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Mecaskey J, Verboom B, Liverani M, Mijumbi-Deve R, Jessani NS. Improving institutional platforms for evidence-informed decision-making: getting beyond technical solutions. Health Res Policy Syst 2023; 21:5. [PMID: 36647051 PMCID: PMC9841961 DOI: 10.1186/s12961-022-00948-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/25/2022] [Indexed: 01/18/2023] Open
Abstract
Purely technical interventions aimed at enhancing evidence-informed decision-making (EIDM) have rarely translated into organizational institutionalization or systems change. A panel of four presentations at the Health Systems Global 2020 conference provides a basis for inference about contextual factors that influence the establishment and sustainability of institutional platforms to support EIDM. These cases include local structures such as citizen panels in Uganda, regional knowledge translation structures such as the West African Health Organization, global multilateral initiatives such as the "One Health" Quadrapartite and regional public health networks in South-East Asia. They point to the importance of political economy as well as technical capability determinants of evidence uptake and utilization at institutional, organizational and individual levels. The cases also lend support to evidence that third-party (broker and intermediary) supportive institutions can facilitate EIDM processes. The involvement of third-party supranational organizations, however, poses challenges in terms of legitimacy and accountability.
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Affiliation(s)
| | - Ben Verboom
- grid.4991.50000 0004 1936 8948University of Oxford, Oxford, United Kingdom
| | - Marco Liverani
- grid.8991.90000 0004 0425 469XDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom ,grid.174567.60000 0000 8902 2273School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Rhona Mijumbi-Deve
- The Center for Rapid Evidence Synthesis (ACRES), Kampala, Uganda ,grid.412988.e0000 0001 0109 131XAfrica Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Nasreen S. Jessani
- grid.11956.3a0000 0001 2214 904XCentre for Evidence Based Health Care, Stellenbosch University, Cape Town, South Africa ,grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins University, Baltimore, MD United States of America
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Durrance-Bagale A, Marzouk M, Agarwal S, Ananthakrishnan A, Gan S, Hayashi M, Jacob-Chow B, Jiayun K, Tung LS, Mkhallalati H, Newaz S, Omar M, Sittimart M, Ung M, Yuze Y, Yang HL, Howard N. Operationalising Regional Cooperation for Infectious Disease Control: A Scoping Review of Regional Disease Control Bodies and Networks. Int J Health Policy Manag 2022; 11:2392-2403. [PMID: 35042324 PMCID: PMC9818116 DOI: 10.34172/ijhpm.2021.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 12/25/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The rapid spread of the coronavirus disease 2019 (COVID-19) pandemic demonstrates the value of regional cooperation in infectious disease prevention and control. We explored the literature on regional infectious disease control bodies, to identify lessons, barriers and enablers to inform operationalisation of a regional infectious disease control body or network in southeast Asia. METHODS We conducted a scoping review to examine existing literature on regional infectious disease control bodies and networks, and to identify lessons that can be learned that will be useful for operationalisation of a regional infectious disease control body such as the Association of Southeast Asian Nations (ASEAN) Center for Public Health Emergency and Emerging Diseases. RESULTS Of the 57 articles included, 53 (93%) were in English, with two (3%) in Spanish and one (2%) each in Dutch and French. Most were commentaries or review articles describing programme initiatives. Sixteen (28%) publications focused on organisations in the Asian continent, with 14 (25%) focused on Africa, and 14 (25%) primarily focused on the European region. Key lessons focused on organisational factors, diagnosis and detection, human resources, communication, accreditation, funding, and sustainability. Enablers and constraints were consistent across regions/ organisations. A clear understanding of the regional context, budgets, cultural or language issues, staffing capacity and governmental priorities, is pivotal. An initial workshop inclusive of the various bodies involved in the design, implementation, monitoring or evaluation of programmes is essential. Clear governance structure, with individual responsibilities clear from the beginning, will reduce friction. Secure, long-term funding is also a key aspect of the success of any programme. CONCLUSION Operationalisation of regional infectious disease bodies and networks is complicated, but with extensive groundwork, and focus on organisational factors, diagnosis and detection, human resources, communication, accreditation, funding, and sustainability, it is achievable. Ways to promote success are to include as many stakeholders as possible from the beginning, to ensure that context-specific factors are considered, and to encourage employees through capacity building and mentoring, to ensure they feel valued and reduce staff turnover.
