research topics in public administration in zambia

Bureaucratic commitment to local government service: Lessons from Zambia

Subscribe to africa in focus, danielle resnick and danielle resnick david m. rubenstein fellow - global economy and development @d_e_resnick gilbert siame gilbert siame associate professor - norwegian university of science and technology, university of zambia (on leave) @curp_unza.

July 29, 2022

Globally, local governments have significant responsibilities for delivering agriculture, education, and health services, and they increasingly are forging their own strategies for tackling climate change , supporting sustainable food systems , and promoting gender equality . In fact, over the last three decades, most regions of the world have experienced progressively greater decentralization , a trend sometimes christened the “ silent revolution .” Despite this broader trend, decentralization faces various challenges that hinder its intended effectiveness. For example, high turnover and low retention of skilled civil servants at the local government level undermine continuity in service provision, reduce public sector accountability to communities for project implementation, and often necessitate additional outlays in scarce resources for training new staff.

In our new journal article , we examine the factors affecting bureaucrats’ continued commitment to local government service in Zambia, which has a long tradition of pursuing greater decentralization. At the advent of multiparty democracy in 1991, the Local Government Act was introduced and stipulated the transfer of 63 functions to the country’s district councils. Successive government administrations, spanning the Movement for Multiparty Democracy (MMD), Patriotic Front (PF), and now the United Party for National Development (UPND), have prioritized enhanced decentralization in the country’s various national development strategies. In fact, the Eighth National Development Plan adopted by the National Assembly in April 2022 focuses on devolving responsibility for even more services to local authorities. Nonetheless, the country’s 116 district councils thus far have been unable to effectively fulfill all of their service delivery mandates, especially in poorly resourced rural areas. Among other factors, bureaucratic retention remains a binding constraint for improving local authorities’ capacity to deliver their assigned functions.

To understand factors affecting bureaucratic retention, we conducted one-on-one surveys with more than 150 bureaucrats across 16 district councils in Zambia’s Central, Copperbelt, Lusaka, and Southern Provinces. The sample included councils with both high levels of poverty as well as relative affluence, urban and rural locales, and those with mayors from the two main political parties, UPND and PF. The respondents included professionals across three levels of seniority—director, midlevel, and general workers. In addition, the respondents represented six main departments within the sampled councils: town clerk’s office, finance department, human resources and administration, public health, housing and social services, and development planning. The table below provides a snapshot of the sample.

Table 1. Descriptive statistics of survey sample

Source: Resnick (2022) Zambia Local Bureaucrats survey, Harvard dataverse, V1. Zambia local bureaucrats survey.

Notes: N= 153 respondents. *Ethnic majority in council (%) means that the respondent’s ethno-linguistic background corresponds to the majority ethno-linguistic group in the council where s/he served at the time of the survey.

Organizational commitment was measured by asking respondents, “What career position do you aspire to have within five years?” All those who expressed interest in continuing in their current position, staying in local government but shifting to another area of expertise, or moving to a senior position in local government within their current area of expertise, were categorized as possessing more commitment to local government. Only 40 percent of the sample expressed such attitudes, while the remainder preferred to obtain jobs with the central government, the private sector, donor organizations, nongovernment organizations, or academia.

We found that one of the most substantively important factors driving civil servants’ commitment to local government was mission alignment, which refers to the congruence between an employee’s values and those of the organization that they serve. Those who noted that the most enjoyable part of their position is contributing to local government and working with community members possessed greater mission alignment. In turn, those with this attitude were more than twice as likely to express interest in staying in local government for the next five years than their colleagues who expressed alternative reasons for working in local government, such as job security, prestige, salary, managing staff, or using their expertise to design programs. On the other hand, those who are better educated are four times as likely to want to leave local government service within the next five years. This dynamic is particularly worrying since it implies that local government is likely to lose those who hold the greatest qualifications even as the councils increasingly require high-skilled workers to deliver quality services. Notably, while salary arrears, non-payment of pensions, unpredictable transfer decisions, and interference by local politicians in everyday tasks are known problems for Zambia’s councils, these factors were not significantly associated with organizational commitment.

The findings hold several policy implications. First, local government training programs need to not only focus on concrete tasks related to everyday job functions but also inculcate a sense of belonging to the local public sector. Programs that socialize new employees to the culture and mission of the organization have been successful elsewhere, such as in Egypt . Second, regular visits to the communities that bureaucrats are intended to serve could also reinforce for staff the primary purpose of their jobs. In Zambia, such visits are particularly important for better-educated civil servants who otherwise focus on office work and meetings with their superiors. Third, commitment to local public service can be enhanced through active recruitment of graduate students in the public administration, who often have a higher degree of intrinsic interest in the goals of public sector service.

Much of the research on bureaucracy emerges from high-income countries where public servants encounter vastly different resource constraints, office settings, institutional challenges, and organizational cultures than their counterparts in low-income contexts. Far too little attention is given to the aspirations, morale, and commitment of public sector bureaucrats in developing countries, and this gap is even greater at the subnational level despite the growing trend of decentralization. Our work aims to spur additional insights on this constituency who are fundamental for implementing policies and services aimed at improving the lives of poor and vulnerable communities.

For a more detailed discussion on this issue, see our recent journal article, “Organizational commitment in local government bureaucracies: The case of Zambia.”

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Ambassador Professor Royson M. Mukwena is the Executive Director of the National Institute of Public Administration in Lusaka-Zambia. Before joining the National Institute of Public Administration, Amb Prof Mukwena was Executive Director of the Organization for Social Science Research in Eastern and Southern Africa (OSSREA) headquartered in Addis Ababa. Amb Prof Mukwena was Zambia’s High Commissioner to the United Kingdom and Ambassador Extraordinary and Plenipotentiary (Resident in London) to The Holy See and Ireland. Prior to London, he was High Commissioner of Zambia to Tanzania and Ambassador Extraordinary and Plenipotentiary (Resident in Dar es Salaam) to the Republics of Burundi, Rwanda, Uganda, and the Union of the Comoros. Before joining the Zambian Diplomatic Service, Prof Mukwena lectured at the Universities of Zambia and Namibia, and served the latter also as Head of the Department of Political and Administrative Studies and Dean of the Faculty of Economics and Management Science. His articles on local government, decentralization and fiscal decentralization in Zambia and Namibia, and on privatization in Africa have appeared in several international journals. He is also co-editor of Governance in Southern Africa and Beyond: Experiences of Institutional and Public Policy Reform in Developing Countries (Gamsberg Macmillan Publishers, Windhoek, 2004) and Decentralization and Regional and Local Government in Namibia (Printech, Windhoek, 2008). Amb. Prof. Mukwena holds Bachelor of Arts (Public Administration) and Master of Public Administration (MPA) degrees from The University of Zambia and PhD from The University of Manchester, United Kingdom.

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Strengthening Gender Equality in Decision Making in Public Administration in Zambia

Sharon Nsana
Harrison Daka (PhD)
Dec 1, 2023
Public Administration

*Sharon Nsana and Harrison Daka (PhD)

University of Zambia

*Corresponding Author

DOI: https://dx.doi.org/10.47772/IJRISS.2023.7011028

Received: 13 October 2023; Revised: 01 November 2023; Accepted: 04 November 2023; Published: 01 December 2023

Achieving significant women representation in decision making positions in public administration has been identified as key step towards achieving gender equality. Gender equality is regarded as a top priority to any institution, not because equality between men and women is an important developmental goal, but because both men and women’s participation in activities that affect them and the nation leads to growth as well as development. Women represent more than half of the world’s population, have talent, are human capital and their productivity is equal to that of men, such that their absence in decision making affects the operations of various institutions. With a female Vice-President appointed to the second highest office in Zambia, Zambia is still one of the poorest ranked countries on the Gender Equality Index. Women in Zambia face numerous obstacles in their everyday lives especially participating in decision making. The country’s strong patriarchal culture and the domination of formal and informal institutions by men partly explains this. Balanced representation of both men and women in decision making is not only important but it is equally essential to have women dispersed throughout different sectors of administrative governance and have them equitably represented at all levels of decision making. This study examined the gender gaps in public administration and focused on how gender equality can be strengthened thereby contributing to the development of tracking mechanisms for gender equality in this sector. The study was based primarily on desk research (analysis of studies, reports and academic publications, policy documents, declarations and media articles) and most importantly built on in-depth interviews with key experts, government representatives and civil society organizations. Therefore, bearing in mind the key barriers that women face in society, the study analyzed whether the recommendations given as well as existence of various legal frameworks leads to increased gender equality in the country or not.

Key terms: Gender equality, public administration, decision making, women

INTRODUCTION

Women’s increased participation in decision making contributes to positive transformative processes for societies, such as changes in laws, policies, services, institutions and social norms (Council of Europe Gender Equality Strategy, 2014-2017). Women’s active participation in decision making is not only important for ensuring equality, but also for establishing their right, addressing various problems and challenges they face in society. According to Domingo et al (2015), women’s voice, access to, or participation in decision making will lead them to have actual influence over decisions and outcomes. Second that women will influence and champion issues of concern to women including gender equality. However, women are underrepresented world over especially in key decision making positions. They are underrepresented at decision making levels in all institutions including the Executive, Legislature, Local government, Quasi-Government institutions, political parties, the private sector, religious bodies and traditional establishments. This is despite many countries having gender policies in place that are to implement and promote gender equality.

Decision making and development are related concepts which go hand in hand as citizens categorized by sex, religion, tribe or color must be involved in decision making for this development to occur. In developing countries, gender equality and development are intertwined; more gender equality creates the conditions to boost economic development and contributes to economic growth, while more development leads to more gender equality (Duflo, 2012). Gender inequality is taken as a common issue of the developing countries as women in these countries are usually tacit and their voice has been hushed due to inherent economic and cultural factors. Therefore, without the active participation of women and the incorporation of women’s perspectives at all levels of decision making, the goals of equality, development and peace cannot be achieved (Beijing Platform for Action, Critical Area G. Para 181). Further, the sustainability of an economy depends on the extent of the integration of women in public decision making and the inclusion of their needs and interests in policy (Husain and Siddiqu, 2002) which ultimately helps to ensure good governance.

