In February 2020, INGSA-Africa announced the winners of their 2019 Essay Competition.
Shortly after, the world was forced to pivot entirely to the threat of COVID-19 and regrettably, these essays were not celebrated in the way we would have liked
So even though the local and global context has now changed so much, we wanted to release the winning essays from 2019 and hope that you find them insightful despite the delay in their publication.
Olasoji Fagbola – Nigeria
The need to incorporate scientific evidence in policy formulation and execution has been widely recognised in literature (Yagboyaju, 2019). Over the years there have been increases of literature focusing on knowledge and how public policies can be better informed by evidence. This practice also termed evidence-informed policy making (EIP) or evidence-based practice has been promoted to help in policy development in most countries (Lomas, 2000; WHO, 2007).
Evidence-Informed Policy-Making (EIP) or Evidence-based practice is defined as the systematic ways to ensure that research evidence becomes incorporated into policy-making. It has been referred to severally as knowledge transfer, knowledge translation, research utilisation, implementation, knowledge exchange, diffusion and dissemination (Graham et al., 2006). One of the characteristics of EIP is the systematic and transparent access to, and appraisal of evidence as an input into policy-making. Thus, science advice is playing an increasing role in the formulation of policy and decision making. Within the innovation literature, evidence is argued to include experiences or received wisdom of individuals. Nonetheless, it is important to emphasise that scientific evidence is argued to be the most reliable among the different facts used to support a policy or conclusion (Campbell et al., 2009; Dobrow et al., 2004).
Therefore, it is not surprising that Evidence-informed policy-making has assumed increased importance in several arenas of policy-making in many countries. However, in most low- and middle-income countries (LMICs) including Nigeria, the lack of effective use of research evidence in policy-making continues to be a major challenge. This article explores the current state of the use of scientific evidence in the formulation and execution of public policies in Nigeria, identifies ways that Evidence-Informed Policy Making (EIP) has been used in specific sectors in Nigeria and recommends ways to enhance Evidence-Informed Policy Making in Nigeria.
Africa has been widely recognized as the poorest continent (Siyanbola et al., 2016). Advances in scientific and technological knowledge made possible the significant reduction of poverty and improvement in the quality of life in both developed and developing countries throughout the 20th century and beyond. The ability of countries to access, select, comprehend, adapt and use scientific and technological knowledge will increasingly be the determinant of material well-being and quality of life. Thus, knowledge, a product of science and scientific enterprise is one of the critical resources that Africa should apply to drive her development aspirations (NACETEM 2014). Access to new knowledge and technology can help developing countries leverage on the benefit of globalisation of technology (Archibugi and Pietrobelli, 2002).
Given the vital importance of the growth and application of new knowledge to this evolutionary process, it is equally an indisputable fact that the interplay between knowledge and its application in development process produces different results for societies at different levels of development with varied policy consequences (Metcalfe and Ramlogan, 2005). The global economic landscape is experiencing rapid changes. Globalisation especially is creating considerable new opportunities and new challenges. Its impacts on national economics is driven by significant progress in science and technology as exemplified by a plethora of breakthroughs in biotechnology, space research, energy development, and information & communication technologies (ICT), among others.
Evidence Informed Policy Making in Nigeria
The failure of most African countries to achieve sustainable development was compounded by African countries’ lackadaisical attitude towards the application and utilization of scientific and technological knowledge for wealth creation and employment generation, as well as other social and economic objectives. To address this, government formulates policies as a course of action or inaction intended to accomplish a goal (Olaopa et al., 2011). Public policy is the output of the political system and it is made up of all the public decisions that governments authoritatively make (Akindele and Olaopa, 2004). The objective of such policy is mainly to solve societal challenges in a fair and equitable manner. In doing this, the process of policy formulation and implementation or service delivery must be participatory in such a way that it is all-inclusive. The policy must be formulated by stakeholders based on consensus. This is to guarantee public ownership, effective participation, legitimacy, and ensure the responsiveness of public policies and institutions to societal needs (Agagu, 2010).
As a departure from previous science and technology policy documents, the new document, for the first time, integrates the concept of innovation to science and technology. This will help in achieving developmental objectives, especially government’s economic agenda. In this sense, there is a swing in focus from knowledge generation to commercialization. This shift in paradigm is imperative in that new knowledge can be generated and deployed to produce goods and services, which will in turn lead to employment generation and wealth creation.
