ARCH Stakeholder Mapping Report

Applying Research to Policy and Practice for Health
Stakeholder Mapping Report
29 th April 2021
Authors:
Wema Mtika 1
Nicole Feune de Colombi 1
Trudie Lang 1
Table of Contents
Executive summary ........................................................................................................................................................... 2
1. Introduction: Applying Research to Policy and Practice for Health (ARCH) programme ......................................... 3
2. Stakeholder mapping ................................................................................................................................................ 3
2.1 Methodology ........................................................................................................................................................... 4
Stakeholder mapping workshop ............................................................................................................................... 4
Online stakeholder mapping survey ......................................................................................................................... 5
2.2 Results ..................................................................................................................................................................... 5
Workshop Participants: ............................................................................................................................................. 5
Meaning of the “research uptake” concept ............................................................................................................. 6
Ten key challenges related to the research uptake process: .................................................................................... 6
Stakeholder snowballing and stakeholder analysis (power interest) ....................................................................... 7
3. Discussion and Key Takeaways ..................................................................................................................................... 7
Limitations: ................................................................................................................................................................... 8
4.Next steps ...................................................................................................................................................................... 8
5. References ................................................................................................................................................................ 9
6. Annex ...................................................................................................................................................................... 11
Annex 1: Workshop exercises ..................................................................................................................................... 11
1
The Global Health Network, Centre for Tropical Medicine and Global Health, University of Oxford, Old Road Campus, Oxford, OX3
7LG, United Kingdom
1

Executive summary
If research is to deliver its maximum impact and positively change health outcomes, findings from health research
should be translated into recommendations that can be implemented within policy and practice. Through the Applying
Research to Policy and Practice for Health (ARCH) programme we aim to bring together researchers, policymakers, and
implementers to address gaps in research uptake to both conduct research to better understand this landscape and
together develop the associated mechanisms to bridge these gaps.
The Global Health Network, with input from Wellcome and DHSC, conducted a stakeholder mapping exercise. This helps
to understand who these key stakeholders are, why they might be interested, how important their involvement is, and
how to engage with them in a way that can contribute to successful research uptake. Following a stakeholder mapping
scoping exercise to establish a methodology, we defined the initial context and scope of the programme and stakeholder
mapping, identified an initial list of stakeholders and their categories, conducted a stakeholder mapping workshop, and
supplemented the workshop data with an online stakeholder mapping survey.
Key take-home messages from the stakeholder mapping exercise
Research uptake is generally understood as “translating research findings into clinical practice and health policy”.
Research Uptake is a critical part of the research cycle: study results and recommendations inform policies and
practices; policies and practices inform research questions to be addressed.
However, there is a knowledge transfer gap between researchers, policymakers, and those who implement work on
the ground/ healthcare settings that needs to be addressed.
For research uptake to happen:
1) community engagement needs to be thought of and incorporated through during the planning phase of
research projects
2) stakeholders’ levels of power and of interest should be considered from the study planning phase, as these
change constantly and can even be “provoked”
2

1. Introduction: Applying Research to Policy and Practice for Health (ARCH) programme
Currently, there is wide separation between teams that undertake health research, those making decisions on health
priorities and policies, and those who are delivering healthcare, particularly in resource-limited settings. Research
considered “successful” typically concludes with the publishing of papers. Less attention is paid to how, and indeed if,
those findings are made visible and accessible to those tasked with decision-making and clinical caregiving. Further,
those working in delivering healthcare are often not aware of new interventions and have no means to determine if
they would bring benefit to their community. Such health interventions could be novel treatments or new approaches
to practice and prevention that would serve to address their local health priorities. Health researchers, decision-makers
and implementers need to work together better to ensure that research evidence is made easily accessible as
recommendations that can be taken up into policy and practice at all levels.
Previous efforts to enable taking research into practice have typically been short-term focussing on a single intervention
or product for a specific disease. As a result, this work was not well-established or embedded into programmes or
institutions. Together these factors represent barriers to the implementation of proven interventions, treatments and
vaccines which ultimately limit the potential benefits to human health. This programme builds upon proven and existing
systems that successfully bring global health organisations together to create efficiency and strong impact by facilitating
knowledge exchange, active coordination, and collaboration.
The Global Health Network aims to bring together researchers, policymakers, and implementers to address these gaps
in research uptake to both conduct research to better understand this landscape and together develop the associated
mechanisms to bridge these gaps. In doing so, we aim to:
• Foster a global, multi-disciplinary community of practice, bringing together research, development, and policyexperts
to share best practice and exchange knowledge and skills. The community will be brought together
through a digital knowledge hub.
