Facilitating the Relationship Between Researchersand Policy-Makers: Experiences from Three EcohealthProjects in West and Central Africa

Brama Kone,1,2 Mathieu Feagan,3,4 Yveline A. Houenou,1,5 Nicolas Brou,1,5,6 Pascal V. Houenou,1,7

Benjamin Fayomi,1,8 Emmanuel Ngnikam,1,9 Gueladio Cisse,1,10 Jerry Spiegel,3,11

and Edouard Kouassi3,12

1Communaute de Pratiques Ecosante pour l’Afrique de l’Ouest et du Centre (COPES-AOC), Cotonou, Benin2Centre Suisse de Recherches Scientifiques en Cote d’Ivoire, Abidjan, Ivory Coast3Canadian Community of Practice in Ecosystem Approaches to Health (CoPEH-Canada), Toronto, ON, Canada4York University and Ryerson University, Toronto, ON, Canada5Universite de Cocody, Abidjan, Ivory Coast6Reseau pour l’Environnement et le Developpement Durable en Afrique, Abidjan, Ivory Coast7Universite d’Abobo-Adjame, Abidjan, Ivory Coast8Universite d’Abomey-Calavi, Calavi, Benin9National Polytechnic Higher School, Yaounde, Cameroon10Institut Tropical et de Sante Publique Suisse (SwissTPH) et Universite de Bale, Basel, Switzerland11School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada12Department of Medicine, Faculty of Medicine, University of Montreal, Maisonneuve-Rosemont Hospital Research Center, and Centre de Recherche

Fernand-Seguin, 5415 Boul. de l’Assomption, Montreal, QC H1T 2M4, Canada

INTRODUCTION

The complexity of today’s environmental health problems

calls for multilevel, intersectorial interventions, involving

the coordinated efforts of researchers, policy-makers, non-

governmental organizations, and affected communities

(Ndiaye 2009; Armitage 2008). The value of applying eco-

system approaches to health in framing research, action,

and policy is being increasingly documented, with exciting

and practical examples emerging (Charron 2011; Webb

et al. 2010; Carden 2009). In this article, we identify con-

cepts that are well-suited to address the gaps in commu-

nication that persist between researchers and policy-makers

in the subregion of West and Central Africa. We then

examine three novel case studies that illustrate the influence

of research on management of major public health issues

and on the overall transformation of the researcher–policy-

maker relationship.

ECOSYSTEM APPROACHES TO HEALTH AND

THE RESEARCHER–POLICY-MAKER INTERFACE

Applying an ecosystem approach to health offers a process

to systematically define and evaluate the determinants of

human and environmental health with a view toward sus-

tainability guided by the principles of (1) transdisciplina-

rity, (2) participation, and (3) social justice and gender

equity (Webb et al. 2010). While transdisciplinarity is de-

fined by some as the joint efforts of several scientific dis-

ciplines to address questions arising between areas of

expertise, others point to cooperation between society and

the academic world to generate ways of knowing that

Published online: January 31, 2012

Correspondence to: Edouard Kouassi, e-mail: edouard.kouassi@umontreal.ca

EcoHealth 8, 413–417, 2011DOI: 10.1007/s10393-012-0740-3

Forum

� 2012 International Association for Ecology and Health

directly includes the needs and visions of affected popula-

tions. Beyond this, participation entails directly involving

communities and other stakeholders within the research

process through contractual, consultative, collaborative, or

collegial means. Finally, social justice and gender equity

demand that the dynamics between the needs and the

interests of different social groups be taken into account.

Thus, ecosystem approaches to health attempt to associate

all relevant actors within an interactive and integrative

process leading to the effective adoption and use of research

results.

THE POLITICS OF RESEARCH AND MAJOR

PUBLIC HEALTH PROBLEMS

Major development-related policy decisions often happen

outside of scientific circles. At the same time, researchers

frequently carry out their research without adequate con-

nection to the realities and needs of people in areas where

the projects occur. To address this gap in communication,

Carden (2009) has called for a ‘‘common language’’ to

highlight factors that come into play in decision making.

