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Koricha ZB, Abraha YG, Ababulgu SA, Abraham G, Morankar S. Community engagement in research addressing infectious diseases of poverty in sub-Saharan Africa: A qualitative systematic review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003167. [PMID: 39008476 PMCID: PMC11249264 DOI: 10.1371/journal.pgph.0003167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/05/2024] [Indexed: 07/17/2024]
Abstract
Though engaging communities in research processes has several advantages and implications, research efforts are poorly embedded in and linked with communities, especially in low- and middle-income countries (LMICs). There is also a need for more empirical evidence on effectively engaging communities in research in LMICs, specifically in Sub-Saharan Africa (SSA). Thus, there is an urgent need to synthesize existing evidence on community engagement experiences in research in SSA. Therefore, this review aimed to synthesize the existing community engagement experiences and related barriers to engaging communities in health research focusing on infectious diseases of poverty in SSA. The systematic review was conducted following the JBI methodology for qualitative systematic reviews. The review included both published and unpublished studies. A thematic analysis approach was used for data synthesis. A total of 40 studies were included in the review. Community engagement in the conceptualization of the research project, analysis, dissemination, and interpretation of the result was rare. On top of this, almost all the research projects engaged the community at a lower level of engagement (i.e., informing or consulting the community at some point in the research process), suggesting the importance of integrating communities in the entire research cycle. The lack of shared control over the research by the community was one of the significant challenges mentioned. This review uncovered that community engagement in the research process is minimal. Nevertheless, the review generated valuable evidence that can inform researchers and research stakeholders to promote effective community engagement in the research process addressing infectious diseases of poverty. Despite these, it requires rigorous primary studies to examine the applicability and usefulness of community engagement, including developing valid metrics of engagement, standardizations of reporting community engagements, and views and understandings of communities and stakeholders on the values, expectations, and concepts of community engagement in research.
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Affiliation(s)
- Zewdie Birhanu Koricha
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence-Based Healthcare and Development Centre: a JBI Centre of Excellence, Jimma University, Jimma, Ethiopia
| | - Yosef Gebreyohannes Abraha
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Public Health Institute, Knowledge Translation Directorate, Addis Ababa, Ethiopia
- The Ethiopian Public Health Institute, Ethiopian Knowledge Translation Group for Health: a JBI Affiliated Group, Addis Ababa, Ethiopia
| | - Sabit Ababor Ababulgu
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Public Health Institute, Knowledge Translation Directorate, Addis Ababa, Ethiopia
- The Ethiopian Public Health Institute, Ethiopian Knowledge Translation Group for Health: a JBI Affiliated Group, Addis Ababa, Ethiopia
| | - Gelila Abraham
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence-Based Healthcare and Development Centre: a JBI Centre of Excellence, Jimma University, Jimma, Ethiopia
- Health Policy & Management Department, Jimma Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sudhakar Morankar
- Public Health Faculty, Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
- Ethiopian Evidence-Based Healthcare and Development Centre: a JBI Centre of Excellence, Jimma University, Jimma, Ethiopia
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Morankar S, Abraham G, Shroff Z, Birhanu Z. "Research ends with publication": a qualitative study on the use of health policy and systems research in Ethiopia. Health Res Policy Syst 2024; 22:1. [PMID: 38167041 PMCID: PMC10759454 DOI: 10.1186/s12961-023-01091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Decision-making about the design and implementation of health care policies should be supported by research evidence. This article reports on a qualitative study on the experiences of both research institutes and policymakers in Ethiopia in generating and using research evidence to inform health policy decision-making. METHODS Semi-structured interviews were conducted from January through March 2020, with representatives of research institutes and with policymakers in Ethiopia. The data collected during the interviews were analyzed thematically. RESULTS Half of the institutions represented had engaged in health policy and systems research (HPSR). These institutes' capacities were limited by multiple factors, including unsupportive research environments; the limited number of researchers with extensive experience; high turnover among senior researchers; lack of staff motivation mechanisms; underdeveloped research culture; limited technical and analytical capacity among researchers; lack of core funding for HPSR; ineffective financial management; and, lack of connections with health policy platforms. Research institutes also lacked the capacity in strategic packaging of findings to influence policy decision-making, although some programs have recently improved in this area. Meanwhile, there lacked a culture of using evidence in policymaking settings. In general, we found that policymakers had poor attitudes towards the quality or value of the evidence, and had little capacity to interpret evidence and apply findings to policy options. As a result, much of the research produced by the institutes have only been relevant academically, with little impact on policy. However, respondents reported that the environment is slowly changing, and the recent creation of a Research Advisory Council at the Ministry of Health offers a promising model. CONCLUSIONS Despite some recent changes, in Ethiopia researchers and policymakers alike often tend to consider health policy and systems research (HPSR) to be not very valuable since the findings generated are rarely used for evidence-informed policy development. Research institutes and researchers need to strengthen their technical, analytical, and administrative capacities (through, among other efforts, seeking more funding for research, and better incentives to attract, retain and build skills among qualified researchers); they also need to improve their understanding of the evidence-to-policy cycle and how to engage effectively with policymakers.
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Affiliation(s)
- Sudhakar Morankar
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gelila Abraham
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia
- Health Policy and Management Department, Public Health Faculty, Jimma Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Zubin Shroff
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Zewdie Birhanu
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia.
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia.