• Understand the research uptake landscape, including stakeholders, barriers, and opportunities, in order to
develop and deliver the tools, resources and training needed to support researchers, policymakers and
development partners in this work.
• Embed a network of Coordinators across the Global South, ensuring the contextual barriers and enablers for
research uptake are understood and addressed throughout this work and bridging between local and global
initiatives within this project.
• Apply advanced digital technology to enable rapid synthesis of available research findings and
recommendations to drive improvements in research uptake, beginning with the findings from the ZIKV
outbreak.
This 2-year Wellcome-funded proof of concept award will develop a strong evidence base for this work and bring
together a global community of practice.
2. Stakeholder mapping
As part of the ARCH programme, there is a need to understand the research uptake landscape. Partnerships with key
stakeholder groups involved in the various aspects of the research uptake are crucial to ensure this project amplifies
existing and ongoing work, reduces duplication and that the strategy and initiatives meet the needs of the health
research community. A key activity to inform who these groups are and how to engage with them is a stakeholder
mapping exercise.
With input from Wellcome and DHSC, in March 2021 we conducted a stakeholder mapping exercise to understand who
these key stakeholders are, why they might be interested, how important their involvement is, and how to engage with
them in a way that can contribute to successful research uptake. Specifically, we conducted the stakeholder mapping
exercise to build a common understanding on significant stakeholders within the research uptake landscape and who
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may impact on programme success, categorise stakeholders according to their (potential) role in the project, assess
acceptability of the project, set a plan for engaging with stakeholders throughout the project, and account for potential
risks to the project and consider appropriate mitigation strategies.
2.1 Methodology
A scoping exercise was undertaken to define the methodology. This revealed that stakeholder mapping methodologies
varied among projects and contexts, and, as such, there was no one standard methodology in literature (2,3,12–15,4–11) .
Nevertheless, most approaches analysed followed the steps of snowballing 2 , and categorising stakeholders according
to their power or influence and interest in the project. Therefore, The Global Health Network adapted and developed a
stakeholder mapping methodology based on different steps of such similar methodologies in literature and
supplemented the steps with an online survey. The ultimate steps were:
1. Defining the initial context and scope of the project and stakeholder mapping
2. Preliminary identification and categorisation of stakeholders
3. Stakeholder mapping workshop
4. Online survey
Defining the initial scope of the mapping exercise included defining the types of organisations, the focus of disease area,
and the locations of individuals and organisations as well as the scale they work at (for example
national/regional/global). ARCH is a global programme that is interested in any health area, and as such, it was agreed
that the programme would be open to all actors working in any health areas.
Next, we identified anticipated stakeholder categories (researchers, academia, policy makers, policy networks, and
health professionals) that were involved in research uptake using guidance from a literature review (2,3,6,8–11,15–17) .
Working with the ARCH partners, a list of known and partner stakeholders were invited to a three stakeholder mapping
workshops organised by The Global Health Network. For those participants that were unable to attend the workshops,
they were invited to take a stakeholder mapping survey containing similar exercises from the workshops.
Stakeholder mapping workshop
In March 2021, The Global Health Network held three virtual workshops with representatives of the initial stakeholder
groups (2,8,9,12) following time zones in Latin America, Africa, and Asia. In response to the COVID-19 pandemic, the
workshops were hosted virtually, using the Zoom video conferencing system. The objectives of these workshops were
to understand:
i. how individuals understand the term “research uptake”
ii. the roles of different stakeholders in relation to research uptake
iii. how different types of stakeholders are perceived
iv. the levels of power and interest stakeholders have regarding research uptake
v. stakeholder relationships and how they work together
In preparation for the workshop, participants were given a pre-workshop exercise in which each participant had to
consider the research uptake landscape and stakeholders in their context. On the day of the workshop, an introduction
of the programme and stakeholder mapping activity was given to participants. Participants were asked to
2
Identifying a wider list of stakeholders and stakeholder categories by starting with a few stakeholders that identify new
stakeholders (19)
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1) explore what research uptake meant and brainstorm other potential better terms that could be used.
2) identify other relevant stakeholders they thought were involved in some way in research uptake in their context
or generally.
3) indicate the stakeholders’ governance levels, key interest, and how they interacted with research uptake.
To achieve this, participants used the ‘Mendelow’s Power-Interest Matrix’ (15) ; placing the stakeholders in the matrix
they most likely belong to, in order to give a visual representation of their positionality in the project, while noting the
reasoning behind that characterisation.
High power
Low interest
Action: Keep
satisfied
High power
High interest
Action: Manage
closely
Low power
Low interest
Action:
Minimum effort
Low power
High interest
Action: Keep
informed
Both the stakeholder snowballing, and analyses were facilitated using Miro, a virtual-group-writing board.