This is not limited to current social organization but can

include the transformation of existing knowledge–power

relations, that Armitage (2008) called ‘‘the language of

partnership, accountability, trust building and knowledge

valuation.’’ Three selected case studies of ecohealth research

in West and Central Africa that examine these themes and

their benefits for local communities are summarized in

Table 1.

Within the scope of the solid waste management

project (a) three national workshops were organized in

each West African country at the beginning, midpoint, and

final phase of the project to, respectively, (1) inform, raise

awareness and mobilize local actors, political, technical,

and financial partners interested in waste management; (2)

validate and set the groundwork for efficient national

waste-management; and (3) secure national, regional, and

local resources to ensure project implementation. Policy-

makers, researchers, the private sector, and NGOs partici-

pated. Also for the project on diarrhoeal diseases manage-

ment (b) three workshops were organized to respectively,

(1) present the project to the different stakeholders and

discuss the main activities and milestones; (2) present the

result of data collection and discuss the main strategies to

fight against diarrhoeal diseases; and (3) evaluate and close

the project. Periodic meetings between the concerned

stakeholders took place in parallel to facilitate information

exchange. In both the projects, decision makers’ partici-

pation from the beginning to the end of the projects in-

creased each party’s interests in the projects as well as the

adoption of a set of common interests. The integration of

the waste management project by the different parties in-

volved gave rise to national projects supported by

researchers and policy-makers in each country. Further-

more, the Senegal office of the NEPAD expressed interest in

using the ecohealth concept and methodology in a project

they were writing to be submitted to the African Devel-

opment Bank. Also, the United Nations Environment

Program (UNEP) retained the environment and health

topic as a priority for the program in relation to the re-

gional office of WHO in Africa.

The involvement of local decision makers (mayors,

heads of communities) and environment and health sec-

retaries in the project of diarrhoeal diseases management

led to the integration of the project by them. A water tap

and a health center for diarrhoeal diseases care were given

to the communities as requested by them. Best practices in

hygiene have been established in the management of solid

waste, household sewage, and access to clean drinking

water. At the community and municipal levels, the project

was cited as an example and the Swiss Centre for Scientific

Research in Cote d’Ivoire has been solicited several times to

help build capacity among populations affected by diar-

rhoeal diseases in lagoon shore villages of the district. At

the national level, the 1-year scope of the project has not

allowed major changes in policy to occur; however, the

ministers of environment and health have expressed a sense

of satisfaction arising from being implicated in an action-

research project based on important questions of envi-

ronmental and human health.

These two examples show that research can have a

multi-level influence on politics, from the community level

upward to the regional and national levels (Armitage 2008),

so long as it is linked to a process of communication that

allows a common language and common aspirations to

emerge within the institutional contexts that frame the

project. It seems that ecohealth is reorienting the re-

searcher–policy relationship in what looks like the right

direction. Strategic alliances between concerned parties can

lead to a common platform for action (Ndiaye 2009).

Furthermore, communication between researchers and

policy-makers must not only occur after projects are fi-

nanced but also during the project’s planning and financing

stages. In other words, projects must be built through the

414 Brama Kone et al.

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Facilitating the Relationship Between Researchers and Policy-Makers 415

common aspirations of policy-makers, researchers, and

communities.

INSTITUTIONALIZING ECOSYSTEM

APPROACHES TO HEALTH IN WEST AND

CENTRAL AFRICA: SUCCESS AND CHALLENGES

Transdisciplinarity does not happen spontaneously but

rather requires experience and practice to realize itself by

inter-individual and inter-institutional relationships. Eco-

health training offers the possibility to develop the skills

and resources to help realize transdisciplinarity for

researchers, policy-makers, as well as other community

actors such as NGOs. Founded on the idea that ecohealth

training could play an important role in building capacity

to address complex problems of environment and health

while nurturing a new awareness of the researcher–policy-

maker relationship, project’s main goal was to institu-

tionalize ecohealth within different research and training

institutions in West and Central Africa. During the first

phase, the approach started to stand on solid grounds in

institutions of involved nations, but it is important to note

that these ecohealth training sessions were open to

researchers, policy-makers, and representatives from NGOs

and civil society from all the West and Central Africa re-

gion. In 3 years, four distinct course syllabi were developed.