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Sales RK, Reyes-Ramos GK, de Veyra C, Gascon G, Barraca V, Garcia G, Yap ME. Advancing health through evidence assisted decisions with health policy and systems research program: a qualitative evaluation of a national health research grant management process in the Philippines. Health Res Policy Syst 2023; 21:73. [PMID: 37443116 DOI: 10.1186/s12961-023-01021-6] [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: 01/02/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Health policy and systems research (HPSR) has influenced Philippine policies, including tobacco control, mental health, and COVID-19. The Department of Health (DOH) Philippines and Philippine Council for Health Research and Development (PCHRD) launched the Advancing Health through Evidence-Assisted Decisions (AHEAD) with HPSR program in 2017, aiming to build a community of researchers and decision-makers committed to evidence production and utilization. Research systems employ grant management processes for transparency and accountability in research funding, preventing waste, fraud, and misuse of funds. METHODS This study evaluated AHEAD-HPSR's grant management using surveys, interviews, and focus groups to document (1) grant administration processes implemented by DOH and PCHRD, and (2) experiences of grantees, program managers, staff, and policymakers. Data were initially analyzed through the USA Grant Accountability Office's Federal Grant Life Cycle, with new themes created as they emerged. The study identified processes and gaps in the research grant life cycle stages: design/redesign, pre-award, award, implementation, closeout, and research dissemination and utilization. RESULTS Identification of research areas for the grant are identified using national and departmental research priorities. While Calls for Proposals are posted publicly, researchers that have previously worked with policymakers are contacted directly to submit proposals. The evaluation found that research is delayed by bureaucracies in grant administration, particularly in financial reporting and ethics review processes. Complying with the terminal financial report was identified as the most challenging part of the grant process due to immense auditing requirements. Grantees recommend the simplification of bureaucracy for fund release to enable them to focus on research work. CONCLUSION This study contributes to the limited literature on health research grant management in developing countries. Valuable information and recommendations were contributed by stakeholders in this evaluation. These are manifestations of a continuing interest and desire to make health policy and systems research in the Philippines more robust and relevant. It is imperative for the program to continually evolve and build systems most applicable to its multidisciplinary context.
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Affiliation(s)
- Reneepearl Kim Sales
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines.
| | - Gladys Kaye Reyes-Ramos
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines
| | - Chiqui de Veyra
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines
| | - Gabrielle Gascon
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines
| | - Vianka Barraca
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines
| | - Gillian Garcia
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines
| | - Maria Eufemia Yap
- Alliance for Improving Health Outcomes, Veria 1 Building, 62 West Avenue, West Triangle, 1104, Quezon City, Philippines
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Canick J, Petrucci B, Patterson R, Saunders J, Htoo Thaw M, Omosule I, Denton A, Xu MJ, Chadha S, Young G, Siafa L, Mortel O, Shamshad A, Reddy A, McCalla M, Prasad K, Yang HH, Pan DR, Shah J, Smith E, Alkire B, Ibekwe T, Waterworth C. An analysis of the inclusion of ear and hearing care in national health policies, strategies and plans. Health Policy Plan 2023; 38:719-725. [PMID: 37130061 PMCID: PMC10274565 DOI: 10.1093/heapol/czad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 03/27/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023] Open
Abstract
Ear- and hearing-related conditions pose a significant global health burden, yet public health policy surrounding ear and hearing care (EHC) in low- and middle-income countries is poorly understood. The present study aims to characterize the inclusion of EHC in national health policy by analysing national health policies, strategies and plans in English, French, Spanish, Portuguese and Arabic. Three EHC keywords were searched, including ear*, hear* and deaf*. The terms 'human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)', 'tuberculosis' and 'malaria' were included as comparison keywords as these conditions have historically garnered political priority in global health. Of the 194 World Health Organization Member States, there were 100 national policies that met the inclusion criteria of document availability, searchable format, language and absence of an associated national EHC strategy. These documents mentioned EHC keywords significantly less than comparison terms, with mention of hearing in 15 documents, ears in 11 documents and deafness in 3 documents. There was a mention of HIV/AIDS in 92 documents, tuberculosis in 88 documents and malaria in 70 documents. Documents in low- and middle-income countries included significantly fewer mentions of EHC terms than those of high-income countries. We conclude that ear and hearing conditions pose a significant burden of disease but are severely underrepresented in national health policy, especially in low- and middle-income countries.
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Affiliation(s)
- Julia Canick
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | | | - Rolvix Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - James Saunders
- Division of Otolaryngology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03766 , USA
| | | | - Ikeoluwa Omosule
- Department of Otorhinolaryngology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Alexa Denton
- Department of Otolaryngology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Mary Jue Xu
- Department of Otolaryngology—Head and Neck Surgery, UCSF, San Francisco , CA 94143, USA
| | - Shelly Chadha
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Gabrielle Young
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Lyna Siafa
- Faculty of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
| | - Olivier Mortel
- Hôpital de l'Université d'état d'Haïti, Port-au-Prince, Haiti
| | - Alizeh Shamshad
- Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Ashwin Reddy
- Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Monet McCalla
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH 45701, USA
| | - Kavita Prasad
- Tufts University School of Medicine, Boston, MA 02111, USA
| | | | - Debbie R Pan
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Jaffer Shah
- Weill Cornell Medicine, New York, NY 10021, USA
| | - Emily Smith
- Duke Global Health Institute, Durham, NC 27710, USA
- Department of Surgery, Duke University, Durham, NC 27710, USA
| | - Blake Alkire
- Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - Titus Ibekwe
- Department of Otorhinolaryngology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Chris Waterworth