Over the years, as noted by Nasser (2017), there seems to be more focus on women’s participation to political positions as an indicator of access to decision making and very little attention given to gender equality in public administration. Public administration determines the manner in which political and economic decisions are implemented and how budgets are planned and executed. Therefore, gender equality in public administration is crucial as a gender sensitive public administration is bound to convert policies into outcomes differently. According to the United Nations Development Programme (UNDP) (2015), public administration is the primary institution responsible for implementing national policies, programs and tasks in which women should be included equally. It is the single largest employer; ensuring gender balance in participation and leadership, adopting and implementing legal and policy frameworks that support gender equality, and building inclusive institutional cultures which has potential to transform the lives and livelihoods of millions of workers worldwide. Thus, the participation of women in decision making in public administration depends on a complex of factors that are economic, cultural and social and these vary from country to country.

In Zambia, public administration both at central and local levels, reflects the orientation and character of domestic politics. Although women make up 50.5% of Zambia’s population as well as the majority of voters, they remain systematically underrepresented especially when it comes to being appointed to decision making positions in public administration. Despite the country signing up to regional and international conventions, the situation of women remains worrying. There has been a growing concern in the recent past among all key stakeholders in the country on the lower levels and number of women’s participation in decision making (Ministry of Gender, 2018). As such, effective public institutions that involve both men and women are essential to the achievement of national and local development goals including poverty reduction, inclusive growth and gender equality. Women’s participation at all levels of decision making should be considered crucial to improving their representative nature, accountability and quality of democracies, as well as making the policy making agendas more gender sensitive.

Public administration is the organization and management of men and materials to achieve the purpose of the government. According to Caiden (1982), public administration refers to the implementation or pronouncements made by recognized public authorities, the organization of enforcement machinery to ensure public conformity and relations between the public and officials appointed to further collective interests. It includes the organization of public affairs, social purposes and collective decision making, the management of public institutions, public offices and public property and the administration of the public officials, covering attitudes and behaviors as well as actions. Public administration, as a process, consists of the actions involved in effecting the intent or desire of a government and public policy. Therefore, in its broadest sense, public administration denotes the work involved in the actual conduct of governmental affairs, regardless of the particular branch of the government concerned. In its narrowest sense, it denotes the operations of the administrative (executive) branch only. It is thus the continuously active business part of government which is concerned with carrying out the law as made by legislative bodies (or other authoritative agents) and interpreted by courts, through the process of organization and management (Willoughby, 1927).

According to the Council of Europe (2017), public institutions have played a critical role in advancing gender equality and women’s empowerment through institutional guarantees and laws on gender equality; national gender policies and action plans; establishing ministries of women, and setting quotas or reservations for women in parliaments, local governments decision making bodies and public agencies. A critical component of gender equality in public administration is parity – equal numbers of women and men working and leading in all levels and sectors of public administration. In this vein, special attention must be paid to women’s inclusion in decision making positions. Gender parity in public decision making is “a matter of the full enjoyment of human rights and of social justice, and a necessary condition for the better functioning of a democratic society”(Ibid). The call for inclusive and representative public administration reflects the ideal that “elected and appointed positions in public life should reflect the societies from which they are drawn, including the major social cleavages of identity politics, such as those of gender identities and sexual orientations, race, religion, and ethnicity, socioeconomic status, income, education, and social class, and geography and region” (Norris, 2020, p. 12).

Gender equality in public administration is about the creation of institutions and cultures that are inclusive. It is a focal point as well as a cross-cutting principle of the 2030 Agenda for Sustainable Development (United Nations, 2019). Specifically Sustainable Development Goal number 5 which focusses on gender equality and empowerment for women and girls, highlighting the need for equal access to economic resources including ownership and control of land and other property and full and effective participation at all levels of decision making (UN, 2015). Thus, as workplaces, public administration must have recruitment, retention and promotion policies that respect human rights, are fair and accessible to all. There must be structures and rules that bolster rather than undermine gender equalities and these must be implemented and enforced. As alluded to by Norris (2020), policies and practices that embrace gender equality must consider ways that sexism and gender bias intersect with other forms of discrimination and marginalization to shape the experiences and outcomes of diverse groups of women and men.

2.1 Situation of women in decision making

Gender equality is a cross cutting issue and a fundamental human right (UNDP Report, 2014). It is a basic human right for everyone, whether male or female and also has instrumental value for development. Studies have consistently shown that improving gender equality enhances growth and productivity, improves outcomes for the next generation, and makes political institutions more representative. Since the launch of the 1995 Beijing Platform for Action in ensuring gender equality, the world has made great strides towards the realization of gender equality (United Nations International Children’s Emergence Fund, 2020). Recently, women’s participation in decision making is improving. In a democratic system for instance, it is impossible to say gender equality and the democratic values have applied without considering the role of women in decision making. Nations in their journey of consolidation of democracy highlight the decision making empowerment of women and have adopted international law and conventions to maintain women’s decision making participation earthly by subscribing to international protocols such as the United Nations Charter on human rights and Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) (Gylman, 2008). However, women’s level of representation in the most important decision making positions is even lower at both subnational and national levels.

According to Hughes et al., (2021), gender equality in public administration has improved in recent years, but there is still a long way to go. Women’s participation in the civil service approaches parity with 46% on average across 139 countries and territories. Yet, significant variation across countries and regions means that only one-third (33%) of countries have reached this goal. At decision making levels of the civil service, women make up only 31% of top leadership positions on average. This is despite the fact that women in governance are necessary to promote gender and income equality to achieve socio-economic emancipation and to realize social justice and equitable development with rapid economic growth. However, there is no comprehensive global baseline through which certain trends can be observed regarding the presence of gender equality in public administration. Around the world, various statistics show that women are underrepresented in positions of decision making; even in countries where women have equal access to education, increased representation in public administration, and in particular in decision making positions, is not always assured. For instance, the gross enrolment rate of women in higher education increased from 19% in 2000 to 43% in 2020, whereas for men it rose more slowly from 19% to 37%. The gender parity index indicates that globally there were 113 women enrolled in higher education for every 100 men in 2020 (United Nations Educational, Scientific and Cultural Organization (UNESCO) Institute for Statistics, 2020).

According to the Report of the World Economic Forum (2023), although there has been an increase in the number of women holding political decision making posts worldwide, achieving gender parity remains a distant goal and regional disparities are significant. Following a series of gradual but steady increases in the share of women in leadership roles over the past two decades, this share has edged up to, on average, 33.7% in 2023 from 33.4% in 2022 across public- and private-sector leadership roles. However, high-frequency data presented in the report shows that hiring rates for women into leadership positions across industries have been in decline since mid-2022. Looking at local government for example, data reveals that significant strides have been made in terms of women’s representation in local government globally, though disparities remain between countries and regions. Out of the 117 countries with available data since 2017, (UN Women, 2022b), only 18 countries, including Bolivia (50.4%), India (44.4%) and France (42.3%), have achieved representation of women of over 40% in local governance. On the other hand, 24 economies, mostly in the Middle East, North Africa, and Sub-Saharan Africa, such as Saudi Arabia (1.2%), Ghana (3.8%), Turkey (10.1%) and Japan (14.31%), have below 15% representation. The remaining 75 economies fall within the 15%-30% range, including diverse nations such as Brazil (15.7%), Indonesia (15.7%), China (28.1%), Ireland (23.9%), Germany (30.3%) and the United Kingdom (35.3%) (WEF, 2023).

The African Gender Index scores show marked differences between the number of men and women in senior and representational positions. The AGI score for the representation and empowerment dimensions is 21.3% (in the range 0 to 1) showing a major gender gap exist. The AGI scores for different countries range between 2.3% and 62.1%. In both the private sector (AGI 22.9% for the top manager of firms) and in public life (AGI 25.3% for parliamentary representation and AGI 26.3% for cabinet ministers), most senior jobs are held by men. The global evidence above shows that greater diversity amongst decision makers matters (African Development Bank and United Nations Economic Commission for Africa (ADB/UNECA), 2019). Thus, the exclusion of women in Africa has been established by a long history and could also be traced to tradition, religion and role conception. African women more than others in comparable regions around the world, have suffered repression. Yet, oral history provided evidence of women playing critical roles at different periods of history; politics, religion or nation-building, military or wars of liberation. In places where dual structures of government are in place, women and men held joint spaces in the administration of their people (Akiyode-Afolabi, 2018). In fact, Africa could add $316 billion or 10% to GDP in the period to 2025 if each country makes advances in gender equality to match the country in the region that has achieved the most progress towards parity. Today, however, this “best-in-region” scenario seems a distant possibility. At the current rate of progress, Africa could take more than 140 years to achieve gender parity (ADB/UNECA, 2019).

Taking a look at public administration in Africa, evidence shows that women are underrepresented at all levels of decision making. The gender disparity is most noticeable at the highest levels of decision making. In these top leadership positions, women make up only 21% of public administrators across eight countries with available data. Women fare slightly better at the next highest decision making level of senior managers. Across the 11 countries with available data, women make up 28% of senior management positions in public administration. Women are best represented in Lesotho, accounting for 38% of civil servants at these top two decision making levels. At the lowest level of decision making monitored, women managers within the civil service make up 30% across 13 countries with available data. At the managerial level, women reach parity in Lesotho (53%) and Namibia (54%). Women remain underrepresented among managers in the remaining 11 countries (UNDP, 2022). The table below shows an extract from the available data and reflects women’s participation in public administration in Africa between 2018 and 2020 from selected countries. From the table, Botswana and Seychelles have achieved the stipulated 50% threshold for women in public administration overall with 60% and 54% respectively. Zambia has a long way to go with a mere 25%, having the same parity as Guinea Bissau.