The use of research results by policy makers and communities in Nigeria has been defined as very limited and challenging and typified by the lack of involvement of policy makers and community in determining the research to be carried out. In Nigeria, one of the most challenging issues associated with evidence-to- policy link is the capacity constraints of policymakers to access, synthesize, adapt and utilize available research evidence (González-Block and Mills, 2013; Uneke et al., 2013). The research-to-policy linkages have been generally seen as weak; and some of the factors that have been given for the low incorporation of research by Nigerian policymakers such as lack of high-quality research, generally weak and unreliable research institutions and evident disconnection between researchers and policymakers. There is little interaction between policymakers and researchers, therefore significant discussion of available research results, their aptness to policy-related problems, and identification of other policy areas requiring research attention is lacking. There is also lack of studies or development in Nigeria that promote evidence-informed policy making involving meetings between researchers, policymakers and the society. Although innovative attempts have been made to connect researchers and policy makers, such attempts focused on organizing a 1-day evidence-to-policy workshop and the effect of these meetings on their practice and getting research into practice is yet to be assessed.
It is therefore obvious that if Nigeria given its natural endowments is to successfully transform its economy and take her rightful place in the comity of nations, science and technology and its integration in national socio-economic development processes must be accorded the highest priority (Federal Republic of Nigeria Science, Technology and Innovation (STI) Policy’, 2011). Looking at economic policies formulated by the government today shows that as a nation we have not really applied science and technology innovation in our policy making.
Nigeria has not been able to accord science and technology innovation the required/needed attention particularly in terms of funding with respect to research and development in the sharing of, and allocation of revenue due to lack of appropriate indicator that shows the implication of such action or inaction. This notwithstanding, various governments have shown interest and increasing appreciation and understanding of the critical role of science and technology in the national political and socio-economic development programmes. In addition, they have at various times made efforts at establishing structures, formulating and designing policies to mobilize science and technology for rapid national development. These bold and deserving efforts have had limited success as the national science and technology system continues to suffer from major weaknesses and constraints as reflected by the inability of the respective policies to attain most of their objectives (Siyanbola et al., 2012). The reason for this includes, among others, lack of concrete evidence to provide the basis for their formulation. Thus, this underscored the need to provide evidence based policy by leveraging on policy research outcomes, including, especially, research and development and Innovation Surveys in line with global best practices.
However, several efforts have been successfully executed in incorporating evidence into policy making in Nigeria particularly in the health sector. This article discusses the use of evidence in the formulation of Human Resources for Health (HRH) policy, the Oral Health (OH) policy and the Integrated Maternal, Newborn and Child Health (IMNCH) strategy. The Federal Ministry of Health and development partners like WHO, UNICEF, Partnership for Transforming Health Systems (DFID), and the United Nations Population Fund, among others, initiated and developed these policies and strategies to strengthen and improve the functioning of the health system to become more equitable and efficient in-service delivery and consequently improve health outcomes. These policies were developed as a result of the Health Sector Reform Program (HSRP) that was initiated in 2003 which was a response to the very low ranking of the Nigerian health system in the year 2000.
The Nigerian IMNCH strategy was launched in 2007. Its objective is to minimize maternal, newborn, and child morbidity and mortality in agreement with the millennium development goals (MDGs) 4 and 5. The policy was as a result of a global agenda to enhance maternal and child health in the MDGs. The strategy was developed within the framework of the National HSRP to tackle the most common factors responsible for maternal and under-5 mortality in Nigeria. The development was supported by Partnership Grant from the Partnership for Maternal, Newborn and Child Health in 2007. The National OH policy was developed in November 2012 after several failed attempts in the 1990’s and early 2000’s at developing and obtaining final approval for an OH policy. It aims to achieve optimal OH for at least 50% of Nigerians through five ways which are: sustainable awareness creation, early detection and prompt treatment of oral diseases using evidence-based interventions, strategic research, workforce development and co-ordination of OH activities including institutionalization of modern dental practices. The policy document was developed by participation of multiple stakeholders of experts in OH, WHO and medical practitioners in the three tiers of the health system. On the other hand, the HRH policy document was first developed in 2006 by diverse stakeholders in health comprising of public and private sector players following world health reports devoted to addressing the global HRH crisis (Federal Ministry of Health, 2010).