- Disability Inclusion for Health and Development, Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
- Audiology and Speech Pathology, University of Melbourne Faculty of Medicine, Dentistry, & Health Sciences, Carlton, VIC, Australia
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Uneke CJ, Okedo-Alex IN, Akamike IC, Uneke BI, Eze II, Chukwu OE, Otubo KI, Urochukwu HC. Institutional roles, structures, funding and research partnerships towards evidence-informed policy-making: a multisector survey among policy-makers in Nigeria. Health Res Policy Syst 2023; 21:36. [PMID: 37237324 DOI: 10.1186/s12961-023-00971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/27/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Evidence-informed policy-making aims to ensure that the best and most relevant evidence is systematically generated and used for policy-making. The aim of this study was to assess institutional structures, funding, policy-maker perspectives on researcher-policy-maker interactions and the use of research evidence in policy-making in five states in Nigeria. METHODS This was a cross-sectional study carried out among 209 participants from two geopolitical zones in Nigeria. Study participants included programme officers/secretaries, managers/department/facility heads and state coordinators/directors/presidents/chairpersons in various ministries and the National Assembly. A pretested semi-structured self-administered questionnaire on a five-point Likert scale was used to collect information on institutional structures for policy and policy-making in participants' organizations, the use of research evidence in policy and policy-making processes, and the status of funding for policy-relevant research in the participants' organizations. Data were analysed using IBM SPSS version 20 software. RESULTS The majority of the respondents were older than 45 years (73.2%), were male (63.2) and had spent 5 years or less (74.6%) in their present position. The majority of the respondents' organizations had a policy in place on research involving all key stakeholders (63.6%), integration of stakeholders' views within the policy on research (58.9%) and a forum to coordinate the setting of research priorities (61.2%). A high mean score of 3.26 was found for the use of routine data generated from within the participants' organizations. Funding for policy-relevant research was captured in the budget (mean = 3.47) but was inadequate (mean = 2.53) and mostly donor-driven (mean = 3.64). Funding approval and release/access processes were also reported to be cumbersome, with mean scores of 3.74 and 3.89, respectively. The results showed that capacity existed among career policy-makers and the Department of Planning, Research and Statistics to advocate for internal funds (mean = 3.55) and to attract external funds such as grants (3.76) for policy-relevant research. Interaction as part of the priority-setting process (mean = 3.01) was the most highly rated form of policy-maker-researcher interaction, while long-term partnerships with researchers (mean = 2.61) had the lower mean score. The agreement that involving policy-makers in the planning and execution of programmes could enhance the evidence-to-policy process had the highest score (mean = 4.40). CONCLUSION The study revealed that although institutional structures such as institutional policies, fora and stakeholder engagement existed in the organizations studied, there was suboptimal use of evidence obtained from research initiated by both internal and external researchers. Organizations surveyed had budget lines for research, but this funding was depicted as inadequate. There was suboptimal actual participation of policy-makers in the co-creation, production and dissemination of evidence. The implementation of contextually relevant and sustained mutual institutional policy-maker-researcher engagement approaches is needed to promote evidence-informed policy-making. Thus there is a need for institutional prioritization and commitment to research evidence generation.
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Affiliation(s)
- Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria.
| | - Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Bilikis Iyabo Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Irene Ifeyinwa Eze
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Onyekachi Echefu Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Kingsley Igboji Otubo
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Henry C Urochukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
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Sirili N, Mloka D, Mselle L, Kisenge R, Mbugi E, Russa D, Nyongole O, Mshana SE, Laisser R, Mteta K, Msuya L, Lyamuya E, Martin-Holland J, Kwesigabo G, Kaaya E. Opportunities and Challenges for Implementation of Harmonized Competence-Based Curricula in Medicine and Nursing Programmes in Tanzania: Experiences of Biomedical Sciences' Stakeholders. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:487-498. [PMID: 37251430 PMCID: PMC10218457 DOI: 10.2147/amep.s381242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 04/20/2023] [Indexed: 05/31/2023]
Abstract
Background In 2012, the Muhimbili University of Health and Allied Sciences (MUHAS) embarked on structured competency-based curricula (CBC) for its programmes. Other health profession training institutions continued with their traditional way of teaching and thus causing variability in the competencies of the graduates. We aimed to analyze the experiences of different stakeholders on the implementation of CBC specifically on biomedical sciences by MUHAS to inform the development of harmonized competency-based curricula in three health professional training institutions in Tanzania. Methods We adopted an exploratory case study to analyse the implementation of CBC in programmes of Medicine and Nursing involving MUHAS graduates, immediate supervisors at the employment sites, faculty, and continuing students at MUHAS. Kiswahili guides were used to conduct the in-depth interviews (IDIs) and focus group discussions (FGDs). Qualitative content analysis was adopted for analysis. Results From the 38 IDIs and 15 FGDs, four categories of human resources teaching and learning environment; curriculum content; and support systems emerged. Human resources were attributed to the shortage of an adequate number of faculty and teaching skills variation. The curriculum content category was linked to the redundancy of courses or topics, poor sequencing of some topics or courses, and limited time for teaching some essential courses or topics. Training and practice area mismatch, accommodation to students, teaching space, and library were the sub-categories linked to teaching and learning environment. Lastly, support systems related to teaching methods and opportunities for improving teaching and learning were revealed. Conclusion The findings of this study highlight the challenges and opportunities for the implementation of CBC. The solutions to the revealed challenges are beyond the training institutions' capacity. The latter call for multi-stakeholder engagement including those from the public and private sectors in health, higher education and finance for common and sustainable solutions.
