Expanding access to sexual and reproductive health and rights through evidence-based policy dialogue: implications for practice from a multicountry initiative.

Abstract

Introduction: Policy dialogue is an important component of evidence-based policy-making. In 2019, WHO and Ministry of Health staff in 15 countries participated in an initiative that involved training and implementation of country-level sexual and reproductive health and rights (SRHR) policy dialogues. An evaluation of the process and outcomes was subsequently undertaken in six of the countries.

Methods: The three-stage policy dialogue initiative included a preparatory phase to develop stakeholder analyses and policy briefs and a 2-day workshop to develop an action plan, followed by continuous support as the national teams implemented the action plans. A participatory, multimethod approach was used to evaluate the policy dialogue initiative, including a desk review of initiative documentation and interviews with project participants.

Results: Participants reported positive experiences of the policy dialogue initiative and felt it improved their knowledge, skills and confidence. The ensuing policy dialogue activities in each country contributed to some SRHR policy development and/or implementation changes. The policy dialogue initiative supported these changes through its practical approach to learning and ongoing technical support. However, the impact of policy dialogues varied depending on political factors, the scope of policy goals, alignment with existing country priorities and stakeholder engagement. Furthermore, facilitating factors included strong support networks, incremental working and preparation for backlash against SRHR.

Conclusions: Our experience highlights the value of policy dialogue for progressing SRHR policy change at the national level and the need for further investments in strengthening the skills of health decision-makers required for effective policy dialogue.