Women’s participation in Public Administration in Africa – 2018 to 2020

Source: UNDP, 2022

The Government of the Republic of Zambia’s vision on gender as is contained in the “Vision 2030” is to achieve gender equity and equality in the socio-economic development process by 2030. In this regard, the government adopted the National Gender Policy (NGP) in 2000 which addressed the need to build and strengthen national capacity for advocating and mainstreaming gender in the development process. The policy was aimed at “achieving full participation of both women and men in the development process at all levels in order to ensure sustainable development and attainment of equity and equality between sexes” (Government of the Republic of Zambia, 2014). Zambia is a state party to a number of international and regional instruments that guarantee the rights of women and gender equality and women’s empowerment including the SDGs, CEDAW (1991), the Beijing Declaration on the Platform for Action (1995), the Convention on Civil and Political Rights (CCPR), the Equal Remuneration Convention, the Convention on Prohibition of Discrimination in Occupations, Convention on the Elimination of the worst forms of Child Labor and the convention on Economic and Social and Cultural Rights (ECOSOC). It is also party to regional policy frameworks such as Maputo Protocol (2003), African Charter on Human and People’s Rights and the Rights of Women (1979), Solemn Declaration on Gender and Equality in Africa (2004), SADC Protocol in Gender and Development Protocol (2008), then subscribes to the COMESA Gender Policy. These instruments advocate women’s equal and effective participation in all areas of decision making (Gender Links Zambia, 2020).

According to Samanga (2019), Zambia has made slight progress and over the past decade, the country has witnessed an unprecedented rise in female leaders serving in influential national positions. Among the notable women are Inonge Wina and Mutale Nalumango, the first female Republican Vice Presidents; Nelly Mutti, the first female Parliament Speaker; Justice Ireen Mambilima, the first female Chief Justice; Stella Libongani, the first female Inspector General of the Zambia Police and Professor Hildah Ngambi, the first female vice-chancellor at a public University. While this development is heralded as a big step in promoting female involvement in governance, history shows that their influence in leadership is not limited to the contemporary period. In Zambia, though there seems to be a fair percentage of women MPs and also those women participating in political life, decision making bodies as well, this has not yet translated into a more equal position of women in general within the society nor has it strengthened gender equality in the social-economic life. Representation has remained below the desired 30% and has remained inadequate in other critical areas of public service and decision making roles especially in public administration as seen in the table below.

Gender representation of management positions in the Public Service

Source: Policy Monitoring and Research Centre, 2020

Despite the appointment of women to key decision making positions such as Vice-President, Chief Justice, Head of the Anti-Corruption Commission, Auditor General, Head of the Drug Enforcement Commission, and President of the Court of Appeal, Zambia has a mere 12% women in parliament and 8% in local government. Current data indicated that on the political empowerment ranking, Zambia stands at number 119 against other countries in the world. When looking at how far countries have gone to close their gender gaps, Zambia ranks number 85 (WEF, 2023). As noted by Kellerman and Rhodes (2007), it is clear that public administrations around the world have not yet tapped the full talents and potential of women. If public administration is to be representative of society and inclusive of women, viable pathways must exist for women to enter and advance to leadership positions at all levels and in all sectors on an equal basis with men. A growing number of women aspire to leadership on the same terms as men and have made the same choices as their male counterparts, but they continue to confront obstacles. Therefore, achieving gender equality is fundamental to the development and progression of society as a whole. From a developmental perspective, equal participation of women in decision making structures is crucial for creating gender sensitive policies and democratic government.

2.2 Obstacles faced by women in decision making

Public institutions have played a critical role in advancing gender equality and women’s empowerment through constitutional guarantees and laws on gender equality; national gender policies and action plans; establishing ministries of women; and setting quotas or reservations for women in parliaments, local government decision making bodies, and public agencies (Council of Europe, 2017). However, gender disparities persist and public policy reforms are still needed to tackle gender inequalities, ensure women’s and men’s equal access to basic services, labor markets, resources, and assets, and to promote equal voice in decision making. According to Nasser (2017), public administration at both local and central level, generally reflects the orientation and character of domestic politics. In patriarchal and exclusionary societies, women, youth and minorities are often excluded from decision making positions in public administration. For instance, it is common in many countries to observe a higher proportion of women in lower-level positions in public administration. Women tend to be more present in ‘support’ functions as well as in ‘traditional’ sectors such as education, health and social care, where they generally earn less than their male colleagues. In short, public administration perpetuates gender biased traditions, attitudes and practices, and this situation often reveals a lack of transparency, effectiveness and inclusion.

Patriarchal system

The Ministry of Gender in its 2019 Report highlights that the Zambian culture is based on patriarchal values across tribes and is highly conservative. Therefore, headship is conferred to men and this perpetuates women’s subordination in decision making, ownership and inheritance of assets. The slow pace in attaining gender equality in the country has therefore been negatively affected by the deep rooted culture and mindset to embrace women and girls as equal partners in national development (Ministry of Gender, 2019). In addition, culturally, Zambia has high power distance and low masculinity scores and so individuals are expected not only to respect and not question authority but also to be seen to be supportive of others. Women therefore do not have equal influence over the policy decisions that affect their lives and the overall development of the state. And this has perpetuated the increase in the gender gaps in public administration.

UNDP (2005), highlights that patriarchy is a very strong factor that explains male dominance over females. It is believed that men will sit back in the family to keep the family name and lineage growing while women will be married out. Thus, while men are being trained for leadership activities, women are confined to household responsibilities; roles ascribed to them by culture which affect them later in life, thereby making them lose self-confidence/worth and have low self-esteem in their career in adult life, politics inclusive. Chiroro (2005), contends that “women are often not treated as full-fledged citizens. Having equal rights on paper does not necessarily translate into effective practices on the ground. Subtle discriminatory mechanisms rooted in patriarchal norms and values continue to pervade people’s lives”. Thus, to do away with patriarchy, men must lead initiatives in changing their behaviors on issues of gender equality, which cascade into the socialization process of the younger generation of men (Mlambo-Ngcuka, 2015).

Findings from the interviews of the study indicated that most respondents agreed and indicated that public administration in Zambia perpetuates gender inequality owing to the patriarchal nature of our system. Most respondents highlighted that in most public institutions, men occupy most of the decision making positions and this has affected the decision making outcomes. Women are mostly given care ministries for example, Community Development and Social Services which was found to be a gender biased ministry and when looking at departments in these ministries, women are condensed in for example, care departments such as Human Resources and fewer in finance and also planning departments.

Stereotypes views

Women in decision making face another obstacle in the form of stereotype views of not only men but women alike. Customary law and patriarchal culture often causes the “gendered division” of labor where men are expected to lead and occupy the decision making roles whether in the home, in the community, or in national life, while women play a subordinate role (International Institute for Democracy and Electoral Assistance, 2021; Poltera, 2019). Such social norms of power allocation make it more difficult for women to leave their traditional domestic roles for public life, and they hinder their career progress even more once they join the public sector. Moreover, scholars (Mwale & Dodo, 2017) noted that early socialization practices for girls, rooted in cultural and social traditions in Africa, prepare young women to be good wives and mothers. On the other hand, Emmet (2001), noted that the rituals and rites of passage pertaining to the boy child nurture them for leadership positions.

Results from the study show that men and women alike agreed that the reason why stereotype views continue to exist in public administration is because of the way we socialize our children from childhood where a boy is groomed to lead and a girl to be led. Some respondents noted also that fewer women who manage to rise the decision making ladder face stereotypes views from both society and organizations and are painted bad. As such, the negative stereotype views towards women’s participation in decision making and leadership roles are not only limited to those who aspire to become leaders but also to those who are already in the decision making spheres. For example, in Zambia, a woman Member of Parliament once requested for the harmonization of statutory laws (Ebeku, 2005) that banned customary practices like bride price and sexual cleansing, which she recalls led to the marginalization of many women. In response, a male member of parliament said that “gender equality would depend on how women behaved”. Another male parliamentarian also shared his view by saying “The so-called discrimination was God-made and would be very difficult to get rid of.” This single case tells everything about the impact of cultural and traditional beliefs even on those people who are at the helm of governance especially in public administration (Ebeku, 2005).

Structural conditions

Public administration in Zambia faces structural challenges as well. The findings from this study revealed that organizational practices including unequal career advancement opportunities between men and women, lack of policies to support women, and lack of respect for women in top positions is still there. With regard to career advancement, findings revealed that sometimes, institutions would rather appoint a man despite both men and women having attained the necessary qualifications needed for that position. This makes the women not really see the requirement to upgrade their qualifications as it serves them no purpose. This result is in line with previous studies by Kiaye & Singh (2013), where they reported that the nature of the work environment faced by women is found to be the major determinant of their career advancement. Further, an empirical study in Kenya’s civil service sector (Kirai & Mukulu, 2012) highlighted that discriminatory practices in recruitment, selection, and promotion towards women have contributed to the limited number of women moving to managerial positions. Respondents of this study indicated that promotion is based on who knows who and also on the informal networking that one has with higher-level leaders in a given organization. Accordingly, they rated discriminating due to their gender (25%), work-life balance (30%), and lack of support from their bosses (24%). These survey results showed that discriminatory organizational structures and practices are major hindrances to women’s career advancement in the public sector.

Another factor that was prominent with the responses was the issue of women refusing to be transferred to posts that detach them from their families. They indicated that men are more willing to work off station than women. Similarly, researchers such as Posholi (2012), argue that since women are torn between work and family demands, their leadership/career advancement is often at a substantial cost of their personal lives. And so, in his survey in Lesotho, Posholi indicated that the majority of women rated conflict with family responsibilities as a barrier to their career advancement. In this way, gender gaps in decision making are exacerbated.

