Evidence-informed policymaking from the Global South is key to advancing the SDGs
Equitable, responsive and inclusive evidence-informed policymaking (EIP) is essential to improving the wellbeing of all populations regardless of their age, gender or socio-economic status, and to accelerating the achievement of the Sustainable Development Goals (SDGs). Today’s development problems are complex, with new and significant hurdles emerging such as climate change, the increase in conflicts within and across borders, political instability, social fragility, food insecurity and health crises. These challenges require engaging not only those that are considered technical experts, but also those who are experiencing these problems firsthand. The input of affected populations and communities has rarely been a part of the evidence informing policymaking.
Underlying these problems are profound social disparities and deepening punitive cultural environments as well as gender and social inequalities. In this complex landscape, policymakers and practitioners continue to grapple with the need to adapt and innovate. Against this backdrop, the utilization of evidence is imperative. It is not only vital for comprehending the intricate dynamics of politics, socio-economics, environmental factors and health but also, more crucially, for informing and steering the development and implementation of policies that are effective, coherent, equitable, inclusive and sensitive to gender considerations.
Timely evidence that responds to the requirements of policymakers, who seek globally informed, locally relevant solutions, is always in demand, especially during emergencies. The COVID-19 pandemic showed that whole-of-government and whole-of-society approaches are needed, encouraging stakeholders to collaborate across sectors and disciplines. For example, in the health sector, health outcomes are strongly influenced by non-medical factors known as the social determinants of health (SDH). Addressing the SDH requires action by all sectors and civil society, beyond the health sector. It is therefore inconceivable that improving the health status of populations can be accomplished without evidence to support interventions to address the SDH. It is this interconnectedness and a supportive evidence ecosystem that are needed now more than ever.
By the evidence ecosystem, I refer to those people, systems and processes that are producing, translating, disseminating and using different types of evidence through working across various relevant sectors and disciplines toward achieving the SDGs. Innovations in capacity development and investing in Global South leadership are critical to strengthening the evidence ecosystem and promoting institutionalization of EIP. These critical factors are described below, including examples of what has been accomplished and how to sustain the efforts for longer-term impact.
Achieving the SDGs requires long-term vision to build the infrastructure for evidence ecosystems to address socio-economic inequalities that lead to worsening forms of discrimination and marginalization of already vulnerable groups, such as women, girls and Indigenous populations. Without institutionalization of evidence ecosystems, these inequalities are perpetuated.
IDRC and the Hewlett Foundation jointly funded the Partnership for Evidence and Equity in Responsive Social Systems (PEERSS) in 2018. PEERSS supported 13 country teams in finding ways to entrench knowledge translation and evidence use to inform policymaking in the social systems. Effective strategies included the establishment of knowledge management and rapid-response service units that supported efforts to institutionalize EIP within government structures. Examples of the effectiveness of each of these strategies are shared below.
Institutionalizing the use of evidence and how embedded evidence-use structures can help
Many countries are now attempting to improve their knowledge translation and EIP systems by piloting rapid-response service units that can help decision-makers access timely and quality data to respond to emerging needs. However, there are gaps in these attempts, such as a lack of know-how, an inability to supply proven approaches that work, and an absence of resources and infrastructure for these systems. PEERSS supported this process and generated several successes and lessons learned.
For example, in Nigeria, the African Institute for Health Policy & Health Systems laid the groundwork for establishing a Rapid Response Services Unit within Parliament to support legislative activities. Through workshops, training opportunities and relationship building, the team obtained buy-in from parliamentary leaders on the need for this type of unit. The team assessed EIP knowledge and capacity among key parliamentary staff directly involved in legislation and used the information to produce a guidance document on utilizing evidence in legislation and the design of initiatives. The Rapid Response Services Unit relies on the existing legislative staff and infrastructure to facilitate a timely supply of evidence.
In Burkina Faso, the Knowledge Management and Transfer Unit (KMTU) within the Ministry of Health supported a study to track the use of COVID-19 funding to inform decision-making and launched an internet portal for the KMTU to improve access to, and use of, documents developed by the ministry.
The Ethiopian Public Health Institute supported efforts to institutionalize evidence use in the Ministry of Health (MOH). The team conducted a situational analysis and established a Health Technology Assessment (HTA) unit in collaboration with the MOH and held a stakeholder dialogue. The HTA unit helped the Extended Immunization Programme at the MOH to use the synthesized evidence in directing decisions on eligibility and priorities for COVID-19 and monkeypox vaccines. The HTA unit is established on the roadmap for institutionalizing EIP by Ethiopia’s health system.