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Affiliation(s)
- Nathanael Sirili
- Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Doreen Mloka
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lilian Mselle
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Rodrick Kisenge
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Erasto Mbugi
- Department of Biochemistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Dennis Russa
- Department of Anatomy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Obadia Nyongole
- Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Rose Laisser
- Archbishop Anthony Mayalla School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Kien Mteta
- Department of Surgery, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Levina Msuya
- Department of Paediatrics and Child Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Eligius Lyamuya
- Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Judith Martin-Holland
- Department of Physiological Nursing, University of San Francisco California, San Francisco, CA, USA
| | - Gideon Kwesigabo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Ephata Kaaya
- Department of Pathology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Kentikelenis A, Ghaffar A, McKee M, Dal Zennaro L, Stuckler D. Global financing for health policy and systems research: a review of funding opportunities. Health Policy Plan 2023; 38:409-416. [PMID: 36546732 PMCID: PMC10019567 DOI: 10.1093/heapol/czac109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/21/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Health policy and systems research (HPSR) is a neglected area in global health financing. Despite repeated calls for greater investment, it seems that there has been little growth. We analysed trends in reported funding and activity between 2015 and 2021 using a novel real-time source of global health data, the Devex.com database, the world's largest source of funding opportunities related to international development. We performed a systematic search of the Devex.com database for HPSR-related terms with a focus on low- and middle-income countries. We included 'programs', 'tenders & grants' and 'contract awards', covering all call statuses (open, closed or forecast). Such funding opportunities were included if they were related specifically to HPSR funding or had an HPSR component; pure biomedical funding was excluded. Our findings reveal a relative neglect of HPSR, as only ∼2% of all global health funding calls included a discernible HPSR component. Despite increases in funding calls until 2019, this situation reversed in 2020, likely reflecting the redirection of resources to rapid assessments of the impacts of the coronavirus disease 2019 (COVID-19) pandemic. Most identified projects represented small-scale opportunities-commonly for consultancies or technical assistance. To the extent that new data were generated, these projects were either tied to a specific large intervention or were narrow in scope to meet a specific challenge-with many examples informing policy responses to the Covid-19 pandemic. Nearly half of advertised funding opportunities were multi-country projects, usually addressing global policy priorities like health systems strengthening or development of coordinated public health policies at a regional level. The Covid-19 pandemic has shown why investing in HPSR is more important than ever to enable the delivery of effective health interventions and avoid costly implementation failures. The evidence presented here highlights the need to scale up efforts to convince global health funders to institutionalize the inclusion of HPSR components in all funding calls.
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Affiliation(s)
- Alexander Kentikelenis
- Department of Social and Political Sciences, Bocconi University, via Roentgen 1, Milan 20136, Italy
| | | | - Martin McKee
- *Corresponding author. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK. E-mail:
| | - Livia Dal Zennaro
- Alliance for Health Policy and Systems Research, World Health Organization, 20 Avenue Appia, Geneva 1211, Switzerland
| | - David Stuckler
- Department of Social and Political Sciences, Bocconi University, via Roentgen 1, Milan 20136, Italy
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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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Eboreime E, Ogwa O, Nnabude R, Aluka-Omitiran K, Banke-Thomas A, Orji N, Eluwa A, Ezeokoli A, Rotimi A, Eze LU, Offiong V, Odu U, Okonkwo R, Umeh C, Ilika F, Oreh A, Adams FN, Okpani IA, Ogundeji Y, Mbachu C, Obi FA, Badejo O. Engaging stakeholders to identify gaps and develop strategies to inform evidence use for health policymaking in Nigeria. Pan Afr Med J 2022; 43:140. [PMID: 36762150 PMCID: PMC9898774 DOI: 10.11604/pamj.2022.43.140.36754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction recent efforts to bridge the evidence-policy gap in low-and middle-income countries have seen growing interest from key audiences such as government, civil society, international organizations, private sector players, academia, and media. One of such engagement was a two-day virtual participant-driven conference (the convening) in Nigeria. The aim of the convening was to develop strategies for improving evidence use in health policy. The convening witnessed a participant blend of health policymakers, researchers, political policymakers, philanthropists, global health practitioners, program officers, students, and the media. Methods in this study, we analyzed conversations at the convening with the aim to disseminate findings to key stakeholders in Nigeria. The recordings from the convening were transcribed and analyzed inductively to identify emerging themes, which were interpreted, and inferences are drawn. Results a total of 630 people attended the convening. Participants joined from 13 countries. Participants identified poor collaboration between researchers and policymakers, poor community involvement in research and policy processes, poor funding for research, and inequalities as key factors inhibiting the use of evidence for policymaking in Nigeria. Strategies proposed to address these challenges include the use of participatory and embedded research methods, leveraging existing systems and networks, advocating for improved funding and ownership for research, and the use of context-sensitive knowledge translation strategies. Conclusion overall, better interaction among the various stakeholders will improve the evidence generation, translation, and use in Nigeria. A road map for the dissemination of findings from this conference has been developed for implementation across the strata of the health system.
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Affiliation(s)
- Ejemai Eboreime
- Talk Health Real Media Limited, Abuja, Nigeria,,Corresponding author: Ejemai Eboreime, Department of Psychiatry, University of Alberta, Edmonton, Canada.