Ecohealth training was introduced into nine programs in

universities and teaching institutions, and has also been

delivered in the form of distance training since 2010.

Twenty-nine young researchers (PhD and Master degrees)

and NGO representatives and nine lecturers completed the

training. One regional conference on the theme of climate

change, water, and health was organized and 145 people,

including researchers, policy-makers, and NGOs represen-

tatives from three continents (Africa, North America, and

Europe) took part.

These outcomes, along with responses from ten

interviews with participants in ecohealth training, suggest

that the process of institutionalizing ecohealth is on a path

toward success, both in terms of number and diversity of

participants as well as the enthusiasm expressed toward the

approach. Still, responses point to certain key challenges,

namely, that (1) barriers between disciplines and institu-

tions remain a stumbling-block for putting ecohealth into

practice; (2) currently few funders know of or are willing to

support ecohealth projects; and (3) few scientific journals

are open to publishing results from transdisciplinary or

participatory studies. Thus, the institutionalization process

needs to face those challenges to succeed and contribute to

a fundamental reorganization of institutional priorities.

CONCLUSION

If correctly implemented, ecosystem approaches to health

can help address the main constraints raised by Carden

(2009) regarding the researcher–policy-maker relationship.

Indeed, these approaches embrace the complexity of this

relationship and use it as a tool in confronting the com-

plexity of environment and health issues. As the case

studies in waste management and diarrhoeal diseases

management suggest, ecosystem approaches to health can

help facilitate a communication process that brings

researchers and policy-makers together in such a way that

communities integrate research results on multiple political

levels. Finally, in a world where institutional and disci-

plinary silos are strong, the institutionalization of ecosys-

tem approaches to health remains a realizable hope in the

mid-to-long-term transformation of the researcher–policy-

maker relationship in developing nations, particularly in

West and Central Africa. These experiences offer an

example for other nations around the world to consider.

The impact we have had in the particular cases in West and

Central Africa hold promise for application at other scales

and in different situations.

ACKNOWLEDGMENTS

This article derives from ongoing discussions of the Policy

Working Group of the International Network of Commu-

nities of Practice in Ecosystem Approaches to Health

(CoPEH-CoIN). The Policy Working Group was formed

along with others during the meetings of CoPEH-CoIN at

the Ecohealth 2010 conference in London in August 2010.

The authors are immensely debtful to all the participants of

CoPEH-CoIN, and to its Coordinator, Bob Woollard, for

helpful and challenging interactions. We thank Margot

Parkes for critical reading of the manuscript prior to

submission. We thank also Dominique Charron and

Margot Parks for providing their permission to cite their

work currently in press that is highly relevant to the topics

of researcher-policy maker relationships in the field of

environment and human health. This work was made

possible thanks to the financial support of the IDRC to the

416 Brama Kone et al.

three research projects described here and to CoPEH-CoIN,

as well as the support of the NCCR North South program

to B. Kone.

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Armitage D (2008) Governance and the commons in a multi-levelworld. International Journal of the Commons 2:7–32

Carden F (2009) Knowledge to policy: making the most ofdevelopment research. http://idl-bnc.idrc.ca/dspace/bitstream/10625/37706/1/127931.pdf. Accessed September 13, 2011

Charron DF (editor) (2011) Ecohealth Research in Practice:Innovative Applications of an Ecosystem Approach to Health,New York/Ottawa: Springer/International Development ResearchCentre

Ndiaye A (2009) Chercheurs et Decideurs d’Afrique. QuellesSynergies pour le Developpement ? Dakar, Senegal: Conseilpour le Developpement de la Recherche en Sciences Sociales enAfrique (CODESRIA)/Ottawa, ON: Centre de Recherches pourle Developpement International (CRDI). http://web.idrc.ca/openebooks/465-9/. Accessed September 13, 2011

Webb JC, Mergler D, Parkes MW, Saint-Charles J, Spiegel J,Waltner-Toews D, Yassi A, Woollard RF (2010) Tools forthoughtful action: the role of ecosystem approaches to health inenhancing public health. Canadian Journal of Public Health101:439–441

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