Inclusive Evidence-To-Policy Processes: Integrated Knowledge Translation for Health Systems Strengthening in LMICs
1
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
2
Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
3
Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
4
Evidence Informed Decision-making Centre, Department of Epidemiology and Biostatistics, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
5
Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Integrated Knowledge Translation (IKT), the sustained collaboration between researchers and evidence users across the research lifecycle and policy-practice ecosystem, aims at bridging gaps between evidence, policy, and practice. While IKT is increasingly promoted in global health, empirical insights into its implementation and systematic monitoring in low- and middle-income countries (LMICs) remain limited.
METHODS:
We synthesised lessons from the Global Evidence, Local Adaptation (GELA) project, a three-year, multi-country initiative (2022–2025) implemented in Malawi, Nigeria, and South Africa aimed at strengthening context-specific, evidence-informed clinical practice guidelines for newborn and child health. Each country developed tailored IKT strategies supported by a dedicated champion and working group. We collected qualitative data from working-group meetings, written reflections, and an endline focus group discussion. This data was analysed thematically to identify cross-country patterns in the planning, implementation and monitoring of IKT.
RESULTS:
Early and continuous stakeholder engagement appeared critical for building trust, legitimacy, and shared ownership. The uptake of IKT varied by institutional maturity: emerging systems (Malawi and Nigeria) showed a greater willingness to engage in co-production, whereas more mature systems (South Africa) required closer alignment with established governance processes. Relational enablers, such as informal networks and interpersonal trust, facilitated engagement but were vulnerable in the absence of institutionalisation. Common challenges among policymakers included leadership turnover, overlapping mandates, limited resources, and fragmented communication. Structured monitoring tools supported adaptive learning in Malawi and Nigeria but were applied inconsistently in South Africa.
CONCLUSIONS:
IKT shows promise as a health systems strengthening approach in LMICs but remains complex to operationalise at scale. Its effectiveness likely depends on early engagement, contextual system alignment, systematic monitoring, and continuous investment in relationships. Developing shared indicators and technology-supported monitoring tools may improve accountability, promote equity, and facilitate cross-country learning, thus advancing IKT as a practical model for evidence-informed, sustainable health system improvement.
Integrated Knowledge Translation (IKT), the sustained collaboration between researchers and evidence users across the research lifecycle and policy-practice ecosystem, aims at bridging gaps between evidence, policy, and practice. While IKT is increasingly promoted in global health, empirical insights into its implementation and systematic monitoring in low- and middle-income countries (LMICs) remain limited.
METHODS:
We synthesised lessons from the Global Evidence, Local Adaptation (GELA) project, a three-year, multi-country initiative (2022–2025) implemented in Malawi, Nigeria, and South Africa aimed at strengthening context-specific, evidence-informed clinical practice guidelines for newborn and child health. Each country developed tailored IKT strategies supported by a dedicated champion and working group. We collected qualitative data from working-group meetings, written reflections, and an endline focus group discussion. This data was analysed thematically to identify cross-country patterns in the planning, implementation and monitoring of IKT.
RESULTS:
Early and continuous stakeholder engagement appeared critical for building trust, legitimacy, and shared ownership. The uptake of IKT varied by institutional maturity: emerging systems (Malawi and Nigeria) showed a greater willingness to engage in co-production, whereas more mature systems (South Africa) required closer alignment with established governance processes. Relational enablers, such as informal networks and interpersonal trust, facilitated engagement but were vulnerable in the absence of institutionalisation. Common challenges among policymakers included leadership turnover, overlapping mandates, limited resources, and fragmented communication. Structured monitoring tools supported adaptive learning in Malawi and Nigeria but were applied inconsistently in South Africa.
CONCLUSIONS:
IKT shows promise as a health systems strengthening approach in LMICs but remains complex to operationalise at scale. Its effectiveness likely depends on early engagement, contextual system alignment, systematic monitoring, and continuous investment in relationships. Developing shared indicators and technology-supported monitoring tools may improve accountability, promote equity, and facilitate cross-country learning, thus advancing IKT as a practical model for evidence-informed, sustainable health system improvement.
| eISSN: | 2654-1459 |
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