Limits to women’s collective action

Achieving gender equality requires women’s active participation and involvement in decision making at all levels, starting in the home and extending to the highest levels of government. The fact that gender inequalities continue to exist in all sectors at all levels, has negative implications on national development (Ministry of Gender and Child Development, 2014). Thus, apart from the legislature and parliamentarian representation, women’s participation as leaders and decision makers in other areas of the public sector is a key step towards women’s empowerment in public life. Women’s inclusion in decision making positions across government sectors and positions such as education, finance, health, energy, defense, and foreign affairs, would help women’s career progress in particular, as well as gender parity in the public sector in general (UNDP, 2021). Without a gender equality culture in the political and societal space, women won’t have opportunities for upward mobility (Inglehart & Norris 2003).

Results from the study indicated that women are fewer in decision making positions because most public institutions in Zambia are politicized and specifically women need to belong to a political party to access decision making positions. Most political parties glaringly have no agenda for gender equality and women are not seen and heard. Their participation is restricted to the women’s wing, to play the cheerleaders role in the party – political game to manipulate the political space. At times, men push forward some women who can serve their interests. Therefore, Bauer & Burnet (2013) argued that increasing the participation of women in public life through the quota system has a symbolic representation effect. They argued that even a small number of women in a decision making role would inspire other women to become more engaged in decision making roles. For example, Bauer & Burnet (2013) in their study found that gender quotas in Botswana and Rwanda have had a significant symbolic effect. Participants of this study from both countries identified women in parliaments and ministries inspired them to seek more decision making roles in their working place. In addition, women from Rwanda reported that, due to more women in the cabinets, parliaments, mayoral offices, and chief executives, the respect they were given by their community was equal to that given to men.

WHAT WORKS TO BUILD REPRESENTATION AND CLOSE GENDER GAPS

From the literature and results presented from our study, it can be noted that increasing the number of women in decision making especially in public administration is of great importance. A fundamental argument for increased representation of women in public service is that when the composition of the public sector reflects the composition of the society it serves, government will be more responsive and effective (Organization for Economic Cooperation and Development (OECD), 2021). Thus, closing gender gaps in public administration is important to ensuring truly inclusive development and democratic governance and helps to restore trust and confidence in public institutions and enhance the sustainability and responsiveness of public policies. From this we learn a few lessons and come up with mechanisms that will help implementers to move towards closing the gender gaps in public administration.

Use of media and media campaigns

The media plays an important role in women’s lives and how it puts their issues to the public is of great help. According to the Office for Democratic Institutions and Human Rights (OSCE/ODIHR), (2014), the media can exercise the utmost influence on how society perceives men and women and their respective roles within it. In 1995, the Beijing Platform for Action recognized and predicted the media’s “potential to make a far greater contribution to the advancement of women” (para. 234). This call has been echoed in the proposed targets under Goal 5 of the post-2015 SDGs. Like in 1995, challenges remain in utilizing media to combat discrimination, counter gender stereotypes and raise awareness of women’s rights issues. While globally, women are greater users of social media than men (McPherson, 2014), many women, especially in developing countries, still do not have access to this technology due to infrastructure, costs and discriminatory social norms (International Center for Research on Women (ICRW), 2010). Social media has proved to be a powerful vehicle for bringing women’s rights issues to the attention of a wider public, galvanizing action on the streets of cities around the world and encouraging policy makers to step up commitments to gender equality.

In Zambia, the media has been helpful in championing the works of women and this has brought courage to would-be women in decision making. The surge of female bloggers has in particular helped attract a younger generation of activists, who represent a key target audience to break established stereotypes and help advance gender equality. The media also have an important role to play in promoting a culture of gender equality and diversity. To do this for example, strategic campaigns to reducing gender stereotypes should be organized to provide space for women from all groups in media and make visible their contribution and participation in all areas of life. Additionally, positive models should be promoted to ensure more women and girls engage in public life and also women’s contribution to politics and policy making should be more visible. This is because the extent to which women are represented in public life and in decision making processes has a gendered impact on policy making (Brody, 2009).

Implement laws and policies that advance gender equality

Governments and organizations across all regions of SSA have introduced certain policies and programs to enhance women’s representation in the public sector. National laws and policies on advancing gender equality are in place in most countries, but rarely enforced in the realm of public administration. The UN’s 2017 report on gender equality noted that most African governments in general struggle to achieve gender equality due to weak policy implementation and poor institutional capacity, which have negatively affected the possible gains that may have been achieved via the quota system and related forms of policy instruments. African governments should therefore build their capacity to adequately implement, monitor, and evaluate progress made in implementing policies, laws, and programs to advance women’s career progress in all sectors (UNESCO, 2017). However, there is a lack of impact evaluation on the effectiveness of these policies.

From the findings of the study, it can be seen that despite enacting progressive policies and legislation and acceding to international instruments that promote women’s participation in decision making, the reality is that participation in decision making processes in Zambia is dominantly male dominated. The situation is that women are under-represented in all decision making processes at all levels including Parliament (17%), Local Government (7%) and Civil Service (10%) (Democracy Works Foundation and Zambia National Women’s Lobby (DWF/ZNWL), 2021). Therefore, in order for the country to move towards closing gender gaps, it is essential to implement policies on gender equality. The Protocols have been signed but implementation remains on mere paper. The Government and stakeholders, especially Civil Society Organizations, have been implementing a lot of interventions that have contributed to achieving SDG5 as evidenced by the country recording a positive trend in the gender inequality index which has continued to fall from 0.627 in 2011 to 0.587 in 2015 and 0.540 for 2018 (UNDP, 2018).

Strengthen training for women in civic rights and leadership skills

Formal and informal training are important and have a great impact on professional performance everywhere in the world. In public administration, training especially for women is important as it brings with it benefits not only to individual women but the institution as well. UNDP (2014) suggests that, as training and other forms of capacity building have strategic importance to increase women’s presence as senior leaders of organizations, governments need to restructure recruitment and development programs to ensure that all women have equal access to managerial, entrepreneurial, technical, and leadership training. In support of this view, a study in Lesotho’s public sector (Posholi, 2012), illustrated that the majority of women interviewed were enthusiastic to study further and advance their careers. Further, that it is important that women receive training before entering politics, while they are running as candidates and during their time in office.

Training of women in public administration is important also in that at the micro-level, organizations have an invaluable role in promoting women to leadership roles. The findings of this study indicated that organizations’ role is multifaceted, from improving the recruitment process, to making evaluation and promotion free of gender bias, to ensuring women have access to the same training and development opportunities as men. Organizations with concrete policies and guidelines that facilitate the career advancement of women have shown improvements in balancing gender in the leadership arena (OECD, 2014). For example, UNDP initiates and supports women public servants in Eritrea and South Sudan to enhance their capacities in leadership through providing leadership capacity and professional development training (Finkel, et al., 2021). Therefore, what works to increase representation of women and close gender gaps in public administration is training for women public servants and managers.

To standardize the definitions of employment in public administration

Zambian public administration institutional arrangement structure from the national, provincial, district and sub-district levels comprising different heads of people. The public sphere consists of politics, administration, and the public; thus, there should be a clear distinction of positions of authority, influence, and decision making at these various levels. There is need to establish standardized definitions of employment in public administration and any related decision making positions not occupied through elections. A common definition of public administration should be employed to establish statistical categories that should then be monitored. Studies show that if employment became a more even playing field, it can create a positive domino effect on other areas prone to gender inequality. This case does not spare Zambia. Bhorat, et al., (2017), recorded that Zambia’s employment equalities are at 67% men dominating women with good wages as compared to the opposite sex. When it comes to job segregation, one of the causes of gender inequality within employment is the division of jobs.

Traditionally, public services employ public servants through a specific legal status that emphasizes stability and lifelong employment. This generally entails high levels of job security, stable but limited (seniority-based) pay and benefits, and a decent pension at the end, based on years of employment. This may work well for occupations that are specific to the public sector, that do not benefit from a high level of movement in and out. However, the future of work brings a need for a wider variety of skills and backgrounds than ever before. With this greater diversity of skills comes the need for a greater diversity of employment models. Traditional civil service employment may not be so attractive for all profiles in the labor market – for example, some in-demand tech professionals may be less interested in being a lifelong civil servant. They may be more interested in taking shorter-term contracts (with higher pay options) that enable them to work on interesting projects with high visibility and impact (OECD, 2020). Thus, a forward-looking public service requires coherent and robust workforce planning. In a fast-changing employment environment, with scarce skills and resources on one side and unpredictable future changes on the other, strategic workforce planning based on foresight capacities has the potential to become a cornerstone of public employment policies (OECD, 2019).

Strengthen the collection and publication of data

According to Domingo et al (2015), the literature on women in leadership in the civil service is sparse and the little data available indicates that there are challenges that women face in decision making. As a result, there is need to strengthen the collection and publication of data on gender equality in public administration especially in Zambia. In 2013, UNDP launched the global Gender Equality in Public Administration (GEPA) initiative with the objectives of: (1) supporting women’s empowerment and expanding their participation and leadership in the executive branches of the state; and (2) contributing to up-to-date evidence of gender equality in public administration to facilitate informed policy and decision making (UNDP, 2014). However, gender equality has not always been a guiding principle of public administration reforms.