Evidence ecosystems require accompanied capacity strengthening in local evidence use
The availability of learning opportunities, tools and frameworks related to knowledge translation and EIP are critical for decision-makers to endorse evidence use for decision-making, planning and programming. PEERSS developed a tailored regional approach to ensure local relevance of capacity strengthening efforts. Key resources generated through the PEERSS partnership are available on the PEERSS website.
PEERSS created four Learning and Collaboration Hubs (L&C hubs) in Africa, Latin America and the Caribbean, Asia and the Middle East, and Europe to strengthen capacities in countries and provide peer platforms and opportunities for learning exchange at global, regional and country levels.
The support provided by the L&C hubs included the development of training kits, systemic reviews, tools and frameworks, such as mapping and stakeholders’ engagement toolkits, training platforms for system reviews and developing stories of change in EIP, and integrating gender equity in research and gender protection in national strategic plans.
The PEERSS country teams and L&C hubs customized support to meet specific country needs for evidence and provided training opportunities for setting priorities for rapid-review methodology across a multi-country academic institution. For example, during the COVID-19 pandemic, the Knowledge to Policy (K2P) Center in Lebanon launched the K2P COVID-19 Series Initiative, which provided rapid-response support to help policymakers and national health authorities make evidence-informed decisions.
In Nigeria, the African Institute for Health Policy & Health Systems developed a certificate course on EIP and knowledge translation/management for policymakers, consisting of eight modules. The team organized several training sessions for decision-makers in the education sector and conducted a rapid review of the reopening of schools during the COVID-19 pandemic. The team trained MOH decision-makers and helped in assessing the effectiveness of the national immunization framework.
The Africa Centre for Evidence (ACE), as an L&C hub in Africa, launched a scoping survey for the Community of Practice on Systems-level Change in Evidence Use, and a series on ‘Why I fell in love with EIDM (evidence-informed decision-making).’ ACE developed training manuals and clinics to use Stories of Change (SOC) and ‘Most Significant Change’ guidelines as part of the SOC clinics held for training PEERSS teams.
PEERSS teams had opportunities to develop and apply tools such as evidence mapping for engaging decision-makers on critical issues throughout the pandemic and beyond. For example, gender-based violence (GBV) has been identified as a major national problem in South Africa. The COVID-19 pandemic hindered GBV services and prevention in South Africa and elsewhere and led to an increase in GBV incidents. The need for evidence-informed policies and an intervention response was urgent. The PEERSS team in South Africa used evidence maps to inform the National Strategic Plan (NSP). These evidence maps included 129 pieces of evidence aligned with, and curated to, the implementation needs of the NSP. Senior leaders requested an update of the evidence on an annual basis and committed resources to integrate the evidence base into NSP implementation.
Sustaining the effort for longer-term impact
In its first phase, PEERSS achieved a great deal, and the growing interest and expertise in evidence meant that a collaborative prioritization exercise was needed. A strategic-planning exercise was conducted during the last year of PEERSS (2022-2023) to understand what lessons were learned and what needed to change for its second phase. The new partnership is renamed “Learning together to advance Evidence and Equity in Policymaking,” or LEEPS for short. The emphasis under LEEPS has now shifted toward more Global South leadership through partner organizations focused on equity measures and in lower-income countries, in particular in sub-Saharan Africa, where the need for EIP support is vast.
Unless the Global South leads in addressing challenges at a country, regional and global level, we will miss a great opportunity to make every life and every individual count. To support this, two African regional hubs have been selected to play key roles in strengthening the knowledge ecosystem and evidence uptake in Africa. The West Africa Regional Hub is led by the African Centre for Equitable Development, and the East Africa Regional Hub is co-led by the Centre for Rapid Evidence Synthesis (ACRES) and the African Institute for Development Policy.
These regional hubs will provide an Africa-based platform for learning and exchange, as well as sustained networks contributing to a community of practice and the sharing of strong examples of South-South synergy and collaboration.
Without long-term investments in the people that make decisions every day and the necessary evidence-use ecosystems, countries will not be able to generate and use the latest evidence, undermining the formulation of the gender-responsive, equitable policies needed to make progress toward the SDGs. This is why IDRC and Hewlett jointly committed to LEEPS, a CAD8.5-million second phase of the partnership, from January 2023 to December 2025.
I am convinced that these types of innovations and investments in capacity strengthening, making tools available, integrating gender and social equity, and promoting Global South leadership are crucial to building sustainable and effective evidence ecosystems to achieve the SDGs.