Online stakeholder mapping survey
An online form was shared to participants that were unable to attend the workshop with the aim of supplementing the
workshop data. The survey was open from 12 th March to 29 th April 2021. Questions sought information about
participants’ demographics, how they understood the term “research uptake”, and then asked them to identify
stakeholders in research uptake and analysing them according to power and interest in research uptake. Responses
were submitted electronically, and subsequently downloaded into an Excel spreadsheet for analysis.
An output from this exercise is that we developed a stakeholder mapping tool containing a step-by-step guide to
stakeholder mapping in research uptake, that other groups can adapt and use. This tool, and the methodology was
adapted from several methodologies identified in the stakeholder mapping methodology scoping exercise. The tool can
be downloaded for free.
2.2 Results
Workshop Participants:
Ten, Eight, and twenty-four individuals attended the stakeholder mapping workshops in Latin America, Asia, and
Africa, respectively. A total of 11 responses to the online survey were recorded between 12 th March 2021 and 29 th
April 2021.
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The figure below shows yellow streaks of the countries in which the survey respondents came from.
Meaning of the “research uptake” concept
Workshop participants and online survey respondents honed on the need to better understand the term “research
uptake”. Although the definitions provided by participants were slightly different, the definitions provided were similar
across participants Latin America, Asia, and Africa. Participants highlighted that another term that could be used was
“research adoption”.
It was also noted that while research uptake is just two words in English, in other languages like Spanish, one must
explain it a bit more. We will still keep considering whether a better term can be found throughout this pilot project.
Ten key challenges related to the research uptake process:
During the workshops, different challenges in research uptake were mentioned. The box contains a summary of them.
1 Priorities of researchers and implementers may differ, and as such have different outputs that may not be used
after the research process is complete.
2 Usually, actors in research uptake do not know how to proceed with study recommendations or how to disseminate
the information to the appropriate audiences.
3 Most research that is promoted is in academia, e.g., undergraduate, and postgraduate levels which may not
necessarily be biomedical and hence findings are hardly implemented.
4 Research findings may be different among studies or contexts which makes it difficult on what information to trust
for implementation.
5 In some cases, social innovation may be a “hindrance” to research uptake because in some instances, communities
find effective solutions themselves.
6 There is often lack of collaboration between ministries of health and researchers because policymakers are often
looking into practical but more economic ways to implement policy and practice.
7 Policy makers are expected to take up work from research findings but do not usually do so because the line of
work where such research recommendations are disseminates is beyond their “comfort zone”.
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8 In some contexts, research work is not of high standard, especially during pandemics. Consequently, most
institutions look up to developed countries for interventions because the perception is that their initiatives are
better.
9 Knowledge generation, including publication of findings is more emphasized than the use of knowledge generated.
10 It is unclear who guides or influences what work or topic is relevant.
Stakeholder snowballing and stakeholder analysis (power interest)
For the workshops and the survey, participants identified stakeholders and the contexts in which they work in, the
health areas they work in, and how they interact with research uptake. These stakeholders have been showcased on
the ‘regions page’ of the ARCH hub (https://arch.tghn.org/regions/).
Following the stakeholder snowballing, participants categorised stakeholders they mentioned and other stakeholder
categories according to the power-interest matrix. Because the stakeholder mapping process was continuous, regional
coordinators for the ARCH programme supplemented the list of identified stakeholders within their networks and
regions.
Through these snowballing activities, we identified 56, 69, 16, and 24 stakeholders for Africa, Latin America, Asia, and
Global respectively.
3. Discussion and Key Takeaways
Participants recognised the revolving nature of the research uptake cycle and the different stakeholders involved. They
concurred that while most research is performed with rigor and integrity and results end up in good publications, what
happens after that is not prioritised. They also agreed how policies and practices should feedback into the research
cycle in generating new research questions, therefore completing the research cycle.
It was also stressed the importance of thinking about research uptake during particular moments throughout the
research cycle. Advocacy of research uptake should be done from the very beginning and at all spatial levels, such as local,
provincial, and federal. Researchers also need to increase their confidence, to plan and conduct research tailored to
taking up the findings or recommendations into policy and practice.
Participants from Asia argued that stakeholders may be able to influence an activity because of other circumstances
such as having a link to an institution or individual who can provide them that power. Participants also highlighted that
the categorisation of stakeholders in this manner is not a static or permanent approach. Levels of power or interest are
constantly changing among stakeholders. Additionally, power and interest levels among stakeholders depend on specific
health issues in question. Like the Asia workshop, participants in the Africa workshop argued that stakeholders,
especially the community, may change their position across the power-interest matrix. Also, they mentioned that some
stakeholder’s interest can be provoked. Such is for example the case of the parliament, who in general has power, but
their interest needs to be “provoked” through engagement. The parliamentarians may not understand the importance
of evidence, but this can be changed or created through policy engagement.