In this vein, UNDP should work with countries to increase the availability of sex-disaggregated data on public administration and prevent barriers in accessing this data. In addition, any future data obtained through the global tracking mechanism should be included in national statistical reports on women and men and widely disseminated. Using standardized statistical definitions, central institutions and national statistical offices must promote the collection of sex-disaggregated data on employment in public administration. This data can be used to inform targets for gender equality in public administration by highlighting any existing gender gaps in decision making positions and specific occupational categories and sectors. Also, it is necessary to establish strategic partnerships to advocate for and assist in collecting data. Establishing partnerships with relevant organizations will ensure the longevity of programs that support gender equality in public administration and encourage the widespread use of the global monitoring mechanism. There are several organizations with the potential to work with UNDP in collecting and disseminating data related to gender equality in public administration, including UN Women, EUROSTAT, ILO, UN Statistics Division, and the European Institute for Gender Equality (OECD, 2014).

Solidarity and feminist organizing

As highlighted above, women’s organizations or organizations that fight for women and issues that concern them, are important in closing gender gaps in Zambia. In many countries, Zambia included, women’s organizations strongly support the participation of women in political and decision making at local, regional and national levels. Women’s movements and organizations are crucial in the struggle for equal participation and representation as they are key to motivating and engaging women in public life and in politics, mobilizing their collective power to demand accountability and change, and for these reasons, their experience and expertise could be used to support women. Women’s organizations can also campaign for flexible working arrangements, childcare, and ending violence against women, which can transform workplace culture and women’s chances of reaching the top (Hinds, 2015). In Namibia, for example, women’s organizations were credited with helping to increase women in national legislatures through advocacy, sensitization, and by working to change electoral systems (Bauer, 2004).

Civil society’s role in empowering the people is well recognized. Civil society organizations in many democracies perform the function of representing the interests and asserting the rights and power of the people. They can come in and help interest groups and people to fight more effectively for their interests, thereby empowering them (Diamond, 1999). Governance cannot exist apart from social development. Many factors affect the formation of institutional and legal principles of public administration transforming it and endowing new characteristics (Mukhametshin et al., 2019). And among other things, it requires effective forms of civil society institutions’ participation in public administration to be integrated (Baibarin, et al., 2016). Therefore, governments should prioritize funds to organizations that work for women and partnerships between government and civil society can contribute to advancing participation. This will in turn help in strengthening and investing in non-governmental organizations and women’s movements would also pressure both governments and society to act on the underrepresentation of women in senior leadership positions in the public sector.

Working with men and identifying male allies

In order to achieve gender equality in public administration, the perspectives of both men and women must be included. Working with political institutions and their predominantly male leaders and interventions that integrate both genders’ perspectives can provide opportunities to promote change from within and gradually alter traditional attitudes about the role of women and men in public and political life. According to Brown & Ostrove (2013), men acting as allies for women may be a powerful means of reducing the effects of underrepresentation. Rather than simply being motivated to self-regulate prejudice toward marginalized others, allies engage in behavior that supports social justice, as such men may be more effective allies than women. The 2021 report, Male allies at work: gender-equality supportive men reduce negative underrepresentation effects among women, showed that having an ally increased the sense of belonging and trust felt among women that they would be treated fairly. Women perceived any ally as empowering, and male allies as setting norms of equality in organizations (Moser & Branscombe, 2022).

Lessons learned from various studies and also field responses indicate that men visibly supporting women at work is even more important in geographies with entrenched gender roles. In certain cultures, male allies can make the difference between slow progress and no progress at all. As such men need to be more actively engaged and involved in the debate and gender transformation process of achieving long-term sustainable gender equality measures and outcomes. Changing the behavior of men can play an important role in changing gender relations and inequalities within society (Mannell, 2014). Also, men allies can support progress towards gender parity in senior leadership in a number of impactful ways. They can proactively exert influence to change behaviors in their own circles as well as shoulder some of the responsibility of facing down sexist behavior in the workplace. By supporting and encouraging female colleagues in ways that work for those colleagues, they can facilitate women’s career progression. And by creating an environment in which women feel as included and heard as their male counterparts, they will help them to achieve their potential, and encourage them not to take their talents elsewhere. Moreover, strengthening partnerships with men as agents of change and dismantling gender stereotypes could influence change in how both genders perceive the participation of women.

Public administration has become an essential and dominant part of society as it plays an important role in people’s lives. A critical mass of women in public administration, in particular in senior decision making positions, is important for equity reasons and because it brings more women’s perspectives to policy and other discussions. Decision making positions in public administration may also be among the few available or ‘acceptable’ employment opportunities for women, making it all the more important that women have a fair chance of competing for them. The minimal participation of women, especially in policy making and leading important organizations and institutions, is still a concern in the context of debates and dialogues about gender equality and equity in Africa.

Findings from the study revealed that women continue to suffer discrimination and are lowly represented in top decision making positions. Women find themselves overrepresented in some policy areas that are considered to have less influence and power but underrepresented in some other areas often considered more prestigious. For example, women most often lead social affairs, education, and women’s affairs ministries, while they are much less likely to lead areas such as defense, finance, and foreign affairs ministries. Many factors were found to be causes for women’s low participation in decision making in Zambia. For example, it was found that even when women succeed in gaining education and enter the decision making mainstream, they are often marginalized by institutional settings that reflect men’s needs and ignores women’s different needs and experience. Thus, women often find themselves isolated and marginalized in unfriendly, if not hostile, male-dominated institutional cultures; where one respondent rightly alluded that in public administration, women must continually prove themselves to be capable, but the men are assumed to be competent even when they are demonstrably not. Women must provide strong arguments to support their views; whereas men are simply believed on the basis of their professional qualifications and personal relationships.

In this vein, this research concludes that it is important to have more women in decision making positions in public administration by creating a gender balance in public administration for example by integrating women into political parties; each person recognizing that shared work and parental responsibilities promote women’s increased participation in public life; change the way we socialize our children; and also establish equal access for women to training in decision making. To reduce gender gaps, it is important to understand that women’s level of participation cannot be judged solely on the number or proportion of women within a particular institution. An individual can have a level of participation ranging from as low as being recorded as a member of the institution but having no input into decision making, or even awareness of the decisions being made (nominal participation); to as high as having considerable voice and influence, and holding a key decision making position (interactive/empowering participation). Therefore, mechanisms such as use of media, training of women in decision making, as well as implementing the various international instruments that fight for women will help reduce the gender gap that exist in public administration.

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Health research knowledge translation into policy in Zambia: policy-maker and researcher perspectives

Annie malama.

1 Department of Health Policy and Management, School of Public Health, University of Zambia, P.O. Box 51110, Lusaka, Zambia

Joseph Mumba Zulu

Selestine nzala.

2 Department of Medical Education, School of Medicine, University of Zambia, P.O. Box 51110, Lusaka, Zambia

Maureen Mupeta Kombe

Adam silumbwe, associated data.

The field notes and interview recorded verbatim and transcripts generated during data collection and analysis of this study are not publicly available to ensure the confidentiality and anonymity of the participating organizations and participants.

The translation of public health research evidence into policy is critical to strengthening the capacity of local health systems to respond to major health challenges. However, a limited amount of public health research evidence generated in developing countries is actually translated into policy because of various factors. This study sought to explore the process of health research knowledge translation into policy and to identify factors that facilitate or hinder the process in Zambia.

This work was an exploratory qualitative study comprising two phases. Firstly, a document review of health policies and strategic frameworks governing research was undertaken to understand the macro-environment for knowledge translation in Zambia. Secondly, key informant interviews were conducted with those responsible for health research and policy formulation. The study interviewed 15 key informants and a thematic analysis approach was used.

The document review showed that there are policy efforts to promote knowledge translation through improvement of the research macro-environment. However, the interviews showed that coordination and linkage of the knowledge creation, translation and policy-making processes remains a challenge owing to lack of research knowledge translation capacity, limited resources and lack of knowledge hubs. Emerging local research leadership and the availability of existing stock of underutilized local health research data provide an opportunity to enhance knowledge translation to feed into policy processes in Zambia.

Conclusions

Public health research knowledge translation into policy remains a challenge in Zambia. To enhance the uptake of research evidence in policy-making, this study suggests the need for improved coordination, financing and capacity-building in knowledge translation processes for both health researchers and policy-makers.

Globally, it has been acknowledged that health research knowledge translation (KT) into policy and practice is vital for enhancing the performance of health systems. However, evidence indicates that whilst there are numerous promising research findings, they are never translated or take a long time to be translated into health policy [ 1 ]. WHO defines KT as “the exchange, synthesis and application of knowledge by relevant stakeholders to accelerate the benefits of global and local innovations in strengthening health systems and improving people’s health” [ 2 ]. The focus is on promoting the application of knowledge through a dynamic and iterative process of interactions among the producers and users of research, removing the barriers to research use, and tailoring information to different target audiences to accelerate the societal or economic impact of health research [ 3 ].

Across the globe, health professionals face the challenge of translating the best available evidence into actual health interventions and policies in a timely manner to provide the most effective care and services [ 4 ]. The gap between existing knowledge and action leads to consequences such as suboptimal use of effective treatments and overuse of ineffective or unproven treatments. This contributes to poor health outcomes, health inequities and a waste of increasingly scarce resources [ 5 ]. Consequently, patients fail to gain maximum benefit from advances in healthcare, resulting in a negative impact on quality of life, productivity and resource utilization at an individual and societal level [ 8 ]. The field of KT aims to close the research–practice gap through the development of KT strategies which are aimed at aligning healthcare professionals’ decision-making with evidence-based recommendations [ 6 ].

The challenge of translating research evidence into policy is evident in most countries. Some of the reasons include policy-makers’ lack of access to research evidence sources, lack of time to review the material, and lack of skills to appraise and understand research evidence [ 7 ]. There exists a visible disconnection between policy-makers and public health researchers, compounded by a complex policy environment and the relationships between government officials and academic researchers. Elements of this complexity include diverse understandings of the nature of policy and how research relates to policy, dealing with multiple stakeholders in the policy-making process, and identifying strategies to manage the different cultures of government and academia [ 8 ]. Further, the focus with regard to policy-making tends to differ in many aspects between policy-makers and researchers. For example, whilst researchers are concerned with ensuring methodologically rigorous evidence, policy-makers may not focus on this.

