Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa : application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework
Date
2021-05-17
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: In response to the “know–do” gap, several initiatives have been implemented to enhance evidenceinformed
decision-making (EIDM). These include individual training, organizational culture change management, and
legislative changes. The importance of relationships and stakeholder engagement in EIDM has led to an evolution
of models and approaches including integrated knowledge translation (IKT). IKT has emerged as a key strategy for
ensuring that engagement is equitable, demand-driven, and responsive. As a result, the African-German Collaboration
for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) incorporated an IKT approach to influence noncommunicable
diseases (NCD) policy and practice. We documented the phased process of developing, implementing,
and monitoring the IKT approach in South Africa; and explored the appropriateness of using the exploration,
preparation, implementation, and sustainment (EPIS) framework for this purpose.
Methods: We mapped the South Africa IKT approach onto the EPIS framework using a framework analysis approach.
Notes of team meetings, stakeholder matrices, and engagement strategies were analysed and purposefully plotted
against the four phases of the framework in order to populate the different constructs. We discussed and finalized the
analysis in a series of online iterations until consensus was reached.
Results: The mapping exercise revealed an IKT approach that was much more iterative, dynamic, and engaging
than initially thought. Several constructs (phase-agnostic) remained important and stable across EPIS phases: stable
and supportive funding; committed and competent leadership; skilled and dedicated IKT champions; diverse and
established personal networks; a conducive and enabling policy environment; and boundary-spanning intermediaries.
Constructs such as “innovations” constantly evolved and adapted to the changing inner and outer contexts
(phase-specific).
Conclusions: Using the EPIS framework to interrogate, reflect on, and document our IKT experiences proved
extremely relevant and useful. Phase-agnostic constructs proved critical to ensure resilience and agility of NCD deliberations and policies in the face of highly dynamic and changing local contexts, particularly in view of the current
coronavirus disease 2019 (COVID-19) pandemic. Bridging IKT with a framework from implementation science
helps to reflect on this process and can guide the development and planning of similar interventions and strategies.
Description
CITATION: Jessani, N. S., et al. 2021. Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa : application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Health Research Policy and Systems, 19:82, doi:10.1186/s12961-021-00733-x.
The original publication is available at http://health-policy-systems.biomedcentral.com
The original publication is available at http://health-policy-systems.biomedcentral.com
Keywords
Noncommunicable disease
Citation
Jessani, N. S., et al. 2021. Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa : application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Health Research Policy and Systems, 19:82, doi:10.1186/s12961-021-00733-x