| | - Oluwafunmike Ogwa
- Systems Development Initiative, Abuja, Nigeria,,Doctorkk Health International, Lagos, Nigeria
| | - Rosemary Nnabude
- Systems Development Initiative, Abuja, Nigeria,,School of Public Health, University of Alberta, Edmonton, Canada
| | - Kasarachi Aluka-Omitiran
- Systems Development Initiative, Abuja, Nigeria,,Department of Community Health Services, National Primary Health Care Development Agency, Abuja, Nigeria
| | - Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, United Kingdom,,London School of Economics and Political Science, London, United Kingdom
| | - Nneka Orji
- Systems Development Initiative, Abuja, Nigeria,,Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Achama Eluwa
- Systems Development Initiative, Abuja, Nigeria,,Health, Nutrition and Population Global Practice Unit, The World Bank, Washington DC, United States of America
| | - Adaobi Ezeokoli
- Systems Development Initiative, Abuja, Nigeria,,Harvard Kennedy School, Harvard University, Cambridge, Massachusetts, United States
| | - Aanu Rotimi
- Systems Development Initiative, Abuja, Nigeria,,Centre for Accountability and Inclusive Development, Abuja, Nigeria
| | - Laz Ude Eze
- Systems Development Initiative, Abuja, Nigeria,,Talk Health Real Media Limited, Abuja, Nigeria
| | - Vanessa Offiong
- Systems Development Initiative, Abuja, Nigeria,,As Equals, CNN International, Abuja, Nigeria
| | - Ugochi Odu
- Systems Development Initiative, Abuja, Nigeria,,Healthreach limited, Abuja, Nigeria
| | - Rita Okonkwo
- Systems Development Initiative, Abuja, Nigeria,,Institute of Human Virology Nigeria, International Research Center of Excellence, Abuja, Nigeria
| | - Chukwunonso Umeh
- Systems Development Initiative, Abuja, Nigeria,,African Youth Initiative on Population Health and Development (AfrYPoD), Abuja, Nigeria
| | - Frances Ilika
- Palladium, Health Policy Plus Project, Abuja, Nigeria
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Transfusion Service, Abuja, Nigeria
| | | | - Ikedichi Arnold Okpani
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Yewande Ogundeji
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Chinyere Mbachu
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Felix Abrahams Obi
- Systems Development Initiative, Abuja, Nigeria,,Results for Development (R4D), Nigeria Country Office, Abuja, Nigeria
| | - Okikiolu Badejo
- Systems Development Initiative, Abuja, Nigeria,,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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10
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Doshmangir L, Mostafavi H, Behzadifar M, Yazdizadeh B, Sajadi HS, Hasanpoor E, Mahdavi M, Majdzadeh R. Individual and institutional capacity-building for evidence-informed health policy-making in Iran: a mix of local and global evidence. Health Res Policy Syst 2022; 20:18. [PMID: 35151312 PMCID: PMC8841080 DOI: 10.1186/s12961-022-00816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Providing valid evidence to policy-makers is a key factor in the development of evidence-informed policy-making (EIPM). This study aims to review interventions used to promote researchers’ and knowledge-producing organizations’ knowledge and skills in the production and translation of evidence to policy-making and explore the interventions at the individual and institutional level in the Iranian health system to strengthen EIPM.
Methods
The study was conducted in two main phases: a systematic review and a qualitative study. First, to conduct the systematic review, the PubMed and Scopus databases were searched. Quality appraisal was done using the Joanna Briggs Institute checklists. Second, semi-structured interviews and document review were used to collect local data. Purposive sampling was used and continued until data saturation. A qualitative content analysis approach was used for data analysis.
Results
From a total of 11,514 retrieved articles, 18 papers were eligible for the analysis. Based on the global evidence, face-to-face training workshops for researchers was the most widely used intervention for strengthening researchers’ capacity regarding EIPM. Target audiences in almost all of the training programmes were researchers. Setting up joint training sessions that helped empower researchers in understanding the needs of health policy-makers had a considerable effect on strengthening EIPM. Based on the local collected evidence, the main interventions for individual and institutional capacity-building were educational and training programmes or courses related to the health system, policy-making and policy analysis, and research cycle management. To implement the individual and institutional interventions, health system planners and authorities and the community were found to have a key role as facilitating factors.
Conclusion
The use of evidence-based interventions for strengthening research centres, such as training health researchers on knowledge translation and tackling institutional barriers that can prevent well-trained researchers from translating their knowledge, as well as the use of mechanisms and networks for effective interactions among policy-makers at the macro and meso (organizational) level and the research centre, will be constructive for individual and institutional capacity-building. The health system needs to strengthen its strategic capacity to facilitate an educational and training culture in order to motivate researchers in producing appropriate evidence for policy-makers.
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11
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Macaulay B, Reinap M, Wilson MG, Kuchenmüller T. Integrating citizen engagement into evidence-informed health policy-making in eastern Europe and central Asia: scoping study and future research priorities. Health Res Policy Syst 2022; 20:11. [PMID: 35042516 PMCID: PMC8764649 DOI: 10.1186/s12961-021-00808-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/16/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The perspectives of citizens are an important and often overlooked source of evidence for informing health policy. Despite growing encouragement for its adoption, little is known regarding how citizen engagement may be integrated into evidence-informed health policy-making in low- and middle-income counties (LMICs) and newly democratic states (NDSs). We aimed to identify the factors and variables affecting the potential integration of citizen engagement into evidence-informed health policy-making in LMICs and NDSs and understand whether its implementation may require a different approach outside of high-income western democracies. Further, we assessed the context-specific considerations for the practical implementation of citizen engagement in one focus region-eastern Europe and central Asia. METHODS First, adopting a scoping review methodology, we conducted and updated searches of six electronic databases, as well as a comprehensive grey literature search, on citizen engagement in LMICs and NDSs, published before December 2019. We extracted insights about the approaches to citizen engagement, as well as implementation considerations (facilitators and barriers) and additional political factors, in developing an analysis framework. Second, we undertook exploratory methods to identify relevant literature on the socio-political environment of the focus region, before subjecting these sources to the same analysis framework. RESULTS Our searches identified 479 unique sources, of which 28 were adjudged to be relevant. The effective integration of citizen engagement within policy-making processes in LMICs and NDSs was found to be predominantly dependent upon the willingness and capacity of citizens and policy-makers. In the focus region, the implementation of citizen engagement within evidence-informed health policy-making is constrained by a lack of mutual trust between citizens and policy-makers. This is exacerbated by inadequate incentives and capacity for either side to engage. CONCLUSIONS This research found no reason why citizen engagement could not adopt the same form in LMICs and NDSs as it does in high-income western democracies. However, it is recognized that certain political contexts may require additional support in developing and implementing citizen engagement, such as through trialling mechanisms at subnational scales. While specifically outlining the potential for citizen engagement, this study highlights the need for further research on its practical implementation.
