Knowledge Exchange With Policy Impact

Bob GardnerThe Art and Science of Knowledge Exchange

CATIE’s Knowledge Exchange ForumOctober 20, 2011

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Why Worry About Policy?

• we are all interested in changing PHA’s lives and tackling social and economic inequality, whether:• developing and winning a national HIV strategy• advocating for particular program investments• getting governments to act on evidence or research

• what is needed by people with HIV/AIDS?• comprehensive health and related services• information to enable individuals to better manage their health care• investment in research and service/program development• and many changes beyond health care and research:

• community capacity and resource building• addressing underlying social determinants of health

• all of these changes flow through government policy in one way or another• maximizing the policy impact of knowledge exchange and research is a critical

part of winning the necessary progressive policy

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Starting Points

Knowledge exchange generally means getting research to those who can act on itWe want to broaden that today: • different forms of knowledge -- practice-based, lessons learned, community experience• different purposes -- making a case for investment, innovation or policy change

To turn knowledge, program proposals or research into policy action requires that:

1. policy makers know about the research or program and its implications → knowledge exchange strategy for all research projects/programs and community organizations

2. policy makers understand the basis of the problem → means reports have to clearly set out policy implications

3. you give policy makers concrete policy solutions or alternatives that will address whatever the problem is → the more ‘policy-ready’ the recommendations, the better

4. policy makers have the political will to act – often beyond the power of individual research projects/programs → where advocacy, alliances and coalitions come in

Maximizing Policy Impact

To have policy impact we need to:• understand the political and policy environment and policy

process within governments• analyze the problem(s) identified by research or community

needs, and develop potential policy solutions• assess the pros and cons and cost benefits of various policy

options• choose and promote policy options that can work • make a convincing case for them -- at best, with concrete

recommendations that can be acted on• develop a targeted knowledge exchange strategy to get the

analysis and options to those who can decide

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Identify the Policy Implications

Assess implications of research findings or program – ‘so what”

• new needs or gaps in existing services identified• community preferences or priorities determined• barriers to getting services or support identified• innovations or ‘best practices’• evaluating what initiatives work –and how, for whom, and in what

contexts• systemic inequities uncovered

What can be done with this knowledge – ‘now what’

• service providers adapt or expand services, govts fund• programs and resource allocations reflect community priorities• program or policy changes to reduce barriers• other providers take them up • adapt and generalize to drive innovation

• policy changes to address systemic foundations of inequities

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Knowledge → ‘policy-ready’

• to get your findings or case to the intended decision makers – in ways they can understand and use – always involves translation

• partially this is cultural• into the very different languages and mind sets of govts • into ‘policy speak’

• partially this is very concrete – translating your findings into:• specific actionable policy options and recommendations• that will work in the existing policy environment• couched in the formats – cabinet briefing notes – and frameworks – cost-

benefit analysis and risk management – that govts use

• the more ‘policy ready’ → the more chance for influence

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Know Your Policy Environment

• to be able to do policy relevant research and influence policy change, you need to know:• the policy framework for your particular issue

• e.g. which levels of govt, and which Ministries or depts govern your issue? • what are the main formal policies that shape your area?• just as impt – what are the unstated assumptions and constraints that

shape the sphere?• what are trends in govt funding and policy in the area?

• how policy is developed:• players, processes and tempo• constraints -- risk averse, short-termism, crisis-driven

• and some specific aspects of the government of the day:• how does your issue relate to its overall agenda?• where is it in the electoral cycle?

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Think of Policy Development as Process

• a particular policy – or policy framework – is the result of decisions made about how to address a particular objective or problem• sometimes this can be a deliberate decision not to address the

particular issue

• within the public service there is a generally a careful process of:• identifying objectives

• assessing a range of possible actions to achieve the result

• analyzing them against number of factors – effectiveness, cost, risk, political context, public and community support, etc.

