Effectiveness and sustainability of a politically responsive institutional capacity strengthening project for improving evidence-informed decision making in the health sector in Kenya: a mixed methods evaluation

Abstract Background: Weak individual and institutional capacities for evidence-informed decision-making (EIDM) are among the factors that have been identified as barriers to EIDM in many low- and middle-income countries. EIDM capacity strengthening initiatives targeting policymakers and researchers have largely focused on improving individual knowledge, attitudes and skills and neglected political and institutional influences. This paper presents results of an evaluation of a programme that aimed to enhance institutional capacity for use of health research in decision-making by the MoH in Kenya. Methods: The ‘Heightening Institutional Capacity for Government Use of Health Research (HIGH-Res)’ was implemented from 2019 to 2022 and targeted Ministry of Health policymakers, researchers and their institutions. The HIGH-Res project design, interventions and implementation were informed by a continuous context analysis at its inception and throughout the implementation phase to ensure its relevance. A theory-based evaluation using mixed methods was conducted during the last quarter of the project’s implementation drawing data from the HIGH-Res project documents, training post-tests, in-depth interviews with a purposive sample of project beneficiaries and individuals not involved in the project interventions, and structured discussions with the project team. The qualitative data was analysed using a thematic approach and the quantitative data was analysed descriptively. Results: The project’s expected results were partially achieved and this was facilitated by: the project team’s EIDM expertise, diligent follow-up support and collaborative approach; MoH and research institutions’ leadership support for the project; the EIDM mandate and interest of policymakers and researchers involved in the project; and the high demand for local evidence during the COVID-19 pandemic. Fewer barriers to the project’s success were cited including bureaucracy at national level. Many opportunities for sustaining the project’s success were identified but some bottlenecks to the sustainability of the project’s outcomes were also noted including the short lifespan of the project, which left some interventions unfinished, coupled with insufficient government investments in EIDM. Conclusions : We conclude that politically responsive institutional EIDM capacity strengthening initiatives targeting African MoH policymakers and researchers and their institutions can be successful in the short-term. Longer term funding for such projects and sustained government investments are necessary for their sustainability.