This article examines the dissemination and uptake of health research into policy and program delivery in four developing countries. In-depth interviews were conducted with health researchers, policymakers, and practitioners at both the local and national level. The study highlights the similarities across the study countries in the barriers to effective dissemination and uptake of research results. A fundamental barrier to the uptake of research by decisionmakers is the lack of appreciation of the important contribution that research can make to policy and program development. A further barrier is researchers' lack of appropriate "packaging" of research findings that consider the needs of different policy audiences. Dissemination within academic circles also restricts access by decisionmakers nd practitioners. Overcoming the barriers requires effort on behalf of researchers, decisionmakers, and donor agencies. The strong presence of donor agencies in developing countries places them in a position both to enable and encourage dissemination activities and communication between researchers and policymakers or practitioners. Increased collaboration between all three parties is one of the key strategies toward increasing the uptake of research into health policy and program development.