Author: Shelly-Ann Hunte, Caribbean Centre for Health Systems Research and Development, The University of the West Indies, St. Augustine, Trinidad and Tobago
Ensuring that the best available research evidence is utilised in the development of social policies and programmes is a key mechanism that can: (i) address some of the challenges related to equity, access, and utilisation of social services; (ii) maximise the use of financial and non-financial resources; (iii) strengthen social protection systems; and (iv) advance the achievement of the Sustainable Development Goals (SDGs). The social protection system in Trinidad and Tobago (T&T), like many other developing countries and Small Island Developing States, face many challenges. These include a weak evidence-base to inform policy and programming, fragmentation of programmes, barriers to entry for specific groups, weak coordination between sectors, etc.
Recognising the need to collaborate with the social sector in T&T to strengthen the capacity to use evidence in policymaking/ decision-making, the Caribbean Centre for Health Systems and Research and Development (CCHSRD), The University of the West Indies implemented several initiatives, under the umbrella of the PEERSS project. These include a Needs Assessment Survey, an Evidence Informed Policymaking (EIP) Training Workshop, and an EIP Coaching programme. One of the objectives of this project was to pilot and iteratively refine methods adapted from the health systems approach to supporting EIP.
In May 2021, social sector ministries in T&T were invited to collaborate with CCHSRD and four responded positively: Ministry of Labour, Ministry of Planning and Development, Ministry of Sport and Community Development and Ministry of Social Development and Family Services. Project engagement meetings were held with senior officials and the project objectives, main activities, deliverables, and timelines were discussed and agreed upon.
Needs Assessment Exercise
To understand the perspectives and approaches to evidence use in decision-making in the social sector, as well as their EIP training needs, an assessment was conducted from June to October 2021. A mixed methods approach was utilised, and the findings highlighted some important challenges that social sector Ministries face. These include inadequate awareness/ understanding of EIP; insufficient capacity, skills, and human resource; and inadequate institutional support to effectively generate and utilise evidence. The Needs Assessment report included recommendations that could contribute to the improvement of the Ministries’ capacity to find, appraise, synthesise, and use evidence to inform decision-making/ policymaking.
EIP Training and Coaching Programme
The findings from the Needs Assessment were used to customise training material for a three-day intensive EIP capacity building workshop which concluded on 1st April 2022. Twenty-one (21) professionals involved in the policy making process at the four (4) ministries participated and the feedback was positive. At least two participants from each Ministry will now advance to a Coaching Programme where the learnings form the workshop would be reinforced and evidence syntheses to address high priority topics/questions would be co-created.
Joint Learning Sessions
Joint learning sessions were incorporated during the training to: (i) identify commonalities and differences in the policymaking process at each Ministry; (ii) find ways to combine expertise and familiarity across the social sectors regarding research evidence and the views of stakeholders, including civil society, and citizens; and (ii) develop new ways of working.
It was clear from these sessions that the mechanisms utilised in health systems research can be adapted to support EIP in social systems in T&T. This includes the use of the integrated knowledge translation framework: priority setting, evidence synthesis, preparation of knowledge translation products (KT), hosting of knowledge uptake activities and implementing post-uptake activities. The discussions centred around the policymaking processes currently utilised at the Ministries and how they aligned with this framework. Agreement was achieved regarding the importance of formal priority setting and the structure and format of KT products including problem framing, grouping of policy options/ elements and implementation considerations. The quality of evidence that should be used to inform policymaking/ decision-making as well as access to databases that contain synthesised evidence on social sector topics were also discussed. Regarding stakeholder consultations, the Ministries had a wealth of experience conducting public consultations; however, the approach utilised varied from Ministry to Ministry. It was agreed that these consultations could benefit from the more participatory, systematic, inclusive, and transparent methods that is used in the health systems approach. The need for post-uptake activities such as advocacy and policy tracing were also discussed.
Immediate Next Steps
Each social sector Ministry has submitted at least one (1) priority topic, generated from informal priority setting, for which evidence was needed for policy action. Within the next six (6) months, as part of the Coaching Programme, these Ministries will collaborate CCHSRD to develop a total of three (3) Rapid Response Briefs, one (1) Evidence Brief for Policy and one (1) Citizens Brief. Additionally, they would also collaborate to host one (1) Stakeholder Dialogue and one (1) Citizens Panel. It is expected that the learnings from this project will be sustained and transferable through continued engagement and training, and the sharing of structured lessons about successful EIP practices, across the health and social sectors. CCHSRD intends to add a social sector chapter of its Community of Practice for Health Policy and Systems Research (COP4HPSR) to further promote and enable ealHhpromo sustainability.