knowledge management & knowledge translation … · •the changing global environment...

Kenya Medical Research Institute

In Search of Better Health

Date: 25TH – 26TH SEPTEMBER, 2019

Prof. Jennifer A. Orwa, Mr. James K. NgumoKnowledge Management Dept., KEMRI

KM Partnership Conference, UN Office, Gigiri, Kenya

KNOWLEDGE MANAGEMENT & KNOWLEDGE TRANSLATION (KM&KT)

PRACTICES – observations & reflections from Kenya Medical Research

Institute experiences

In Search of Better Healthwww.kemri.org

OUTLINE• The changing global environment

• Introduction

• Broad overview of the issues relating to KM

• KEMRI – KM Dept. background information

• Current KEMRI knowledge management & knowledge translation activities

• Output in next 3 years

• Recommendations

• Acknowledgements


Observation 1 –

THE CHANGING GLOBAL ENVIRONMENT (from analog to

digital revolution)


1. Just too much of it and not always what you need.

2. Multiple parallel demands

3. Information goes up and never comes down.

4. Key consumers of information not being served:

- Policy makers- Health managers- Service providers- General public

Drowning in data & related publications!


Introduction

• Different scholars have postulated that there are no two public health situations that are identical.

• Therefore, linking health research evidence to action is critical for our responses to contemporary public health challenges.

• Important for making evidence-informed decisions about the kind of health programs and services to provide as well as decisions about improving health systems within which the programs and services are provided.

• In developing countries, it has undoubtedly remained a big challenge despite the international attention and efforts.


Health Research Landscape in Kenya

• No dedicated mechanism of structured interaction between researchers, policy makers and practitioners

• Policy and decision makers continue to face difficulties in accessing and using research evidence for policy and decision-making.


Introduction (2)• From previous KEMRI research publications - the reasons on why

decision makers are NOT able to use evidence are summarized in 4 broad themes: individual, institutional, communication skills, and timing barriers

• In addition, the would-be users of evidence often are UNABLE to access optimally packaged, high quality and context relevant research outputs in a timely manner.

• Decisions are mutually arrived at and, by nature, it involves consultative aspects involving both participatory and problem-based learning process (Ciliska, D, 2010).


Observation 2 –

We are not using what is available!


1. The “Know-Do-Gap” phenomena – (WHO, 2002) i.e. many publications BUT decision makers do not know HOW to use the evidence to inform decision making process.

2. There exists sufficient evidence, knowledge, and financial resources to reduce substantially the intolerable burdens of disease in our region.

3. Weak processes to facilitate rapid and efficient translation of knowledge to policy and action.

4. Researchers have been relatively ineffective in pushing their evidence to policy and practice, and

5. Policy makers have been relatively inefficient in pulling evidence into policy and practice.

We need to bridge this gap!


Observation 3 –

KEMRI - high supply of research outputs BUT low

uptake by decision makers!


Why establish KM Office?• There exists a number of publications, reports, database containing

useful evidence (there over 3,000 KEMRI publications in peer reviewed journals).

• Some research undertaking have informed and changed practice and policies (but how many?).

• Dissemination Practices – KEMRI’s existing knowledge assets are published in a number of international peer reviewed journals, database, and presented in local, regional and international conferences.


The need to establish a KM Office KEMRI management established the Office of AD (RD&KM) with a view of being overall responsible for developing standard KM / KT structures for:

• Identifying & capturing, • synthesizing (thro systematic reviews & meta

analysis), • packaging, dissemination/sharing and • application of knowledge aimed at improving the use

of research evidence to inform policy and practice


Interventions

• We are in the process of developing strategies to manage the wealth of knowledge that KEMRI has developed over the years through its research as an asset and leverage this asset for a competitive edge

• Mapping of KEMRI assets, health related research institutions & associated data sources


Interventions… • Engagements with County health management teams and

workers for capacity building in KT and Evidence Based Decision Making (pilot counties)

• Busia, Bungoma, Isiolo, Kisumu, Kirinyaga, Kilifi, Kitui, Kwale, Makueni, Machakos, Mombasa, Nyeri, Nyahururu, TaitaTaveta Counties

• Kenya Health Forum 2018 (by MoH): the experiences on the above was shared with participants from all counties present-Health Systems Strengthening Towards UHC


Reflection 1 –

Institutionalizing KM Culture in KEMRI

KEY ACTIVITES…


1. Development of a KEMRI research repository & database

Narrative Output Status

There exists electronic database

of KEMRI protocols and

publications at SERU, IRG office,

and the library.

These database are either in

WORD format or Excel

spreadsheet files.

A document indicating

the situation analysis

of KEMRI KM

activities

Drafting of KM report is

in progress.


1. Development of a KEMRI research repository & database… contd.


The largest database that contain a

significant collection of KEMRI

publications (previous & current)

are the online publishing houses

such as Hinari, PubMed, and PLoS

One.

A list of previous KEMRI

publications to facilitate

systematic reviews, meta-

analysis and mapping of

research studies under

various disease domains

& health systems sub-

themes.

KM has developed a

data architect

schema on how best

to link KEMRI

publications and

SERU database.


2. Development of national health research platform


KM is assisting the MoH in the

development of a KHO –

Research platform (KHRO).

This is a national wide activity

which will involve development of

a centralized repository of past

and ongoing research in health.

KEMRI is taking lead

National exercise towards

development of national

research web platform.