Onwujekwe et al. (2015), inferred that evidence played a huge role in the formulation of the above stated policies. According to the respondents, ten types of evidence were used to develop policies within the three case studies. They are survey reports, research publications, systemic review reports of programs, proceedings from expert consultation meetings, experience and opinions of experts and policymakers, national and international policy documents, epidemiological reports and documents on lessons learned from international experiences, and best practice guidelines. Both formal and informal types of evidence were used in the development of the three policies, though the analysis shows that the formal types of evidence played a greater role. For the OH and HRH policies, informal evidence such as experts’ experiences and opinions, were reported to have been useful in the policy drafting stage. Both formal and informal evidences were mentioned in the HRH and OH policies, while the development of the IMNCH was developed from more formal evidence. Generally, respondents stated that formal evidence, like survey reports and research publications were most useful in the agenda-setting stage to identify the need for the policy and initiating the policy development process. International and local evidence were used to establish the need for the policy and develop policy.
Amongst all evidence used, the one considered to be the most important by the majority of respondents across the three cases were findings from national surveys (such as baseline surveys or situation analysis) because they were context-specific, timely and gave a true picture of what was on the ground. Most respondents felt that the methodological rigor, availability of survey reports, relevance, and ease of obtaining the information from these surveys were also what made it especially useful. Survey reports and research publications informed the policy development process across the case studies. These survey reports and research publications were most useful in the agenda setting stage because they provided the push needed to bring the topic on the policy agenda thus initiating the first stage of the policy development process.
Also, journal publications from the Lancet series in IMNCH policy and WHO publications in OH policy were used to a large extent in the problem definition stage and helped buttress the data obtained from the surveys. They provided data on best practices for the OH and IMNCH policies, which helped in development of the policy (WHO, 2013). Reports from expert consultants were also seen by the respondents as relevant in the policy drafting stage because they now built on the information provided by the surveys to enhance the evidence used. The expert consultations gave a practical aspect to the development of the policy because most of the evidence gotten from this source was based on experience of the stakeholders, and that gave more value to the evidence obtained. Furthermore, involvement of technical experts (including researchers) who have an appreciation for evidence and its use in policymaking, also contributes to evidence-based policymaking.
For instance 1% budget appropriation for universal health coverage the allocation of 1% of the consolidated revenue fund (CRF) for the basic healthcare provision fund (BHCPF); in an attempt that will lead to achieving the National Health Act (NHA) of 2014. The NHA provides a legal and policy framework for basic healthcare provision. The NHA was conceived in response to Nigeria’s dire health outcomes and was only passed after a decade of campaigning by civil society and the medical community. Nigeria has the second largest HIV epidemic in the world with 3.2 million infected people. Every day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes Nigeria the second largest contributor to the under–five and maternal mortality rate in the world. These outcomes represent nothing short of a national crisis. The lack of funding for the Basic Health Care Provision Fund (BHCPF), a key component of the NHA, has perpetuated these poor health outcomes. The BHCPF is designed to deliver a basic package of health services to all Nigerians through the primary health system. With N55.15 billion now allocated for the BHCPF, the country can finally begin to properly implement the most significant piece of health policy in her recent history thus in alignment with the sustainable development goals.
Law prohibiting cultivation and use of cannabis and related substances. The use and cultivation of cannabis is not only hinged on the moral point of view, various scientific and non-scientific research and surveys has exposed the health, social and economic implications of legalizing the cultivation and use of this substance. The findings of a survey (The descriptive national survey of drug use in Nigeria, 2018) further highlighted some the effects and dangers of cannabis cultivation and use, and this report prompted the presidential advisory committee on Drug abuse. The National Drug control Master Plan (2015 – 2019) (a policy document on how to fight drug abuse in Nigeria is a product of a scientific research and advice).
Government requires scientific evidences in a wide range of situations, from long term policy development through to urgent crisis management (OECD, 2015). One of the most significant
manifestations of science impact on society has been its place within public policy. There is an ever growing recognition that science has an important role to play in virtually every dimension of policy making at every level of government, from local to international. These dimensions exist in the social, environmental, and infrastructural areas as well as innovation and economic sectors (Gluckman, 2016).
Science-based evidence has proven to be relevant in formulating public policies. However, the practice is relatively new in Nigeria and has not gained much ground. Therefore, there should be collaborative efforts to increase awareness of Evidenced based policy making and collaborative effort should be made between the government, individuals and researchers to ensure that science-based evidences are implemented in initiating and developing policies in Nigeria.
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