The feasibility of “one-stop shop” for local health policy and systems evidence in Uganda and other low-and middle- income countries

Abstract

Introduction: The increase in global efforts towards evidence-based decision making has led to a remarkable growth in knowledge translation. As such, there have been initiatives to develop “one-stop shops” for supporting dissemination of the evidence (resulting from growth in knowledge translation). However, this has been majorly in high income countries. Such resources especially, those focused on local policy-relevant documents have been lacking in low-and middle-income countries. There has been little or no empirical work undertaken in such countries to understand how user-friendly resources can be developed. Thus, our research work aimed to address the critical gaps in literature and advance methods for developing “one-stop shops” with a focus on resources for local policy documents in low-and middle-income countries.

Methods: In this research, we utilized a number of designs including a scoping review of Uganda-specific, health policy, and systems relevant documents produced between 2000 and 2014 to identify and characterize the available health policy and system-relevant documents in Uganda. We also used a cross-sectional study design involving in-depth interviews with potential users including policymakers, health policy advisors, health managers and researchers to generate evidence on their experience with the clearinghouse. Lastly, we used a single case study design to critically analyse and provide a comprehensive account of the development process of the Uganda Clearinghouse for Health Policy and System Research.

Findings: This research work revealed that different types of health policy and system relevant documents do exist in Uganda, a country with limited resources. The different document types cover a wide range of health topics with varying volumes and that it is possible to find and index such information in a user-friendly “one-stop shop” despite limitations in this setting. It also demonstrated that target users were able to use an online “one-stop shop” to successfully search for information with accuracy and completeness in a short time. The users were also satisfied with the resource regarding its accessibility on the web, ease of use, organization of information, visual appearance and content. Lastly, this research work identified a seven-steps iterative process for developing a one-stop shop for local health policy and system relevant documents. The idea of seven-steps process is new and has not been previously identified by any research efforts on “one-stop shops” for evidence.

Conclusion: This thesis contributes to addressing important knowledge gaps and advancing methods for developing a user-friendly “one-stop shop” for local health policy and system documents in low- and middle-income countries. To develop “a one-stop shop”, one needs to follow a seven-steps iterative process. Further, a tailored index based on health system topics and what the users consider to be national health priorities can be applied to organise its content in a user-friendly manner. Lastly, the usability of such a resource can be improved by regularly appraising and updating its content, in addition to optimizing its capacity to search for information and having it hosted by a credible institution.