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Affiliation(s)
- Bobby Macaulay
- World Health Organization Regional Office for Europe, Copenhagen, Denmark.
| | - Marge Reinap
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Michael G Wilson
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Tanja Kuchenmüller
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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12
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Doshmangir L, Yazdizadeh B, Sajadi HS, Mohtasham F, Majdzadeh R. What is going on in the future for evidence-informed health policymaking in Iran? J Evid Based Med 2021; 14:285-290. [PMID: 34904390 DOI: 10.1111/jebm.12458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/08/2021] [Accepted: 09/22/2021] [Indexed: 01/11/2023]
Affiliation(s)
- Leila Doshmangir
- Department of Health Policy & Management, Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, School of Management & Medical Informatics, and Social Determinants of Health Services Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Haniye Sadat Sajadi
- Knowledge Utilization Research Center, University Research & Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Mohtasham
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community-Based Participatory Research Center, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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Igiri BE, Okoduwa SIR, Akabuogu EP, Okoduwa UJ, Enang IA, Idowu OO, Abdullahi S, Onukak IE, Onuruka CC, Christopher OPO, Salawu AO, Chris AO, Onyemachi DI. Focused Research on the Challenges and Productivity of Researchers in Nigerian Academic Institutions Without Funding. Front Res Metr Anal 2021; 6:727228. [PMID: 34805734 PMCID: PMC8596491 DOI: 10.3389/frma.2021.727228] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The challenge of research funding constraints has brought to bear enormous pressure on researchers. Research productivity is relevant to prestige and career progression of academic staff. However, this study aimed to explore significant challenges associated with researchers' productivity and the impact of non-funding of research in Nigerian research and tertiary institutions. Methods: This study adopted a qualitative exploratory design involving academics at various research and tertiary institutions across the six geographical regions in Nigeria. A semi-structured questionnaire was distributed electronically to all participants who consented to take part in this study. Exactly 4,159 questionnaires were administered and 2,350 were completely filled and returned. Pearson correlation matrices with logistic regression were used for data analysis and are presented in frequencies and percentages. Results: On challenges faced by respondents, 42.98% reported a lack of research funding, 17.11% mentioned brain drain challenge while 8.85% indicated a lack of motivation. Of the 23,927 publications reported, the number of those in sciences, engineering, and medical sciences averaged 9.6, 11.5, and 9.5 respectively. The average number of publications by women (10.8) was more than by men (9.7). Lecturers had the highest average research publication number (11.8) followed by researchers (10.2) and others (3.9). Men had the highest (11.9) average number of conferences compared to women (9.2). Participants in engineering had an average number of 13.8 conferences per respondents followed by those in education (11.2), sciences (11.1), and 10.9 for those in agricultural sciences. The result revealed a negative significant correlation between research publication and academic qualification at p < 0.01. Positive significant correlation was observed between research productivity and discipline at p < 0.05. Findings show that the combined influence of the independent variables on research productivity was significant using linear regression analysis. Conclusions: The failure to prioritize research has resulted in underdevelopment in Nigeria. It is therefore imperative that the federal government prioritize research and establish a functional Special Research Trust Fund to oversee research funding in Nigeria.
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Affiliation(s)
- Bernard E Igiri
- Directorate of Research and Development, Nigerian Institute of Leather and Science Technology (NILEST), Zaria, Nigeria
| | - Stanley I R Okoduwa
- Directorate of Research and Development, Nigerian Institute of Leather and Science Technology (NILEST), Zaria, Nigeria.,Department of Biochemistry, Babcock University, Ilishan-Remo, Nigeria
| | - Ebere P Akabuogu
- Directorate of Research and Development, Nigerian Institute of Leather and Science Technology (NILEST), Zaria, Nigeria
| | - Ugochi J Okoduwa
- Industrial and Environmental Pollution Department, National Research Institute for Chemical Technology, (NARICT), Zaria, Nigeria
| | - Idongesit A Enang
- Industrial and Environmental Pollution Department, National Research Institute for Chemical Technology, (NARICT), Zaria, Nigeria
| | | | - Suleiman Abdullahi
- Directorate of Research and Development, Nigerian Institute of Leather and Science Technology (NILEST), Zaria, Nigeria
| | - Imeh E Onukak
- North Central Regional Extension Centre, NILEST, Utako-Abuja, Nigeria
| | | | | | | | - Aimee O Chris
- Directorate of Research and Development, Nigerian Institute of Leather and Science Technology (NILEST), Zaria, Nigeria
| | - David I Onyemachi
- Directorate of Research and Development, Nigerian Institute of Leather and Science Technology (NILEST), Zaria, Nigeria
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14
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Ezenwaka U, Onwujekwe O. Getting Evidence From Health Policy and Systems Research Into Policy and Practice for Controlling Endemic Tropical Diseases in Nigeria: Assessing Knowledge, Capacity, and Use. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.735990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundGetting evidence from Health Policy and Systems Research (HPSR) into policy and practice for effective control of neglected tropical diseases (NTDs) is essential for providing better service delivery because evidence-informed decision-making improves the effectiveness of a health system and health outcomes. The paper provides new knowledge on the policy-/decision-makers’ level of knowledge, capacity to use, and how evidence from HPSR has been used in decision-making for the control of endemic tropical diseases (ETDs), especially the NTDs and malaria in Nigeria.MethodsA cross-sectional qualitative study of decision-makers was undertaken in Anambra and Enugu states, southeast Nigeria. Data was collected through in-depth interviews (n=22) of purposively selected decision-makers to assess how HPSR evidence is translated into policy and practice for controlling ETDs. The respondents were selected based on their job description, roles, and involvement in the control of ETDs. Data were analyzed using the thematic content approach.ResultsThere is a considerable level of knowledge on HPSR and its relationship with evidence-informed policy- and decision-making towards control of ETDs and health system strengthening. Organizational capacity to use HPSR evidence in decision-making was found to be weak due to various reasons such as no embedded structure for translating research evidence to policy and practice, lack of decision-making autonomy by individuals, and politically driven decisions. Few respondents have either ever used or are currently using HPRS evidence for developing/reviewing and implementing strategies for ETDs programs. Majority of the respondents reported that their main source of evidence was routine data from health information management system, which they found useful due to its representativeness and completeness. Main enabler for using HPSR evidence for decision-making is existing collaborations between researchers and policy-/decision-makers.ConclusionThere is a high level of awareness about evidence from HPSR and the usefulness of such evidence in decision-making. However, this awareness does not translate to optimal use of evidence for decision-making due to weak organizational capacity and other constraints. There is the need to invest in capacity-building activities to develop a critical mass of users of evidence (policy-/decision-makers) to facilitate enhanced uptake of high-quality evidence into policy decisions for better control of ETDs.