A high stakes activity in

which WHO is waiting for

KEMRI to guide in the

development the platform as

an example to the rest of the

world.

Defined research

indicators.

Defined data

schema.

Developed ToRs for

a consultant to be

hired for the purpose

of collating data.


VISUALIZATION OF THE KEMRI HEALTH RESEARCH OBSERVATORY DASHBOARD

Malaria53%

URTI11%

Road Traffic Injuries

9%

Diarrhea11%

Cancer5%

Parasitic Infections

11%

Concentration of Research Domains

24.1

35.1

30.2 29.6 30.1

12.8

8.85.5 6.5 7.8

52 3

5 43.3

12.5 11.58.8

10.5

2.5 1.8

9.1 8.812.5

2013 2014 2015 2016 2017

Top 5 morbidty conditions

Malaria Flu Stomachache URTI Diarrhea

Disease Type Outcomes Impact Number

of Studies

Quality of

Research

Evidence

(using

GRADE*)

Malaria (1) Community Efforts Evidence is suggestive that community engagement could help in contact tracing and

early treatment leading to better patient outcomes.

(3) Low

(2) Diagnosis & patient management There is no effect on HMM on clinical malaria. More emphasis on laboratory diagnosis (5) High

(3) Donor Efforts For P. falciparum clonal dynamic evaluation, it is important to perform PCR to

saturation for determination of clonal diversity and at log phase for determination of

clonal abundance.

(2) High

(4) Funding Proper mechanisms of procurement, forecasting, storage, monitoring and distribution

of human rabies vaccines are hindered by factors such as poor availability of

antimalaria consumption data and relative high cost of antimalaria.

(1) Low

SUMMARY OF RESEARCH FINDINGS (per county)


3. Compilation of a list of research assets & staff skills mix available in KEMRI


This is part of ongoing efforts

towards compilation of KEMRI

research assets as well as

documenting existing KM

resources.

A document and

database containing KM

assets and skills

resources available in

the Institute.

So far, KM has

received feedback

from various offices.

The team is compiling

a database and a

research directory.


4. Compilation of directory of all national health research stakeholders (under the KHO)


This is part of the national

research by MoH to compile a

list of national research

institutions and existing research

capacity.

KEMRI is taking lead in this

effort under the KHRO –

Research TWG

A list & an electronic

directory of all institutions

(public & private)

undertaking research for

health in Kenya.

Developed a data

capture template.

KHRO stakeholder

meeting, map R4H

data sources.


5. Towards development of a research-for-health policy document & related guidelines.


KM member are part of the Kenya

taskforce on the development of R4H

taskforce which is aiming at

developing a national policy to guide

research in reproductive health.

A document on KM

Policy Document

Currently reviewing

stakeholders’ inputs on

an initial policy

document.


6. Towards development of an EAC regional KM policy & strategic plan (2018 – 2022)


KM office gave technical assistance in

the development of a KM policy

document for the EAC – Health

Department.

The policy paper is to guide the

Health Department on how to

harmonize KM operations at the EAC

region in matters relating to health

programs.

A knowledge

management policy

document for the

EAC Health

Department.

A draft knowledge

management policy.

It is undergoing

validation by the 6

EAC Ministries of

Health.


7. Capacity building in Knowledge management & knowledge transfer


KM Office has commenced the

process of development of a

KM training curriculum &

manuals (for research

scientists & county health

workers).

A KM curriculum and

2 manuals

developed.

So far, we defined the scope

of the KM / KT of the

curriculum.

Design of the course topics &

outline templates in process.


KENYAMEDICAL RESEARCH INSTITUTE

KNOWLEDGE MANAGEMENT:

DRAFT - 1EVIDENCE INFORMED

DECISION MAKING (EIDM) FOR

COUNTY HEALTH

MANAGEMENT TEAMS

KENYAMEDICAL RESEARCH

INSTITUTE

KNOWLEDGE

MANAGEMENT SERIES

KNOWLEDGE TRANSFER

-

A TRAINING MODULE

FOR HEALTH RESEARCH

GROUPS


Reflection 2 –

KEMRI’s KM Activities – next steps; scaling-up & ensuring sustainability …


Output in next 3 years• Deploy a robust platform (both online and offline versions) to

facilitate access to and sharing of knowledge

• Leverage of existing technology (invest) - Big Data system to facilitate SMART decisions (data science concepts, analytics & visualization)

• Encourage active communities of practice to enable networking and mutual dialogues among KEMRI researchers and all stakeholders

• Deliberate / intentional capacity strengthening in use & dissemination of research already available through systematic reviews, meta analysis and policy development


Reflection 3 –

Parting Shot…

Genesis of using evidence – you need context, research evidence & research

question(s)


Recommendations

• We need to invest in technology, big data system and embrace knowledge-based economy

• To move from industrial to knowledge economy, the culture of KM & KT must be well-coordinated to provide a platform that can harness the power of research and knowledge management for UHC

• Health is a precursor to economic development and therefore all stakeholders should embrace change in particular institutional culture change that will facilitate information sharing and mentorship


Acknowledgement

• MoH

• East Africa Community (EAC), Health Department

• Counties CECs of Health & Health Management Teams

• Director General & CEO, KEMRI

• Staff of KEMRI

• KEMRI KM Implementation Team


Asanteni Sana for

your attention &

Join the evidence

use Revolution

knowledge management & knowledge translation … · •the changing global environment...

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