Despite the widely documented principle barriers to KT, it is important to note common approaches that enhance evidence uptake which resonate with policy-makers [ 9 ]. Researchers ought to adapt the key messages from their research evidence for different policy-makers to facilitate adoption [ 5 ]. Other studies encourage the building of partnerships between researchers and policy-makers that allow for dialogue and trust-building around the tasks of asking and answering relevant research questions [ 10 ]. Further, bridging the gap between health policy-makers and researchers may require involving both parties in planning and execution of health research, institutionalizing research and ensuring that researchers pay attention to the needs of policy-makers [ 11 ]. Even with some of these recommendations, engagement between health policy-makers and researchers remains slow, particularly in low- and middle-income countries, which affects the rate at which research evidence influences policies to improve population health.

In Zambia, the field of KT has evolved over the years, particularly in the health sector, where the Ministry of Health (MoH) has created a specific position for a KT expert. Policies and programmes have been initiated to provide guidance for national-level KT efforts [ 12 ]. This includes the establishment of the National Health Research Authority (NHRA), a regulatory body which was created under the National Health Research Act, 2013 [No. 2 of 2013] to promote, regulate and coordinate ethical conduct of quality health research and facilitate evidence-based policies and programmes that improve population health [ 13 ]. Despite the stated progress, studies on KT in Zambia have remained scarce, particularly with regard to understanding the context within which the process occurs. This study sought to explore the process of health research KT into policy and to identify factors that facilitate or hinder the process in Zambia.

Study design

A qualitative case study design comprising a document review and key informant interviews was adopted. The case study design helped to describe the KT process, the context in which it occurs and to identify related factors [ 14 ]. The knowledge-to-action (KTA) framework was used to explore the process of KT [ 15 ]. National-level policy documents were reviewed to assess the degree to which the policy environment is enabling health research KT in Zambia.

Study setting and participants

The study was conducted in Lusaka, the capital city of Zambia, because this is where most national policy-makers and public health researchers are based. Study participants comprised those who had worked for at least 1 year in their respective organizations and were responsible for conducting health research and/or were involved in the process of health policy formulation. They were required to at least have had experience in conducting studies that in one way or another informed government health policy.

The key informants included policy-makers and representatives from various public health research organizations within Zambia, with headquarters in Lusaka District, that were involved in generating evidence, regulating health research and implementing health programmes (Tables (Tables1 1 and and2). 2 ). Among the organizations included were the NHRA, the University of Zambia School of Public Health (UNZASoPH), Zambia National Public Health Institute (ZNPHI), Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS), Centre for Infectious Disease Research in Zambia (CIDRZ) and National AIDS Council (NAC), MoH and the National Assembly Parliamentary Health Committee.

Key informants: policy-makers/regulators/implementers

MoH Ministry of Health; NHRA National Health Research Authority

Key informants: knowledge creators

CIDRZ Centre for Infectious Disease Research in Zambia; UNZASoPH University of Zambia School of Public Health; NAC National AIDS Council; ZNPHI Zambia National Public Health Institute; SAfAIDS Southern Africa HIV and AIDS Information Dissemination Service; NHRA National Health Research Authority

Sampling methods

The study utilized both purposive and snowball sampling techniques in selecting participants in order to achieve a maximum-diversity sample across the targeted population. We had anticipated that 20 key informants were enough to gain the information sought. However, a total of 15 key informants were interviewed because information saturation was reached. The term saturation commonly indicates that, based on the data collected or data analysed thus far, further data collection and/or analysis is unnecessary [ 16 ].

Data collection method

We first reviewed key health policy documents to become familiar with how the policy and legal environment in Zambia affects the translation of evidence into policy. The health policy documents and strategies were systematically selected from MoH, as the ministry governs health research and sets the direction for evidence-based decision-making in the country. Key informant interviews were then conducted, which were aimed at collecting data from participants who were experts as well as key stakeholders in health research KT. Tables Tables1 1 and and2 2 show the key informants interviewed. The interviews varied according to whether the participant was a policy-maker or health researcher in their respective organization. The key informants were individually contacted and asked to participate in the study. When they agreed, an appointment was set. Both face-to-face and phone interviews were employed. A voice recorder was used to capture the data, with consent from the participants. After each interview, the key informants were asked to suggest names of people who would provide more information on the research topic. The researchers then contacted the suggested names and proceeded to schedule an interview. The data were collected over a period of 3 months.

Data analysis

A thematic analysis approach, which is the process of identifying themes and patterns within the data, was utilized using NVivo 12 software [ 17 ]. Initially, the transcripts were read to become familiar with the data, at the same time paying attention to emergent themes addressing KT and factors shaping the process. Useful notes from the field reports were extracted and themes generated. A predetermined coding structure consisting of the adapted core thematic areas of the KTA framework was used to explore the KT process [ 15 ]. Once all data were coded in their respective themes, code reports were then generated and analysed.

Ethical considerations

This study received ethical approval from the University of Zambia Biomedical Research Ethics Committee (UNZABREC) as well as the NHRA. Relevant approvals were also obtained from the MoH. All the participants in this study provided consent. Information sheets detailing the study description were shared with all participants prior to the interviews, and signed consent was obtained.

The qualitative results are presented in two parts: firstly, the document review that details the positions of various national health research governing policy documents on KT (Table (Table3); 3 ); and secondly, the key informant interview data, which are presented according to policy-maker and researcher perspectives with respective verbatim quotes. The data detailing the KT process are organized according to key constructs of the adapted KTA framework to explain the KT process [ 15 ]. The KTA framework has two cycles: firstly, the knowledge creation cycle, which consists of actors and roles in KT, knowledge synthesis, knowledge products, dissemination and priority-setting; and secondly, the knowledge application cycles, which consist of adoption and adaptation of research findings as well as monitoring and evaluation. The factors shaping the KT are categorized as barriers or enablers (Table (Table4 4 ).

Health research governing policy documents in Zambia

Key thematic categories

The reviewed policy documents seek to promote translation of health research into policy by providing a legal framework to regulate and coordinate all health research activities in Zambia, alignment of research evidence to the national health goals and objectives, and development of mechanisms and criteria for identifying and agreeing on national health research priorities. However, these policies seem to focus more on improving the research environment, with rather unclear guidelines on how to ensure that health research knowledge is translated and adopted in national health policies by policy-makers. The policy documents only refer to limited aspects of KT. Further, the policies do not state what roles should be played by various actors in the KT process to ensure that evidence is incorporated in national health policies.

Research knowledge creation

Actors and roles in health research kt into policy.

The major actors identified as being directly involved in the process of translating research evidence into policy are the researchers who generate the knowledge, the government through the Executive, Legislature and the Judiciary as well as the policy-makers from the MoH, and other stakeholders such as the media, funders and the communities who advocate for policies to be formulated based on available evidence. Some respondents, however, indicated that there are different roles that each actor plays depending on the stage of KT and the policy process. Relationships among the key actors in the KT and policy process play an important role in influencing the embracing of evidence in national public health policies. One policy-maker stated:

The main actors are the researchers themselves, the health workers who are the implementers and policy-makers, but there are many stakeholders, as well as the Ministry of Health who is ourselves. This is because what is likely to happen is that, if a researcher conducts their research, the next thing they want to do is to inform Ministry of Health of the results. This is important; they have to engage the Ministry of Health because we are the ones who proceed to do any implementation. [KI #8, Policy-maker]

Another policy-maker added:

It depends with the kind of policy to be formulated and at what stage of the policy process. If it’s change of policy on, say, user fees for health services and introduction of health insurance, the ministerial cabinet and other arms of government will play an important role in the policy formulation at that level. [KI #14, Policy-maker]

Knowledge synthesis

Some researchers indicated that most research institutions had limited capacity to synthesize health research findings because they were inadequately trained in synthesis techniques. A major impediment to conducting research synthesis was the inherent time, effort and resources required to undertake such an activity. Most research conducted was merely for academic purposes, with limited emphasis on methodological rigor, which compromised the quality of evidence. In addition, a large proportion of research was donor-funded, and when research is externally funded it is sometimes difficult to access the findings owing to data restrictions in the contractual agreements. This meant that during synthesis, researchers may not have access to certain kinds of evidence, and even when they do, the quality may be an issue. It was the view of the researchers that most local health research institutions are not set up to conduct data synthesis, as one researcher noted:

Knowledge synthesis is very important, and part of the reason why knowledge translation in this country is poor is because research institutions are not set to synthesize knowledge. We have a lot of data that are collected in vain and are left to waste. We have students, academicians from outside Zambia accessing that data, translating and publishing it into papers, while the Zambians are simple data collectors. [KI #1, Health Researcher]

Knowledge products–research outputs

Health researchers agreed that they produced knowledge in various research programmes that included sexual reproductive health, HIV, tuberculosis (TB) and malaria, among others. Some research organizations had particular strength in conducting clinical trials and evaluating HIV vaccines, and worked on endemic diseases such as shigella, cholera, typhoid and E. coli . Much health research knowledge is generated locally, some of which has been used to inform policy, as some health researchers noted regarding their focus areas of knowledge creation:

Our research centres around communicable diseases (HIV, hepatitis, TB) and noncommunicable diseases (diabetes, hypertension). [KI #9, Health Researcher/Policy-maker]

Another health researcher had this to say:

We do various health research programmes, clinical trials, we evaluate HIV vaccines and drugs, and now we are working on HIV virus vaccine, as well as TB. [KI #1, Health Researcher]

