Bulletin of the World Health Organization

Creating windows of opportunity for policy change: incorporating evidence into decentralized planning in Kenya

Lori S Ashford, Rhonda R Smith, Roger-Mark De Souza, Fariyal F Fikree, & Nancy V Yinger



Because researchers and policy-makers work in different spheres, policy decisions in the health arena are often not based on available scientific evidence.


We describe a model that illustrates the policy process and how to work strategically to translate knowledge into policy actions. Several types of activity — agenda-setting, coalition building and policy learning — together can create a window of opportunity for policy change.

Local Setting

Activities were undertaken as part of the Kenyan Ministry of Health’s new decentralized planning-process. The objective was to ensure that the results of a national assessment of health services were used in the preparation of district-level health plans.

Relevant changes

Following the intervention, 70 district-level, evidence-based work plans were developed and approved by the Kenyan Ministry of Health.

Lessons learned

Substantial investment and effort are needed to bring stakeholders together to work towards policy change. More in-depth evaluation of these efforts can aid understanding of how systematic approaches to policy change can be replicated elsewhere.