The utilisation of health research in policy-making: concepts, examples and methods of assessment

Abstract

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions.The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation.Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation.Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis.Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies.

Figure 1

The Place of Policy-Making in the Stages of Assessment of Research Utilisation and Final Outcomes. Key: Direct lines within the flow or feedback Indirect lines of communication Primary Outputs – Publications, trained researchers Secondary Outputs – Policies from national, local and professional bodies Final Outcomes – Health and equity gains, cost-effectiveness and economic benefits Source: Adapted from S Hanney, S Kuruvilla: HRSPA Project 4: Utilisation of research to inform policy, practice and public understanding and improve health and health equity. WHO/Wellcome Trust Technical Workshop. London, January 2002; and S Hanney et al 2000, Evaluation, 6, published by Sage [29].

Figure 2

Decision Context, Research Inputs and Forms of Research Utilisation in Policy-Making