa are currently sharing coordination role in EVIDENT. EVIDENT’s challenges included insufficient funding arrangements, leading to inadequate time commitment by partners, feeling of disconnectedness while working virtually, and initial lack of experience in EIDM. Despite these, EVIDENT was well received, globally. Lessons learnt from implementing EVIDENT includes: existence of high demand for EIDM at both regional and country levels, need to establish partnerships with existing regional/global platforms (e.g. SUN, CAADP, etc.) for sustainability, EIDM needs to adapt processes to individual settings rather than a one-size-fits-all approach, and realization that evidence synthesis (e.g. systematic reviews) takes more time to achieve results than often expected. Conclusion and recommendations: EVIDENT has become a champion of EIDM in nutrition in Africa. Continued efforts focusing on leadership, creation of demand for evidence in nutrition policy and programming in Africa, are needed to capitalize on the investment made in capacity throughout EVIDENT’s lifetime. The lessons from the evaluation can contribute to future perspectives on EIDM in Africa and elsewhere