📄 health policy

Intellectual Property Literacy, Innovation Readiness and Innovation Practice in Syria's Pharmaceutical Sector: A Cross-Sectional Study

This cross-sectional study of Syrian pharmaceutical professionals reveals that while innovation attitudes and IP literacy are high, actual innovation practice remains low due to insufficient innovation readiness, highlighting the critical role of contextual and institutional enabling factors in resource-constrained settings.

Original authors: Khatib, C., Alkozy, H., Hamdan, Z., Isber, M., Mlhem, J.

Published 2026-06-23

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CC BY 4.0

Original authors: Khatib, C., Alkozy, H., Hamdan, Z., Isber, M., Mlhem, J.

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ⚕️ This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer

The Big Picture: The "Want vs. Can" Gap

Imagine a group of people who are all huge fans of cooking. They love food, they know the names of every spice, they can recite recipes from memory, and they genuinely believe that cooking delicious meals is the most important thing in the world.

However, when you look at their actual kitchens, they are empty. There are no stoves, no pots, no ingredients, and no electricity. Even though they love cooking and know how to cook, they aren't actually making any meals.

This is exactly what the researchers found in Syria's pharmaceutical (medicine-making) sector. They studied 303 professionals (doctors, pharmacists, students, and teachers) to see how their knowledge, attitudes, and actual actions lined up.

The Four Key Ingredients

The study looked at four specific things, which we can think of as ingredients in a recipe for innovation:

IP Literacy (The Recipe Book): This is how much the professionals know about "Intellectual Property" (IP). Do they understand patents? Do they know how to protect a new drug idea?
- The Result: Their knowledge was okay, but not perfect. They knew about half of the rules.
Innovation Attitudes (The Appetite): This is how much they want to innovate. Do they think it's a good idea? Do they support new ideas?
- The Result: Very High. Everyone agreed that innovation is great. They were enthusiastic and supportive.
Innovation Readiness (The Kitchen): This is the most important finding. It measures the environment. Do they have a lab? Do they have funding? Does their boss support them? Is there a clear path to turn an idea into a real product?
- The Result: Very Low. The "kitchen" was broken. There were no tools, no support, and no infrastructure to actually make things happen.
Innovation Practice (The Meal): This is what they actually did. Did they file a patent? Did they start a research project?
- The Result: Very Low. Despite loving the idea of innovation, almost no one was actually doing it.

The Big Surprise: Knowing and Loving Isn't Enough

Usually, we think the process works like a straight line:

If you know how to cook (Knowledge) + If you love food (Attitude) = You will cook (Practice).

But this study found that this line is broken in Syria's pharmaceutical sector.

The professionals had high knowledge and high love for innovation.
But because the Kitchen (Readiness) was empty, they couldn't cook.
The researchers found that having a positive attitude didn't predict whether someone would actually innovate. The only thing that mattered was whether they had the tools and support (Readiness) to do it.

The "Academic" Difference

The study also noticed a difference between different groups of people, like comparing a home cook to a professional chef in a fancy restaurant:

Practicing Pharmacists (The Home Cooks): They had the biggest gap. They loved the idea of innovation, but their "kitchen" was the most broken. They had the least ability to actually do anything.
Academics/University Staff (The Chefs in Fancy Kitchens): They had the highest "Readiness" scores. They had better access to labs, research funding, and support. Consequently, they were the only group actually doing some innovation work.

The Main Takeaway

The paper concludes that you cannot fix the problem just by teaching people more about patents or trying to make them "feel" more excited about innovation. They already feel excited.

The problem is structural. It's like trying to teach someone to drive a car when there are no roads and no cars available.

To get more innovation happening, the researchers suggest we need to stop focusing only on the people's minds (knowledge and feelings) and start fixing the environment (the roads and the cars). We need to build the "kitchens" (labs, funding, university-industry partnerships) so that the people who are already eager to innovate actually have a place to do it.

In short: You can have the best chefs in the world with the best recipes, but if you don't give them a kitchen, they won't make a single meal.

Technical Summary: Intellectual Property Literacy, Innovation Readiness and Innovation Practice in Syria's Pharmaceutical Sector

Problem Statement
Pharmaceutical innovation in transitional and resource-constrained economies often exhibits a persistent gap between innovation potential (knowledge and attitudes) and realized innovation activity. While the Knowledge–Attitude–Practice (KAP) framework is widely used to explain innovation behavior, empirical evidence suggests this relationship is neither uniform nor linear, particularly when structural constraints, regulatory uncertainty, or limited institutional support exist. In Syria's pharmaceutical sector, there is a lack of empirical evidence examining how intellectual property (IP) literacy, innovation attitudes, innovation readiness, and innovation practice coexist within a single analytical framework. Specifically, it remains unclear whether "innovation readiness"—conceptualized here as reported enabling institutional and structural conditions—provides descriptive value beyond conventional knowledge and attitudinal measures.