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Affiliation(s)
- Anna Durrance-Bagale
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
- London School of Hygiene and Tropical Medicine, London, UK
| | - Manar Marzouk
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | | | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Sarah Gan
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Michiko Hayashi
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Beth Jacob-Chow
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Koh Jiayun
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Lam Sze Tung
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Hala Mkhallalati
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Sanjida Newaz
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Maryam Omar
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Manit Sittimart
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Mengieng Ung
- Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Singapore, Singapore
| | - Yang Yuze
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Hsu Li Yang
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Natasha Howard
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
- London School of Hygiene and Tropical Medicine, London, UK
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Durrance-Bagale A, Marzouk M, Ananthakrishnan A, Nagashima-Hayashi M, Lam ST, Sittimart M, Howard N. 'Science is only half of it': Expert perspectives on operationalising infectious disease control cooperation in the ASEAN region. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000424. [PMID: 36962233 PMCID: PMC10021729 DOI: 10.1371/journal.pgph.0000424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022]
Abstract
Governmental awareness of the potential spread of infectious disease, exemplified by the current Covid-19 pandemic, ideally results in collective action, as countries coordinate a response that benefits all, contributing expertise, resources, knowledge and experience to achieve a common public good. However, operationalising regional cooperation is difficult, with barriers including lack of political will, regional heterogeneity, and existing geopolitical issues. We interviewed 23 people with regional expertise focusing on Asia, Africa, the Americas and Europe. All interviewees held senior positions in regional bodies or networks or had significant experience working with them. Operationalisation of a regional infectious disease body is complex but areas interviewees highlighted-organisational factors (e.g. integration and harmonisation; cross-border issues; funding, financing and sustainability; capacity-building; data sharing); governance and diplomacy (e.g. building collaborations and partnerships; communication; role of communities; diplomacy; leadership; ownership; sovereignty; political commitment); and stakeholders and multilateral agreements-will help promote successful operationalisation. The international infectious disease community has learned valuable lessons from the Covid-19 pandemic, not least the necessity of pooling human, financial and technological resources, constructing positive working relationships with neighbours, and sharing data. Without this kind of regional cooperation, infectious diseases will continue to threaten our future, and the next pandemic may have even more far-reaching effects.
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Affiliation(s)
- Anna Durrance-Bagale
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Manar Marzouk
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sze Tung Lam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Manit Sittimart
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Natasha Howard
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Liverani M, Teng S, Le MS, Coker R. Sharing public health data and information across borders: lessons from Southeast Asia. Global Health 2018; 14:94. [PMID: 30268139 PMCID: PMC6162912 DOI: 10.1186/s12992-018-0415-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 09/19/2018] [Indexed: 11/16/2022] Open
Abstract
Background The importance of data and information sharing for the prevention and control of infectious diseases has long been recognised. In recent years, public health emergencies such as avian influenza, drug-resistant malaria, and Ebola have brought renewed attention to the need for effective communication channels between health authorities, particularly in regional contexts where neighbouring countries share common health threats. However, little empirical research has been conducted to date to explore the range of factors that may affect the transfer, exchange, and use of public health data and expertise across borders, especially in developing contexts. Methods To explore these issues, 60 interviews were conducted with domestic and international stakeholders in Cambodia and Vietnam, selected amongst those who were involved in regional public health programmes and networks. Data analysis was structured around three categories mapped across the dataset: (1) the nature of shared data and information; (2) the nature of communication channels; and (3) how information flow may be affected by the local, regional, and global system of rules and arrangements. Results There has been a great intensification in the circulation of data, information, and expertise across borders in Southeast Asia. However, findings from this study document ways in which the movement of data and information from production sites to other places can be challenging due to different standards and practices, language barriers, different national structures and rules that govern the circulation of health information inside and outside countries, imbalances in capacities and power, and sustainability of financing arrangements. Conclusions Our study highlights the complex socio-technical nature of data and information sharing, suggesting that best practices require significant involvement of an independent third-party brokering organisation or office, which can redress imbalances between country partners at different levels in the data sharing process, create meaningful communication channels and make the most of shared information and data sets.
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Affiliation(s)
- Marco Liverani
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK. .,Faculty of Public Health, Mahidol University, Bangkok, Thailand.
| | - Srey Teng
- Department of Communicable Disease Control, Ministry of Health, Phnom Penh, Cambodia
| | - Minh Sat Le
- Ministry of Science and Technology, Hanoi, Vietnam
| | - Richard Coker
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.,Faculty of Public Health, Mahidol University, Bangkok, Thailand
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Liverani M, Coker R. Protecting Europe from diseases: from the international sanitary conferences to the ECDC. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2012; 37:915-934. [PMID: 22899842 DOI: 10.1215/03616878-1813772] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In the past few decades there has been increased integration of communicable disease policies in Europe. The historical roots of this process date back to the mid-nineteenth century, when national authorities realized that the cross-boundary spread of diseases cannot be only a matter of national governance but requires common agreements and regulations. In the early 1950s the structuring of the World Health Organization in regional offices further contributed to the definition of Europe as a unit for risk assessments and international health cooperation. More recently the consolidation of the European Union has provided new institutional bases for shaping communicable disease policies at the supranational level. This article reviews these different attempts to protect the European space from diseases. It is argued that changing modes of communicable disease control not only have reflected shifts in public health priorities and institutional contexts but have also been important loci where different understandings of Europe and European political identity emerged and were negotiated. Against this background the article then examines past achievements and future challenges of the current European framework and discusses implications for the wider process of European integration.
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