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BMC Health Services Research

Open Access

Key influences over actors’ preferences and use of evidence in policy development: insights from the Nigerian IMNCH strategy

  • Chinyere Mbachu1,
  • Ifeanyi Chikezie1, 2,
  • Sloudo Eze2,
  • Obinna Onwujekwe1, 2,
  • Benjamin Uzochukwu1, 3 and
  • Nkoli Ezumah1, 4
BMC Health Services Research201414(Suppl 2):P76

Published: 7 July 2014


Policy MakingPolicy DevelopmentExpert KnowledgePolicy ProcessActor Category


Evidence based policy-making has been promoted as a means of ensuring better outcomes but what counts as evidence in policy-making lies within a spectrum of expert knowledge through scientifically generated information. Different actors provide varying degrees of support for and use of different types of evidence in policy development. Since not all forms of evidence share an equal validity or weighting for policy-makers, it is important to understand the key factors that influence their choice of evidence.

Materials and methods

A retrospective cross-sectional study was carried out at the national level in Nigeria. A case-study approach was used and the Nigerian Integrated Maternal Newborn and Child Health (IMNCH) strategy was selected because it met the criteria of being: (i) recently developed (<10 years old); and (ii) of international prominence. Two frameworks were used for conceptualization and data analysis namely: (i) framework for analyzing the role of evidence in policy making developed by Mirzoev et al., in 2012, and (ii) the policy triangle. They were used to explore the key contextual and participatory influences on choice of evidence in developing the IMNCH strategy. Data was collected through review of relevant national documents and in-depth interviews of purposefully selected key policy and decision makers. Thematic analysis was applied.


The breadth of evidence used was wide, ranging from expert opinions to systematic reviews. The choice of different types of evidence was found to overlap across actor categories. Key influences over actors’ choice of evidence were: (i) perceived robustness of evidence - comprehensive, representative, recent, scientifically sound; (ii) roles in evidence process, i.e. their degree and level of participation in evidence generation and dissemination, vis-à-vis their role in the policy process; and (iii) contextual factors such as global agenda and influence, timeline for strategy development, availability of resources for evidence generation, and lessons from previously unsuccessful policies/plans.


Actors’ choice of evidence in policy making is influenced not only by the characteristics of evidence, but on the roles these actors play in the process, their power to influence the policy, and the context in which evidence is used.

Authors’ Affiliations

Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, Nigeria
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
Department of Sociology, University of Nigeria, Nsukka, Nigeria


© Mbachu et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.