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Propelling decision-makers to action! The (he)art of an issue brief


Propelling decision-makers to action! The (he)art of an issue brief

Future Health Systems

By Dr. Nasreen Jessani, Johns Hopkins Bloomberg School of Public Health and Stellenbosch University, South Africa, and Karine Gatellier, Institute of Development Studies, UK, and a member of the FHS PIRU team

  • What is the difference between research and evidence?
  • What is evidence informed decision-making (EIDM)?
  • How do you use a stakeholder map to develop an effective knowledge translation (KT) strategy?
  • How do you engage differently with different stakeholders?
  • What is the difference between a policy brief and an issue brief?

These are some of the critical questions FHS partners from Ethiopia, Uganda, India and Liberia grappled with at the recent FHS “Issue Briefs: A Knowledge translation tool for evidence-informed decision-making” workshop held at IIFPHC-E from March 26-29, 2018.

FHS partners alongside other researchers from Ethiopian research institutes and universities, and practitioners from the Federal Ministry of Health in Ethiopia gathered to take a deep dive into the art and science of writing an Issue Brief.

Using constructivist approaches to learning, facilitators supported participants to appeal to the head and the heart in order to produce convincing arguments -packaged in an issue brief - to their chosen decision-makers that would propel them to action.

Know your audience

Once participants were introduced to key concepts of EIDM and KT – and before even thinking about issue briefs - they were thrown into a Discovery session – a simulation of a policy dialogue to better understand the importance of knowing one’s stakeholders when it comes to knowledge translation. Various roles were represented at a lively policy dialogue on addressing inequitable access and utilization of health services in an imaginary district.

It worked. The exercise got everyone thinking: it is not enough to have research evidence at hand; it needs to be contextualised and worded in a way that will touch the stakeholder emotionally. Therefore, you need to understand your audience’s perspective and be aware of conflicting interests. There will be blockers, silent boosters, passive resisters and champions - what is their power and influence on your problem or issue? What is your purpose for engaging with them?

If an issue brief is an appropriate tool to influence the stakeholder you have identified, then the content of the issue brief is driven by its audience and purpose.

What is an issue brief?

Once again – participants were presented with a Discovery session where they were curators of an art gallery. Six example issue briefs made up the gallery and participants were asked to appraise them. By the end of the session, participants had intuitively determined what makes for a “good” issue brief.

In essence, an Issue Brief is a concise document that communicates practical solutions for decision-making or implementation of key issues. This can be a tall order for researchers who are used to brilliantly doing just the opposite. “How can you be concise without losing the message?” someone asked. Indeed, that’s not an easy task – but its not impossible either!

At first, participants grappled with what differentiates an issue brief from a policy brief, but quickly came to the realisation that Issue briefs are a) aimed at a variety of decision-makers - not just policy makers b) can focus on the results of one piece of relevant research (that may not be a body of evidence) c) and can be written and disseminated before the research is actually published, thus being very useful. This also led the group to discuss how loosely the term policy brief if often used.

Top tips for writing an issue brief

So what were some of memorable aspects? Participants concurred that the Issue brief should be:

  • Interesting, fresh, and contextualised. This comes back to the point about knowing your audience. It is important to balance the types of evidence used to ensure the brief speaks to the audience in question and grabs their attention.
  • Short and concise. Decision-makers have limited time and should be able to get the gist of the brief by skimming through it. Is it between 2-4 pages? Is it succinct?
  • Clear and with realistic recommendations. The issue brief is targeted at a specific stakeholder. That decision-maker needs to understand clearly what he/she is asked to act upon, and the recommendations must be activities within that person’s power. Is the title a clear call to action? Is there coherence between the results and the priorities recommended?
  • Is the brief visually appealing?It is useful to have visual elements that support the text and draw in the reader. Are there relevant graphics - photos, quotes, charts?

The People’s choice award goes to…

Winning issue brief 2018.png

After some friendly competition displaying the completed issue briefs, a key decision-maker from the Ethiopian MOH and the participants judged the eight briefs. And the winner was………….Team Uganda! Congratulations on an excellent issue brief for the District Health Officer on making health facilities friendly for physically disabled women.

“Translating evidence into policy is a difficult job!” as one of the participants stated at the beginning of the workshop. However, by the end of the week, there was no doubt that a new wave of knowledge translation champions had arisen.

Reflections from participants

The practical session and simulations instruction methods were so creative that they kept me engaged. Reflection and trying out before each session challenged me to think a lot; the instruction was interesting before you are told something, you are challenged to think about it. The instruction was amazing; so engaging and helpful wherever I needed guidance.

All the FHS researchers need to get training in knowledge translation through issue brief so that our research moves along the way to impact decision making and practice.

The method of delivery is excellent. The content of the workshops the areas/topics covered addressed my knowledge and skill gaps. The training provide me hands on training and the output is great.

The entire workshop was very interactive. We got to hear everyone’s opinion and feedback. Having to produce a final product makes the workshop more interesting