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15
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Ghaffar A, Gupta A, Kampo A, Swaminathan S. The value and promise of embedded research. Health Res Policy Syst 2021; 19:99. [PMID: 34380500 PMCID: PMC8356373 DOI: 10.1186/s12961-021-00744-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Abdul Ghaffar
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
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16
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Sajadi HS, Majdzadeh R, Ehsani-Chimeh E, Yazdizadeh B, Nikooee S, Pourabbasi A, Lavis J. Policy options to increase motivation for improving evidence-informed health policy-making in Iran. Health Res Policy Syst 2021; 19:91. [PMID: 34098971 PMCID: PMC8186173 DOI: 10.1186/s12961-021-00737-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 05/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Current incentive programmes are not sufficient to motivate researchers and policy-makers to use research evidence in policy-making. We conducted a mixed-methods design to identify context-based policy options for strengthening motivations among health researchers and policy-makers to support evidence-informed health policy-making (EIHP) in Iran. METHODS This study was conducted in 2019 in two phases. In the first phase, we conducted a scoping review to extract interventions implemented or proposed to strengthen motivations to support EIHP. Additionally, we employed a comparative case study design for reviewing the performance evaluation (PE) processes in Iran and other selected countries to determine the current individual and organizational incentives to encourage EIHP. In the second phase, we developed two policy briefs and then convened two policy dialogues, with 12 and 8 key informants, respectively, where the briefs were discussed. Data were analysed using manifest content analysis in order to propose contextualized policy options. RESULTS The policy options identified to motivate health researchers and policy-makers to support EIHP in Iran were: revising the criteria of academic PE; designing appropriate incentive programmes for nonacademic researchers; developing an indicator for the evaluation of research impact on policy-making or health outcomes; revising the current policies of scientific journals; revising existing funding mechanisms; presenting the knowledge translation plan when submitting a research proposal, as a mandatory condition; encouraging and supporting mechanisms for increasing interactions between policy-makers and researchers; and revising some administrative processes (e.g. managers and staff PEs; selection, appointment, and changing managers and reward mechanisms). CONCLUSIONS The current individual or organizational incentives are mainly focused on publications, rather than encouraging researchers and policy-makers to support EIHP. Relying more on incentives that consider the other impacts of research (e.g. impacts on health system and policy, or health outcomes) is recommended. These incentives may encourage individuals and organizations to be more involved in conducting research evidence, resulting in promoting EIHP. TRIAL REGISTRATION NA.
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Affiliation(s)
- Haniye Sadat Sajadi
- Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community-Based Participatory-Research Center, Knowledge Utilization Research Center, and School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ehsani-Chimeh
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Nikooee
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Pourabbasi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - John Lavis
- McMaster Health Forum and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
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17
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Okedo-Alex IN, Akamike IC, Olisaekee GO, Okeke CC, Uneke CJ. Identifying advocacy strategies, challenges and opportunities for increasing domestic health policy and health systems research funding in Nigeria: Perspectives of researchers and policymakers. Health Res Policy Syst 2021; 19:41. [PMID: 33752682 PMCID: PMC7983353 DOI: 10.1186/s12961-021-00701-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Poor funding for Health Policy and Systems Research (HPSR) is a major constraint to the development, generation and uptake of HPSR evidence in Low and Middle-Income countries. The study assessed the status of HPSR domestic funding and advocacy strategies for improving HPSR funding in Nigeria. It equally explored the knowledge and perception of the domestic funding status of HPSR and the effect of capacity building on the knowledge of domestic funding for HPSR in Nigeria. Methods This was a sub-national study involving policymakers and researchers from Enugu and Ebonyi States in Southeast Nigeria who participated in the sub-national Health Systems Global convening for the African region. A before-after study design (workshop) was utilized. Data collection employed semi-structured questionnaires, group and panel discussions. The workshop facilitated knowledge of HPSR, funding processes, and advocacy strategies for increased domestic funding for HPSR. Pre and immediate post-workshop knowledge assessments were done. Data were analyzed using SPSS version 25 and thematic analysis. Results Twenty-six participants were involved in the study. Half were females (50.0%) and 46.2% were aged 35–44 years. Policymakers constituted 23.1% of the participants. Domestic funding for HPSR in Nigeria was adjudged to be grossly inadequate. Identified barriers to domestic funding of HPSR included bureaucratic bottlenecks, political and policy transitions, and corruption. Potential opportunities centered on existing policy documents and emerging private sector willingness to fund health research. Multi-stakeholder advocacy coalitions, continuous advocacy and researcher skill-building on advocacy with active private sector involvement were the strategies proffered by the participants. Pre-workshop, understanding of the meaning of HPSR had the highest mean ratings while knowledge of budgeting processes and use of legal action to enable opportunities for budget advocacy for HPSR funding had the lowest mean ratings. Following the capacity-building workshop, all knowledge and understanding parameters markedly improved (percentage increase of 12.5%–71.0%). Conclusion This study found that there was paucity of domestic funding for HPSR in Nigeria alongside poor knowledge of budgeting and advocacy strategies among both policymakers and researchers. We recommend the deployment of these identified strategies and wider national and regional stakeholder engagement towards prioritizing and improving domestic funding for HPSR.
