This post is based on a blog in the PATH M&E Community of Practice newsletter.
Why do we need knowledge brokers?
We know that very little of the health data and evidence produced is systematically used to inform programs and policies. This observation has led to the creation of entire disciplines of “knowledge translation” and “evidence-based policy-making.” One of the key observations of these disciplines is that relationships matter. We can build all the databases, write all the policy briefs, or create all the data in the world, but it won’t be used unless we invest in the social element.
In her seminal article about the diffusion of innovations in healthcare organizations, Trisha Greenhalgh said, “knowledge depends for its circulation on interpersonal networks, and will only diffuse if these social features are taken into account and barriers overcome.”
Barriers exist. Even when networks exist, people are less likely to exchange information than to engage in other types of exchanges. And when we look at the direction of information exchange, people are much more likely to provide it than request it (although neither process happens very often). Look at the networks below – the same people, but three different types of relationships. On the left, the ties represent whether they reported interacting at all during policy development; in the middle the ties represent whether they provided research evidence to one another; on the left, ties represent whether they requested evidence from one another.
Figure 1. Policy actors in Burkina Faso according to three types of relationship ties
Why are we reticent to ask for information? Wouldn't it vastly improve our work? Yes, I found in Burkina Faso that policy actors who exchanged information were more likely to use it to inform their decision-making.
That’s where knowledge brokers come in. Knowledge brokers can be ad-hoc and informal, or a formal role in an organization. Evaluations of formalized knowledge brokering roles in high- and low-income countries have suggested that they are effective at building individual and organizational capacity to use data. So what can we do to identify, support, or be effective knowledge brokers?
1. Brokers are bridge builders
Knowledge brokers are strategically connected in their networks such that they are able to reach many otherwise unconnected actors. They build bridges between communities. They understand the context. They possess an intuitive mental map of their networks and know where to build the next bridge. We call this metric of strategic connectedness betweenness centrality, and the graph below shows the most strategically connected health systems researcher according to betweenness centrality. This person can theoretically reach the most other actors in this community to share new knowledge.
Figure 2. Co-authorship network of health systems researchers, nodes sized by betweenness centrality
2. Brokers come from the inside
Knowledge brokers are perceived to be more credible and trustworthy if they are embedded in the organizations they target, like ministries of health or health services organizations. Detailed network mapping and qualitative interviews in Burkina Faso demonstrated that policy actors were more likely to adopt ideas from someone within the ministry than from development partners (even though the development partners had better network connectivity). This is further evidence to refute the "two communities" hypothesis prevalent in KT, which has also been challenged by others and stands in our way of designing interventions that recognize the role flexibility of actors in policy-making.
Our team’s work on the Gavi Full Country Evaluation is also showing the importance of trust in the provision of technical assistance for vaccine decision-making. This is not the first time that approachability and patience has been identified as necessary traits of a knowledge broker.