Further, it was emphasised by the participants that communities 3 are usually not involved in research process, and
especially in the formulation of research proposals, which then in return makes it hard for them to understand how
research results and resulting action (policies) impact their life. As such, research needs to be brought to communities
3
Referred here by participants as group that benefits from research, such as health personnel, local governments, or non-profit
organisations, etc.
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in the planning phase whilst engaging them. Communities should be involved in deciding steps to be taken, giving
feedback, and building consensus. Research initiatives must also come from the community in order to ensure
sustainability of implemented initiatives.
Additionally, dialogue between researchers and policy makers and implementers should be fostered so that policy
makers understand research recommendations and are able to action them, likewise researchers can generate
appropriate and needed research questions for policy makers and implementers. This shows that a workspace is needed
to foster the dialogue between different stakeholders in the research uptake process. A solution to this could be the
development of a virtual workspace: policy lab.
Limitations:
Overall, participants were able to identify stakeholders they had heard of, or had interacted with in some way, but their
limited ability to completely characterise the stakeholders on the snowballing table could be attributed to limited
knowledge in what the stakeholders do or workshop time constraints. Similarly, it was difficult for the workshop
participants to categorise every stakeholder they had snowballed earlier on the power-interest matrix. As such,
participants categorised broader stakeholder groups on the power-interest and not specific organisation names. These
data were better captured in the online form because for every stakeholder entry, respondents had to categorise the
stakeholder instantaneously. Nevertheless, the workshops enabled richer discussions especially revolving around the
concept of research uptake.
4.Next steps
Using the data collated from the stakeholder mapping exercises, a stakeholder engagement plan is being developed for
the ARCH programme. Working alongside ARCH partners, regional coordinators and engaged stakeholders, the Global
health network will:
• Creation of a virtual workspace (policy lab) to foster dialogue between different stakeholders, raise awareness
and visibility and to link research groups working on recommendation strategies and outputs for their findings
• Develop tools and resources so that research uptake can be easily embedded in the planning phase of research
projects, such as embedding it in protocol development tools
• Use these findings and our evolving outputs to develop training courses, awareness videos and as a module
within the Diploma in Global Health Research we are developing
• Showcase studies’ methodologies and research results dissemination activities that have achieved successful
translation into policy and/or practice
• Build in a Research Uptake workstream within our regional coordination centre and research capacity network
programmes (such as EDCTP, REDe, ALERRT and others) with nominated champions who can work together
through the ARCH hub
• Connect research consortia, development agencies and others through the hub to engage together in this aim
• Publish and present at conferences to raise awareness and engagement
We also recognise that stakeholder mapping is neither a static nor a “once off” process. As such, we will continue to
iteratively map and engage with more stakeholders using the online survey throughout the programme.
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6. Annex
Annex 1: Workshop exercises
1. What does research uptake mean to you?
What do we mean by research uptake?
Our current working definition of research uptake characterises this as the ecosystem in which research findings are
transformed into recommendations and taken up into policy and practice, including the systems, people and processes
of research uptake.
This is a working definition, and we warmly invite your perspectives on terminology and definitions.
2. Stakeholder Identification and Snowballing
Make a list of stakeholders you know that are involved in research uptake under the categories in the table below. You
may add an extra category(s). Fill in their governance level, interest, and ways in which they interact with research
uptake (for example, this could be influencing others, generating knowledge, knowledge brokering). Please be as specific
as possible with this exercise.
Stakeholder
group
Stakeholder
organisation
name/
Governance
(country,
international
level
region/
Key
(topic/
area)
interest
health
Interactions
Researchers
Policy makers
Policy
Networks
Healthcare
workers
Other
stakeholders
Any other
comments or
observations
form the listing
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3. Power Interest Matrix
Using the stakeholder ‘power-interest’ matrix and interpretation below, where would you place the stakeholders, you
have listed in 1? Note down the reason why
i. High power/influence and high interest: these are “key players” and are considered a
high priority to be fully engaged in the project
i. High power/influence and low interest: these are “context settlers” and should still be
kept satisfied, but not to a great extent
ii. Low power and high interest: these are “subjects” and may point out areas of
improvement. They may become influential by collaborating with other influential
stakeholders
iii. Low power and low interest: these are the “crowd”, and there is little need for
consideration and engagement. A constant check on their levels of power and interest
should constantly be checked nevertheless, in case it changes
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