The most frequently mentioned element of health research KT into policy was the development of policy briefs that are shared and debated with the relevant technical working groups (TWGs). These TWGs consist of experts in the key fields, who interrogate key recommendations from the policy briefs on such aspects as operational feasibility and relevance to the local context. The TWGs are then responsible for engaging and guiding the MoH to take relevant policy action. Some policy-makers noted that once the policy brief has been discussed, a policy dialogue then ensues. The dialogue involves a large number of stakeholders and continues for some time until a decision is made about whether some recommendations can be incorporated into policy. However, this process unfolds differently depending on the context, and in some instances may not happen for certain health policies, as one policy-maker/researcher explained:

Once the research has been done, there is a development of what we call a policy or technical brief. So once a policy brief has been developed, then that is basically submitted to the Ministry of Health usually through the technical group. Once that stage of submitting the policy brief to the technical group has passed, then it goes to the senior management of the Ministry of Health; then the senior management will discuss that issue, and then if they find that there is sufficient evidence they will proceed with guiding the policy formulation. [KI 11, Policy-maker/Health Researcher]

Dissemination of research findings

Some health researchers indicated that they did not make their research findings available to policy-makers because they were not obliged to do so and policy-makers did not ask for the evidence. However, they used various avenues including conferences, meetings and journals for dissemination of the health research findings. It was reported that even when researchers did disseminate information, it was difficult for policy-makers to use some of the research findings because of the way it was communicated. Sometimes the researchers did not communicate their findings clearly, as their reports were filled with technical language, making it difficult for interpretation and use by policy-makers. The policy-makers highlighted the need for research information to be presented in actionable format. Further, it was suggested that researchers ought to prioritize dissemination of findings locally as opposed to international platforms. One of the researchers remarked:

What has been happening is that a lot of people conducting research are academicians, and so a lot of times they opt to publish their results in high-impact factor journals so that the paper is seen by the world. For sure we are not disseminating that information adequately within our local platforms so as to influence the different policy agendas that happening. [KI #12, Health Researcher]

A policy-maker also recounted:

With knowledge translation, the method of communication is really key, so we would disseminate, but most of the time when we do the study, we have the conclusions. You may have the recommendations but the recommendations may not be as useful, because sometimes the researchers are not describing how these recommendations can be operationalized, which makes it difficult for the policy-makers to consider this evidence. [KI #15, Policy-maker]

The policy-makers and health researchers acknowledged that dissemination is an important step in KT to inform evidence-based policies. However, for the research results to be utilized, it is important that they are strategically disseminated to those that make policy decisions. It was reported that there is a directorate of policy and planning within the MoH that seeks to ensure that health policies are evidence-informed. Such departments should not be left out when disseminating research findings that may have wider health policy implications, as a policy-maker/researcher explained:

Within the Ministry of Health, we have directorates of policy and planning, which are very influential in shaping ministerial policy decisions. Such a department should be strategically engaged during dissemination if our research findings have to be adopted in public health policies. We should not only disseminate, but as well follow up with the policy-makers to ensure a better understanding of what we are proposing as researchers. [KI #8, Policy-maker/Health Researcher]

Research priority-setting

The key informants revealed that there were no clear research priority-setting mechanisms in most institutions. Both the researchers and policy-makers felt that external funding dictates the local research agenda and/or priority-setting in their respective institutions, which ultimately affects how policy-makers receive or perceive the evidence provided to them. Policy-makers may sometimes perceive externally funded research findings as not promoting national interests, and hence disregard them, however important. Whilst funders may have greater influence on local research priorities, it was also mentioned that some studies are commissioned based on programme implementation gaps as well as their public health relevance. A health researcher explained:

We don’t have indigenous funding of our own, so we cannot determine that we are going to research on this. Our researchers respond to competitive calls for funding, and those calls come with already predefined areas. So I think while we might be talking about setting priorities in research, that is an effort in futility. You only set priorities when you have money to fund those priorities; we respond to funds. [KI #1, Health Researcher]

One policy-maker remarked:

Most research that is conducted is sponsored by donors; therefore, only research in which donors have interest is sponsored and undertaken, thereby leaving the other research that the government would want to research on. [KI #13, Policy-maker]

Another policy-maker who is also a health researcher indicated:

It is very difficult to come up with the priority areas because there is a degree of inter-relation. However, you all know that we have got partnerships that help us to combat some of these communicable diseases such as HIV, so that makes it easy for priority-setting because some of the top ten communicable diseases are of public health significance. [KI #9, Health Researcher/Policy-maker]

Research knowledge application

Adoption and adaptation of research findings to local context.

Some policy-makers and researchers shared experiences of when research findings were used to inform policy. One such example was the integrated management of malaria and pneumonia study that was conducted in Chikankata, Southern Province of Zambia, in 2009. The study was looking at community health workers’ capacity to diagnose and treat both malaria and pneumonia. The results of the study were used to inform the policy on integrated community case management of malaria, pneumonia and diarrhoea. However, both the policy-makers and researchers mentioned that even when evidence is adopted, there are not adequate monitoring mechanisms for monitoring the performance of the evidence-informed policies.

In our study, the first thing we did was the presentation of findings to the child health technical working group. After discussing the findings and the recommended policy options, it was found to be of value. The Ministry of Health agreed to implement what is now called the integrated community case management of malaria, pneumonia and diarrhoea. The decision was made that community health workers can prescribe amoxicillin and utilize the rapid diagnostic test to diagnose malaria. We advocated for this policy because there had been overwhelming evidence this could be done by the community. [K4 #13, Health Researcher]

Facilitators of research KT

Emerging leadership to support local research.

Both the health researchers and policy-makers were of the view that there is political will from the leadership at the MoH to accord the required importance to research KT. To this effect, the MoH has facilitated the creation of the NHRA to coordinate research and facilitate KT. The MoH has undergone various reforms over the years in order to reposition itself for better management and use of research evidence and translate it into policy by providing a legal framework. This has culminated in the creation of the KT officer’s position within the MoH. However, it was noted that this position still required more technical and financial support to work more effectively. This should include the capacity to manage all forms of knowledge, including programmatic knowledge, across the various departments of the MoH to inform policy.

One of the ingredients that are leading knowledge translation process is mainly leadership and the environment, because we have had research since time in memorial. Because research is a big thing, it needs to stand on its own. Some of the factors enhancing knowledge translation is mainly related to what is being envisioned by leadership, which I think is what should be the case. [KI #8, Health Researcher/Policy-maker]

Availability of locally collected data

Locally generated knowledge was reported to have a greater impact on policy-making because it was tailored to the local needs. Some health researchers noted that the volume of locally generated research had been increasing, which meant that the evidence base is widening. There exists a large pool of routinely collected data in the health information management systems that is underutilized, yet may provide critical evidence to inform policy. However, it was stated that local research was too fragmented, in that researchers doing similar work sometimes present conflicting results, which negatively affects evidence use in policy-making, as one of the health researchers remarked:

We could use more of the already existing locally collected data. We do have a lot of data sources but they are so fragmented. The Ministry of Education has information system, Ministry of Health, National AIDS Council, etc. Also, every researcher is doing their own things with some otherwise conflicting findings on key topics. This defragmentation makes it hard for the policy-makers. [KI #4, Health Researcher/Policy Advocate]

Barriers to research KT

Limited kt capacity.

Most researchers and policy-makers were of the view that there was limited capacity and understanding of the various facets of KT among both the researchers and policy-makers. Enhancing skills needed for conducting research and KT were identified as key to improving the uptake of evidence in Zambian health policies. Continuous capacity-building on the different elements of KT among knowledge translators and policy-makers, as well as development of effective communication strategies, should be prioritized. It was indicated that building the capacity to generate knowledge that is useful at different stages of the policy process is needed. In addition, it was stated that capacity-building for policy-makers will enable them to engage effectively with the health research findings, as one health researcher/policy-maker noted:

It is very important to have a skill as you embark on certain processes that are both research itself and knowledge translation. So, in terms of skills, I mentioned that a lot of people have gotten education, but we are still a growing country so we may still have gaps here and there in terms of skills to conduct research, but also at the level of policy translation its either insufficient or inadequate. [KI #7, Health Researcher/Policy-maker]

Another policy-maker/health researcher stated:

[The] capacity to generate the knowledge, analyse the data in such a way that it is useful for policy-makers, synthesize that research knowledge into a form that can be used into policy formulation, is the key, as well as the capacity of the policy-makers themselves to appreciate the research knowledge and be able to utilize that knowledge for policy formulation. [KI #11, Policy-maker/Health Researcher]

Limited resources

Health researchers and policy-makers stated that lack of resources is an impediment to the process of translating health research knowledge into policy. Researchers stated that research is expensive, and thus having the resources to conduct research is one of the greatest challenges. Resources refer not only to financial support, but also equipment and infrastructure. The lack of resources constrains the research process including the outputs, which limits the chances of the findings being translated into policy. Furthermore, it was suggested that government should increase funding to research. One health researcher indicated:

Research is not a cheap exercise and for my capacity to be felt as the researcher, it requires some resources, qualified human resource, it will require infrastructure if you have to do more especially in the health sector, the health sector is really different from maybe commerce. In the health sector if you have to do meaningful research, it has to be pure science, so it is expensive for all those equipment and chemicals. [KI #10, Health Researcher]

A policy-maker had this to say concerning the limited resources in carrying out health research:

Research knowledge is sometimes inaccurate due to limited funds to finance health research. [KI #13, Policy-maker]

Lack of a national knowledge hub for health research findings

The participants indicated that Zambia lacked a national knowledge hub for all health research findings generated locally. Some health researchers and policy-makers reported that there is research conducted in many parts of the country, but only research from key provinces such as Lusaka and Copperbelt may come to the attention of policy-makers, while other research findings from other districts, however important, may receive less attention. It was suggested that the creation of a national repository that gathers evidence and disseminates it across the researcher and policy communities would help to improve KT. A health researcher stated:

