EVIPNetNews - Issue N 29 - Mar 2012

Cuervo Amore, Dr. Luis Gabriel (WDC)

EVIPNetNews

March 2012 Issue 29 1. Highlight 2. Empirical studies 3. Systematic reviews 4. Relevant publications 5. Events 6. Relevant tools & links

Experiences, methods and tools for research translation to policy

1 - HIGHLIGHTS Independent Expert Review Group (iERG)

News from EVIPNet Members or Activities

The Independent Expert Review Group or iERG of the Commission for Women’s and Children’s Health is calling all stakeholders to submit evidence to inform their first 2012 annual report to be delivered to the UN Secretary‐General in September this year.

EVIPNet and report on Building Regional NCD Research Agenda and Enhancing Implementation of NCD Action Plan (pages 250 to 255)

Deadline for submission – 31 May 2012 2 - EMPIRICAL STUDIES

Next EVIPNet Events Capacity Building Workshop on evidence brief for policy development, Burkina Faso, Bobo Dioulasso from 26 to 28 March 2012 Finding Evidence Capacity Building Workshop, Cameroun, Youndé, from 23 to 27 April 2012

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Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers El‐Jardali, F., Lavis, J., Ataya, N., Jamal, D. (2012). Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers. Implementation Science, 7(2), 16.

New forum HIFA-EVIPNet-Fr was launched at the 12th AHILA Congress in Ouagadougou, Burkina Faso, the 13th October 2010 to address the information needs of policymakers, researchers and others stakeholders in French-speaking Africa, in evidence informed policy making.

Join HIFA-EVIPNet-Fr To join, please email your name, job title, organisation, country of residence, and brief description of professional interests to: hifa-evipnet-fradmin@dgroups.org

This multi‐country study (Bahrain, Egypt, Iran, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, and Yemen) explores researchers’ views and experiences regarding the role of health systems and policy research evidence in health policymaking in the EMR, including the factors that influence health policymaking, barriers and facilitators to the use of evidence, and the factors that increase researchers’ engagement in KTE..

Health Policy and Systems Research in Twelve Eastern Mediterranean Countries: a stocktaking of production and gaps (2000-2008)

El‐Jardali, F., Jamal, D., Ataya, N., Jaafar, M., Saned Raouf, Claudia Matta, Saja Michael and Colette Smith. (2011). Health Policy and Systems Research in Twelve Eastern Mediterranean Countries: a stocktaking of production and gaps (2000‐ 2008) Health Research Policy and Systems.

The objectives of this study are to: (1) profile the production of Health Policy and Systems Research (HPSR) published between 2000 and 2008 in 12 countries in the Eastern Mediterranean Region (EMR): Bahrain, Egypt, Jordan, Lebanon, Libya, Morocco, Oman, Palestine, Sudan, Syria, Tunisia, and Yemen; (2) identify gaps; and (3) assess the extent to which existing HPSR produced in the region addresses regional priorities pertaining to Health Financing, Human Resources for Health and the Role of the Non‐State Sector. This is the first stocktaking paper of HPSR production and gaps in the EMR. Results showed an increase in HPSR production which peaked after 2005. Most identified articles focused on Delivery Arrangements (68.1%), and Implementation Strategies (24.4%). Most HPSR addressed priorities in Human Resources for Health (39%), and some articles focused on Health Financing (12%) and Role of the Non‐ State Sector (6.1%).

Despite global calls for producing and translating HPSR into policy, there are still significant gaps in the EMR. More efforts are needed to produce HPSR and align production and translation with the demand for evidence by policymakers. Findings can help inform and direct future plans and activities for the Evidence Informed Policy Network‐ EMR, World Health Organization‐ EMR, and the Middle East and North Africa Health Policy Forum, in addition to being useful for countries that host or are planning to host KT platforms in the region.

Approaches to developing the capacity of health policy analysis institutes: a comparative case study

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Bennett, S., Corluka, A., Doherty, J.,& Tangcharoensathien, V. (2012). Approaches to developing the capacity of health policy analysis institutes: a comparative case study. Health Research Policy and Systems, 10(7), 19.

Comparative case studies of six health policy analysis institutes (3 from Asia and 3 from Africa) were conducted. In each region an NGO institute, an institute linked to government and a university based institute were included. The findings are organized around four key themes: (i) Financial resources ; (ii) Human resources ; and (iii) Governance and management .

Evidence summaries: the evolution of a rapid review approach Khangura, S., Konnyu, K., Cushman, R., Grimshaw, J., Moher, D.(2012). Evidence summaries: the evolution of a rapid review approach. BioMed Central, 1(10), 22.

Rapid reviews have emerged as a streamlined approach to synthesizing evidence ‐ typically for informing emergent decisions faced by decision makers in health care settings. Although there is growing use of rapid review 'methods', and proliferation of rapid review products, there is a dearth of published literature on rapid review methodology.

This paper outlines [the authors] experience with rapidly producing, publishing and disseminating evidence summaries in the context of our Knowledge to Action (KTA) research program. The Knowledge to Action KTA research program is a two‐year project designed to develop and assess the impact of a regional knowledge infrastructure that supports evidence‐informed decision making by regional managers and stakeholders.