• always trade-offs, compromise , different “publics” affected

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Analyzing Policy Options• policy options are the different legislative, program, funding, and other

ways governments can act to meet defined objectives• to identify the best options, think of a wide range of factors such as

• how complex and big a policy change you are looking for• impact (balancing criteria such as equity, efficiency, stability)• cost – be specific -- is it short-term, capital or operating, one-time or

continuing, etc.?• versus benefits – specify here too – are the benefits short-term or

more long term -- such as eventual reduced health care expenditures as a result of upstream investment in health promotion and prevention?

• timing – how long to show an impact?• for government, assessing pros-cons, risks and cost-benefits is a

standard part of policy process• for you, posing recommendations/demands in terms used and

understood within the policy process increases your credibility and usability

Making the Case to Policy Makers

• know your audience -- and the policy environment and way of thinking within govts• pick the right person/level to make pitch to – with the authority and levers to act• be aware of their position and constraints

• think translation: from options to a winnable case• framed in ways that resonate with policy makers• making complex issues understandable and actionable• with a human story for elected officials especially (and the media)

• customize reports for policy audiences• separate/short policy implications summaries• in terms they understand and with concrete recommendations they can act on• use the forms they are used to – decks and briefing notes• e.g. always address cost benefits, risk management, options and other factors that govt

policy makers think about• all geared to different levels and functions within govt – e.g. different for Deputy

Minister than mid-level policy analyst

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Making the Case to Policy Makers II

• meeting is best, plus covering letter/brief• consider your most effective ‘line-up’ to make the case

• not just one-time, but systematic outreach and follow up with policy makers• follow up meetings• as part of long-term strategy to build relationships with key policy

makers in your spheres

• always a question of balance:• need hard-nosed analysis• always stay grounded in movement/community principles → limit

on room to compromise• but also strategically opportunistic → maximize chance of winning

case

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Take the ‘Long View’

• think long-term – significant policy change can take many years• but also look for immediate winnable issues

• to build momentum and hope• but be careful of co-optation & short-term reforms that deflect from long-

term goals• Caledon Institute for Social Policy has term “relentless incrementalism”• have good peripheral vision -- situate your issue in relation to

• other comparable issues → to build coalitions – the wider the better, with ‘unusual suspects’ as well

• the overall govt policy agenda -- back to ‘fit’ • be prepared for set-backs:

• even the most compelling evidence and well crafted brief doesn't always drive policy

• politics does

It’s Also/All About Power

• driving policy change on complex/contentious issues is not just about presenting the best evidence and case

• governments and politicians have to have the political will to act

• long history of HIV/AIDS movement = have to be forced

• critical importance of political and community mobilization:• building and staying grounded in community movements• building/sustaining broad coalitions for change

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Get Some Help

• policy analysis is a specialized trade and the policy world is a complex and difficult environment

• community organizations, service providers and researchers can’t drop everything and become policy analysts and advocates

• so draw on specialized expertise in knowledge exchange• partner with organizations with policy expertise• back to need for systematic strategy:

• partner with govts early in policy or research process• build relationships • see knowledge exchange as dynamic and iterative process

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Key Messagesto ensure you have a real impact on policy requires:

1. getting research findings or the policy case to the right people – in terms they can use

2. understanding the environment in which govt policy decisions are made3. being able to identify the policy implications of your research or

identified community needs -- and to translate that into concrete policy options to solve the problems you have found

4. assessing the most effective – and winnable – policy options5. being able to make an effective – and winning -- case for your policy

recommendations6. partnering with those with specific policy and knowledge exchange

expertise and experience7. grounding your research and policy advocacy in wider campaigns and

alliances for social change will maximize its impact

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• these speaking notes and further resources on policy directions to enhance health equity, health reform and the social determinants of health are available on our site at http://wellesleyinstitute.com

• there are resources on enhancing the policy impact of research and many workshops on community-based research more generally at http://www.wellesleyinstitute.com/resources

• my email is bob@wellesleyinstitute.com• I would be interested in any comments on the ideas in this

presentation and any information or analysis on initiatives or experience that address health equity

Following Up

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