Uptake of evidence in policy development: the case of user fees for health care in public health facilities in Uganda

dc.contributor.authorNabyonga-Orem, Juliet
dc.contributor.authorSsengooba, Freddie
dc.contributor.authorMijumbi, Rhona
dc.contributor.authorKirunga Tashobya, Christine
dc.contributor.authorMarchal, Bruno
dc.contributor.authorCriel, Bart
dc.date.accessioned2022-03-11T15:47:02Z
dc.date.available2022-03-11T15:47:02Z
dc.date.issued2014
dc.description.abstractSeveral countries in Sub Saharan Africa have abolished user fees for health care but the extent to which such a policy decision is guided by evidence needs further exploration. We explored the barriers and facilitating factors to uptake of evidence in the process of user fee abolition in Uganda and how the context and stakeholders involved shaped the uptake of evidence. This study builds on previous work in Uganda that led to the development of a middle range theory (MRT) outlining the main facilitating factors for knowledge translation (KT). Application of the MRT to the case of abolition of user fees contributes to its refining. Methods: Employing a theory-driven inquiry and case study approach given the need for in-depth investigation, we reviewed documents and conducted interviews with 32 purposefully selected key informants. We assessed whether evidence was available, had or had not been considered in policy development and the reasons why and; assessed how the actors and the context shaped the uptake of evidence. Results: Symbolic, conceptual and instrumental uses of evidence were manifest. Different actors were influenced by different types of evidence. While technocrats in the ministry of health (MoH) relied on formal research, politicians relied on community complaints. The capacity of the MoH to lead the KT process was weak and the partnerships for KT were informal. The political window and alignment of the evidence with overall government discourse enhanced uptake of evidence. Stakeholders were divided, seemed to be polarized for various reasons and had varying levels of support and influence impacting the uptake of evidence.en_US
dc.identifier.citationNabyonga-Orem, J., Ssengooba, F., Mijumbi, R., Kirunga Tashobya, C., Marchal, B., & Criel, B. (2014). Uptake of evidence in policy development: the case of user fees for health care in public health facilities in Uganda. BMC health services research, 14(1), 1-19.10.1186/s12913-014-0639-5en_US
dc.identifier.otherDOI 10.1186/s12913-014-0639-5
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2778
dc.language.isoenen_US
dc.publisherBMC health services researchen_US
dc.subjectUser feesen_US
dc.subjectHealth careen_US
dc.subjectPublic facilitiesen_US
dc.subjectPolicy developmenten_US
dc.subjectKnowledge translationen_US
dc.subjectUgandaen_US
dc.titleUptake of evidence in policy development: the case of user fees for health care in public health facilities in Ugandaen_US
dc.typeArticleen_US
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