Methodology
This study employed a cross-sectional observational design to examine relationships among four domains within Syria's pharmaceutical sector.

Participants: A convenience sample of 303 pharmaceutical professionals (practicing pharmacists, students, and academics) was recruited between March and April 2026.
Data Collection: An online questionnaire was administered via Google Forms. Participants provided electronic informed consent.
Variables and Indices: Four composite indices were constructed as formative indicators (0–100 scale):
1. Pharmaceutical Intellectual Property Literacy Score (PILS): Based on 9 binary items regarding objective IP knowledge.
2. Intellectual Property Attitude Index (IAI): Based on 10 Likert-type items regarding attitudinal orientations.
3. Innovation Readiness Score (IRS): A composite indicator of reported enabling conditions (e.g., access to infrastructure, organizational support).
4. Innovation Practice Index (IPI): Based on 3 binary items regarding participation in IP applications, projects, and collaborations.
Statistical Analysis: The analysis utilized descriptive statistics, Pearson correlations, one-way ANOVA with Tukey HSD post-hoc tests, and Ordinary Least Squares (OLS) regression with HC3 heteroscedasticity-consistent standard errors. The study explicitly avoided latent-variable modeling and causal inference, focusing instead on identifying empirical patterns of association. Robustness was verified through sensitivity analyses (e.g., exclusion of influential observations, alternative error estimators).

Key Results

Domain Disparity: A pronounced imbalance was observed across domains. Innovation attitudes were comparatively high (Mean = 73.56/100), whereas innovation readiness (Mean = 17.00/100) and innovation practice (Mean = 12.65/100) were substantially lower. IP literacy occupied an intermediate position (Mean = 37.70/100).
Correlation Structure:
- IP literacy (PILS) was positively associated with innovation readiness ( $r = 0.384, p < 0.001$ ) and innovation practice ( $r = 0.205, p < 0.001$ ).
- Innovation attitudes (IAI) showed no statistically significant association with reported innovation practice ( $p = 0.106$ ) and only a weak association with readiness ( $p = 0.070$ ).
- Readiness and practice were significantly correlated ( $r = 0.274, p < 0.001$ ).
Professional Group Differences: Significant differences were found in readiness and practice across professional groups ( $p < 0.001$ ), with academics scoring highest. However, no significant differences were observed for IP literacy or attitudes across groups.
Regression Findings:
- In a baseline model predicting innovation practice, IP literacy and attitudes explained 8.2% of the variance ( $R^2 = 0.082$ ).
- The inclusion of innovation readiness increased the explained variance to 14.0% ( $\Delta R^2 = 0.058, p = 0.028$ ).
- In the readiness-expanded model, innovation readiness remained a significant predictor of practice ( $\beta = 0.19, p = 0.028$ ), while the association between IP literacy and practice became non-significant ( $\beta = 0.12, p = 0.140$ ). Innovation attitudes remained non-significant in all specifications.

Key Contributions

Conceptual Refinement: The study introduces "innovation readiness" as an empirically observable, capability-oriented domain distinct from individual psychological traits. It operationalizes readiness as a proxy for reported enabling conditions (infrastructure, support, exposure) rather than a latent motivational construct.
Empirical Pattern Identification: The research documents a specific "diagnostic gap" in a resource-constrained setting where high attitudinal support does not translate into practice, and where knowledge alone is insufficient to explain behavioral variation without accounting for contextual readiness.
Methodological Transparency: The study adheres to STROBE guidelines and the ChecKAP framework, explicitly reporting internal consistency coefficients for transparency while acknowledging the formative nature of the indices. It provides full reproducibility materials, including code and de-identified data.

Significance and Claims
The paper claims that in resource-constrained pharmaceutical systems, high levels of innovation-related knowledge and positive attitudes do not necessarily correspond to high levels of innovation practice. The findings suggest that innovation readiness captures enabling conditions that are not reflected by knowledge or attitudinal measures alone.

The authors assert that the inclusion of readiness improves the descriptive fit of models predicting innovation practice, indicating that contextual factors may be more closely aligned with reported innovation activity than attitudinal measures. Consequently, the study argues that policy and educational strategies aimed solely at improving knowledge or attitudes may encounter diminishing returns if institutional bottlenecks limit the feasibility of innovation-related activities. The authors suggest that strengthening innovation-oriented education, university–industry engagement, and institutional support structures may be necessary to cultivate innovation competencies and support the translation of research into practical applications in Syria.

The study explicitly cautions that these findings represent descriptive associations from a cross-sectional design and do not establish causality, mediation, or temporal ordering. Future research is required to validate these patterns across different institutional settings and through longitudinal designs.