There is need to put up systems and strategies for creating national health knowledge hubs with appropriate standard operating procedures for access and storage and must be accessible and available to researchers and policy-makers. Health research results are there not to be packed, but to help us create evidence and inform policies, so for that reason we are not able to do that, and so this has remained part of the complex challenge of translating evidence to policy. [KI #2, Health Researcher]

In addition, some health researchers noted that KT was limited because there are not adequate platforms through which both health researchers and policy-makers can communicate on innovative ways to incorporate research findings during the different phases of policy formulation. Some health researchers indicated a need to strengthen platforms where research findings, in addition to producing the required reports, are regularly shared with the policy-makers. Direct engagement platforms such as the parliamentary committee on health, where researchers would present findings to lawmakers, were however said to be inadequate in the KT-to-policy process. A health researcher and a policy-maker, respectively, remarked:

I think that knowledge translation into policy is extremely limited because there have not been platforms that are integrated and coordinated where this is done. But I think that there should be platforms where there is a policy engagement and others where researchers and policy-makers need to interact and engage each other. [KI #2, Health Researcher] Quite often we are not part of stakeholder consultation, and yet we are expected to come and debate these laws and policies, and approve. That is why we have bad laws, because people do not have knowledge or an idea of what they are doing. So how do we expect people to make the law when they don’t understand the issues around it? [KI #3, Policy-maker]

Another health researcher indicated:

There is a gap in Zambia because knowledge translation is being embarked on now. I was saying that knowledge translation is important. Secondly, there seems to be a gap because there are a lot of research results that we have which I think have not been implemented into policy, and why is that? it is because for all these years we have not had a platform to use to ensure that there is knowledge translation. [KI #10, Health Researcher]

The study findings show the complexity and insufficient cohesion of the current KT process in Zambia despite positive efforts over the years. The document review highlights the fact that the promotion of KT in most research governing policies through systems to harness local research is still inadequate. The document review further shows that there are efforts to improve the health research environment through regulation, coordination and institutional strengthening. However, the policies should go beyond prescribing a research environment, to focus more on specific aspects of KT such as evidence generation, synthesis, dissemination and implementation [ 18 ]. Furthermore, policies should seek to address the complex structure, iterative nature and inclusiveness of both the KT and policy processes [ 10 , 19 ].

The Zambian government acknowledges the strategic role of KT in attaining national health goals, as evidenced by the creation of the NHRA by an act of parliament. The NHRA has made considerable progress in providing a platform for engagement of policy-makers, health researchers, the media and other interested stakeholders through annual research conferences. The value of creating space for dialogue between policy-makers and researchers to facilitate exchange during the policy-making process is highlighted by Nutley el al. [ 20 ]. Whilst the conferences by the NHRA are ideal for dissemination of research findings, there is a need for platforms that promote consistent engagement between policy-makers and researchers to allow for iterative and continuous exchange between the KT and policy processes. Suggestions to this effect may take the form of structured committees or working groups. An open regular update and exchange forum including the media and civil society would ensure diverse input, building trust and shared insight to ensure relevance for population health outcomes [ 21 , 22 ].

Prior to the NHRA, early efforts to govern national-level KT in Zambia culminated in the creation of the Zambia Forum for Health Research (ZAMFOHR). This platform was created with the help of the WHO Evidence-Informed Policy Network (EVIPNet). Lessons from setting up the ZAMFOHR platform, still valid today, highlight the value of strategic leadership to manage linkages between policy-makers and researchers, building capacities in knowledge synthesis, communication and brokering [ 12 ]. Lessons from ZAMFOHR underscore the importance of developing coherent national/institutional KT strategies that are embedded within KT structures across various governance levels to feed into policy development and decision-making processes [ 23 , 24 ].

KT efforts in Zambia have lagged due to limited investment in the national health research systems (NHRS). According to Kapata et al., this can frustrate health systems in their quest to achieve desired population health goals, because the NHRS may not adequately generate the required evidence to inform policy [ 25 ]. Furthermore, the lack of integrated and coordinated knowledge hubs hinders KT and development of the NHRS. Various researchers and routine data collection systems are gathering huge amounts of data on similar public health domains but are underutilized and disconnected on otherwise common aspects [ 26 ]. To improve KT, the safeguarding of knowledge generated by various health researchers and routine data systems must be ensured through the creation and linking of common data repositories and systems in order to coordinate knowledge creation, translation and use among various stakeholders.

In terms of research priorities, the need for new data must be appropriately balanced with the use and quality improvement of existing data. Researchers and policy-makers each have their own dependencies, which may amount to vested interests. Such are legitimate if open for discussion. Donors influence research through their conditions for funding, which may be more donor country- or global programme-based and thus a concern for country relevance [ 27 , 28 ]. This includes donor programme-associated commercial consultancies, which may be largely uncritical towards methodologically weak terms of reference and are not held responsible for the changes that are effected after their departure. Here it would be better for donors to assign relevant in-country university and independent research institutions [ 29 ]. In addition, the government should consistently commit funds to health research and strengthening of the NHRA’s capacity to enhance the uptake of health research knowledge in policy-making through establishment of appropriate regulations and incentives.

KT occurs in a complex social system of interactions among various stakeholders. Possible interventions to enhance this process should be collaborative and two-way in nature, involving both the policy-makers and researchers. Strategies to improve evidence use in public health policy-making include regular contact with knowledge brokers to increase access to evidence, developing skills in appraisal and integration of evidence, and strengthening networks and exploring organizational factors to build organizational cultures receptive to embedding evidence in practice [ 30 ]. Knowledge translators need to identify key messages for different target audiences and to fashion these in language and KT products that are easily assimilated by different audiences [ 31 ]. A number of reviews provide a wide range of options for bridging the gap between policy/decision-makers and researchers [ 24 , 30 ]. These reviews suggest that efforts to undertake translation of knowledge into policy are likely to produce desired results if they adopt KT strategies informed by an assessment of the local context by identifying potential enablers and how to overcome barriers.

When it comes to evidence/knowledge use in policy-making, it is also important to consider the models of policy-making that are being used. The different types of research evidence and their characteristics should equally be considered. Different forms of research evidence may serve best for certain kinds of policy decisions and policy-makers [ 32 ]. However, in much of the prevailing literature, the term health research evidence is very broad and could be subdivided into, for example, clinical, implementation and systems research. For knowledge, one could make a distinction between health outcome and managerial knowledge. For policy, however, this may be aligned with specific current policy and strategic recommendations or with adding insight to improve the quality of routine information systems. This could be anything from promoting a new and strengthened approach to a disease or condition or a specific problem, to a more general input to broader concerns for overall population health. In all contexts, general KT principles are applicable if the intention is widespread adoption of research evidence in the policy and decision processes.

Study strength and limitations

This study was a qualitative study which allowed for detailed collection of data regarding the process of health research KT into policy in Zambia. However, though the study facilitated a rich description of the KT process, the responses given by participants could not be measured. Furthermore, the data collection from the policy-makers was a challenge due to their busy schedules. For this reason, we could not interview as many as we would have wanted. However, our having access to parliamentarians who sit on the parliamentary health committee compensated for our inability to interview a larger number of policy-makers. Through the diverse yet fairly small group of key informants, a number of important conditions for an effective KT process were identified. The study provides a rich perspective of some of these important conditions as well as challenges facing KT in Zambia.

KT can address many of the challenges faced in the health sector in Zambia by implementing known policy interventions informed by available health research evidence/knowledge. Health research KT into policy remains a challenge in Zambia despite positive efforts over the years, owing to a number of contextual factors that shape the uptake of health research. These include, among others, limited resources, lack of space for dialogue, continued policy–researcher divide and lack of coordinated national knowledge hubs. There is a need for national health knowledge hubs with appropriate standard operating procedures that should be accessible to both researchers and policy-makers. Furthermore, there is a need to create more spaces for dialogue between health researchers and policy-makers as well as continuous strengthening and monitoring of KT capacity. Efforts that strengthen coordination of the process of health research KT among health researchers, policy-makers and key stakeholders will be vital in obtaining the full benefits of local evidence in improving the health of Zambians.

Acknowledgements

We wish to acknowledge the supervisory team comprising Dr Joseph Zulu, Mr Adam Silumbwe, Dr Selestine Nzala and Ms Maureen Kombe. We also thank Dr Peter Hangoma, Mr Chris Mweemba, Dr Julius Kapembwa and Dr Bornwell Sikateyo for the guidance and encouragement. Annie Malama, the first author, was a postgraduate Master of Public Health student at the University of Zambia during the drafting of this manuscript.

Abbreviations

Authors’ contributions.

AM conceived of the study, conducted data collection and drafted the manuscript. JMZ, SN, MK supervised the data collection, analysis and reporting of the results. JMZ, SN and AS oversaw the manuscript drafting by reviewing and providing feedback. AS ensured a critical review of the final document and approved the submission. All authors read and approved the final manuscript.

This study received partial funding from Bergen University and the University of Zambia, School of Public Health Scholarship for scientific writing to help with the drafting of the manuscript.

Availability of data and materials

Ethics approval and consent to participate.

Ethical approval was provided by the University of Zambia Biomedical Research Ethics Committee (UNZABREC), and clearance to conduct research was sought and granted by the National Health Research Authority (NHRA). Consent form and information sheet were administered to participants before conducting face-to-face interviews and read to participants before the phone call interview.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Annie Malama, Email: moc.oohay@abmeewmma .

Joseph Mumba Zulu, Email: moc.liamg@uluzabmumhpesoj .

Selestine Nzala, Email: moc.oohay@alaznenitseles .

Maureen Mupeta Kombe, Email: moc.oohay@86ebmok .

Adam Silumbwe, Email: moc.liamg@ewbmulismada .

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Reforms in public sector management: a relevant issue for the citizens of Zambia

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