Book excerpt: The research in this technical brief is part of a multi-country study commissioned by the Alliance for Health Policy and Systems Research to understand the evidence-to-policy process around health decisions in Ghana, Ethiopia and Mozambique. Through surveys and in-depth interviews with representatives from 54 locally based research institutions and 41 health policy-makers, the studies explored the entire chain of evidence generation, from conception of the research idea, through to its synthesis and dissemination. For each country, this included discussions with key actors involved in tracer policies. This technical brief distils regional lessons from the studies and offers a set of recommendations to support efforts to develop and strengthen existing institutions towards enhanced uptake of research.