Guidance for Evidence-Informed Policies about Health Systems: Rationale for and Challenges of Guidance Development Bosch‐Capblanch, X., N. Lavis, J., Lewin, S., Atun, R., Røttingen, JR., Droschel, D., Beck, L., Abalos, E., El‐Jardali, F., Gilson, L., Oliver, S., Wyss, K., Tugwell, P., Kulier, R., Pang, T., Haines, A. (2012). Guidance for Evidence‐Informed Policies about Health Systems: Rationale for and Challenges of Guidance Development. Plos Medicine, 9(3), 8.

In the first paper in a three‐part series on health systems guidance, Xavier Bosch‐ Capblanch and colleagues examine how guidance is currently formulated in low‐ and middle‐income countries, and the challenges to developing such guidance.

Weak health systems hinder the implementation of effective interventions; policies to strengthen such systems need to draw on the best available evidence. Health systems evidence is best delivered in the form of guidance embedded in policy formulation processes, but health systems guidance is poorly developed at present.

The translation of research on problems, interventions, and implementation into decisions and policies that affect how systems are organized is one challenge facing the development of health systems guidance. The development of guidance that is 3

timely and usable by the broad range of health systems stakeholders, and of methods to appraise the quality of health systems guidance, are additional challenges. Further research is needed to adapt existing approaches (e.g., those used in clinical guidelines) to produce meaningful advice that accounts for the complexity of health systems, political systems, and contexts.

Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda Nabyonga Orem J., Kaawa Mafigiri D., Marchal B., Ssengooba F., Macq J., Criel B.(2012). Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda. BMC Public Health, 12(1), 9.

Use of evidence in health policymaking plays an important role, especially in resource‐constrained settings where informed decisions on resource allocation are paramount. Several knowledge translation (KT) models have been developed, but few have been applied to health policymaking in low income countries. If KT models are expected to explain evidence uptake and implementation, or lack of it, they must be contextualized and take into account the specificity of low income countries for example, the strong influence of donors. The main objective of this research is to elaborate a Middle Range Theory (MRT) of KT in Uganda that can also serve as a reference for other low‐ and middle income countries. Review of the literature revealed that the most common emerging facilitating factors could be grouped under institutional strengthening for KT, research characteristics, dissemination, partnerships and political context. The analysis of interviews, however, showed that policymakers and researchers ranked institutional strengthening for KT, research characteristics and partnerships as the most important. New factors emphasized by respondents were the use of mainstreamed structures within MoH to coordinate and disseminate research, the separation of roles between researchers and policymakers, and the role of the community and civil society in KT.

Building capacity for evidence informed decision making in public health: a case study of organizational change Peirson, L., Ciliska, D., Dobbins, M ., Mowat, D. (2012). Building capacity for evidence informed decision making in public health: a case study of organizational change. BMC Public Health, 12(137)

This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In‐depth information was gathered from two sets of semi‐structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. The critical factors and dynamics for 4

building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management.

3 - SYSTEMATIC REVIEWS The McMaster Health Forum Health Systems Evidence provides links to graded systematic reviews that may be helpful for evidence‐informed policy‐making.

4 - RELEVANT PUBLICATIONS

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Tackling Cross-Sectoral Challenges to Advance Health as Part of Foreign Policy

Faid, M.(2012). Tackling Cross‐Sectoral Challenges to Advance Health as Part of Foreign Policy. Oslo: Fridtjof Nansen Institute

This report is based on the general assumption that the integration of global health into foreign policy‐making is beneficial for advancing global health goals. This follows the appeal of the Oslo Ministerial Group, which posited in their Oslo Declaration (2007)* that health should be integrated into various sectors of foreign policy. This study explores how health can emerge in global governance areas in which the political importance of health has long been poorly understood. The study examines the lessons learned from other trans‐sectoral issues in inter‐ national affairs. We believe that more knowledge is needed on how health can be integrated into other sectors of global governance as an approach to strengthen the global health and foreign policy relationship.

Political recognition of the need for cross‐sectoral integration of global health is growing, as witnessed by the accumulating global momentum concerning the structural conditions impacting on health. This is reflected in the recent report Global Health and Foreign Policy prepared by the Director General of the WHO to the UN Secretary‐General (A/66/497), which documents the rise in linkages between global health and non‐health sectors.

Getting Started with Health in All Policies: A Resource Pack

Shankardass, K., Solar, O., Murphy, K., Freiler, A., Bobbili, S., Bayoumi, A., Campo, O. (2011). Getting Started with Health in All Policies: A Resource Pack. Ontario: Centre for Research on Inner City Health (CRICH) in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and Ministry of Health and Long‐Term Care

“Health in All Policies” is a new but increasingly recognized term to describe “whole‐of‐government” approaches for reducing population health inequities. A “Health in All Policies” approach makes formal and sustained use of structures, mechanisms, and actions that are managed mainly outside of the health care sector to improve population health and reduce health inequities across social groups.

In 2010 the Ministry launched a broad set of studies and consultations to assess the relevance and feasibility of a government‐wide “Health in All Policies” approach to reducing health inequities. This report contributes to the Ministry’s initiative. It summarizes results of a scoping review of the international literature on equity‐ focused “Health in All Policies” initiatives, conducted by the Centre for Research on Inner City Health. A total of 4833 scholarly articles and 501 sources of grey literature were gathered based on a keyword search. Following screening and sorting, 163 articles were retained, and intersectoral health activities were described in 43 countries. Further screening identified 16 jurisdictions that have implemented a “Health in All Policies” approach, specifically.

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