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Affiliation(s)
- Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria. .,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | | | | | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
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18
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Erismann S, Pesantes MA, Beran D, Leuenberger A, Farnham A, Berger Gonzalez de White M, Labhardt ND, Tediosi F, Akweongo P, Kuwawenaruwa A, Zinsstag J, Brugger F, Somerville C, Wyss K, Prytherch H. How to bring research evidence into policy? Synthesizing strategies of five research projects in low-and middle-income countries. Health Res Policy Syst 2021; 19:29. [PMID: 33676518 PMCID: PMC7936421 DOI: 10.1186/s12961-020-00646-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/15/2020] [Indexed: 01/25/2023] Open
Abstract
Background Addressing the uptake of research findings into policy-making is increasingly important for researchers who ultimately seek to contribute to improved health outcomes. The aims of the Swiss Programme for Research on Global Issues for Development (r4d Programme) initiated by the Swiss National Science Foundation and the Swiss Agency for Development and Cooperation are to create and disseminate knowledge that supports policy changes in the context of the 2030 Agenda for Sustainable Development. This paper reports on five r4d research projects and shows how researchers engage with various stakeholders, including policy-makers, in order to assure uptake of the research results. Methods Eleven in-depth interviews were conducted with principal investigators and their research partners from five r4d projects, using a semi-structured interview guide. The interviews explored the process of how stakeholders and policy-makers were engaged in the research project. Results Three key strategies were identified as fostering research uptake into policies and practices: (S1) stakeholders directly engaged with and sought evidence from researchers; (S2) stakeholders were involved in the design and throughout the implementation of the research project; and (S3) stakeholders engaged in participatory and transdisciplinary research approaches to coproduce knowledge and inform policy. In the first strategy, research evidence was directly taken up by international stakeholders as they were actively seeking new evidence on a very specific topic to up-date international guidelines. In the second strategy, examples from two r4d projects show that collaboration with stakeholders from early on in the projects increased the likelihood of translating research into policy, but that the latter was more effective in a supportive and stable policy environment. The third strategy adopted by two other r4d projects demonstrates the benefits of promoting colearning as a way to address potential power dynamics and working effectively across the local policy landscape through robust research partnerships. Conclusions This paper provides insights into the different strategies that facilitate collaboration and communication between stakeholders, including policy-makers, and researchers. However, it remains necessary to increase our understanding of the interests and motivations of the different actors involved in the process of influencing policy, identify clear policy-influencing objectives and provide more institutional support to engage in this complex and time-intensive process.
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Affiliation(s)
- Séverine Erismann
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Maria Amalia Pesantes
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Andrea Leuenberger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Andrea Farnham
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Monica Berger Gonzalez de White
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala, Guatemala
| | - Niklaus Daniel Labhardt
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Patricia Akweongo
- School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - August Kuwawenaruwa
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Ifakara Health Institute, Plot 463, Kiko Avenue Mikocheni, Dar es Salaam, Tanzania
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Fritz Brugger
- Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Claire Somerville
- Gender Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Helen Prytherch
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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Dagenais C. Research use at the Ministry of Health in Burkina Faso: the decision-makers' perspective. Implement Sci Commun 2021; 2:22. [PMID: 33597047 PMCID: PMC7890999 DOI: 10.1186/s43058-021-00126-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Despite the increased emphasis placed on the use of evidence for policy development, relatively few initiatives have been developed to support evidence-informed decision-making, especially in West Africa. Moreover, studies examining the conditions under which policy-makers use research-based evidence are still scarce, but they show that their attitudes and opinions about research are one of the main determinants of such use. In February 2017, Burkina Faso’s Minister of Health planned to create a unit to promote evidence-informed decision-making within the ministry. Before the unit was set up, documenting the attitudes towards research at the highest levels of his Ministry appeared profitable to the unit’s planning. Method Individual interviews were conducted by the author with 14 actors positioned to consider evidence during decision-making from the Burkina Faso’s Minister of health cabinet. An interview grid was used to explore several themes such as attitudes towards research, obstacles and facilitators to research use, example of research use in decision-making and finally, ways to increase decision-makers’ participation in knowledge transfer activities. Interviews were partially transcribed and analysed by the author. Results The results show a mixed attitude towards research and relatively little indication of research use reported by respondents. Important obstacles were identified: evidence inaccessibility, lack of implementation guidelines, absence of clear communication strategy and studies’ lack of relevance for decision-making. Many suggestions were proposed such as raising awareness, improving access and research communication and prioritizing interactions with researchers. Respondents agree with the low participation of decision-makers in knowledge transfer activities: more leadership from the senior officials was suggested and greater awareness of the importance of their presence. Conclusions The conclusion presents avenues for reflection and action to increase the potential impact of the knowledge transfer unit planned within the Ministry of Health of Burkina Faso. This innovative initiative will be impactful if the obstacles identified in this study and policy-makers’ preferences and needs are taken into account during its development and implementation.
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Affiliation(s)
- Christian Dagenais
- Department of Psychology, University of Montreal, P.O. Box 6128, Centre-Ville Station, Pavillon Marie-Victorin, Bureau C-355, Montreal, QC, H3C 3J7, Canada.
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20
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Moutselos K, Maglogiannis I. Evidence-based Public Health Policy Models Development and Evaluation using Big Data Analytics and Web Technologies. Med Arch 2021; 74:47-53. [PMID: 32317835 PMCID: PMC7164729 DOI: 10.5455/medarh.2020.74.47-53] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Introduction. According to WHO, “health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society”. Although policymaking is important to be based on scientific evidence, in many countries, evidence-informed decision-making remains the exception rather than the rule. Aim: This work presents a cloud-based Decision Support System for public health decision-making. Methods: In CrowdHEALTH, the concept of a Public Health Policy (PHP) is directly connected with one or more Key Performance Indexes (KPIs). The design and technical details of the system implementations are reported, along with use case scenarios. Results: The Policy Development Toolkit presents a unique interface and point of reference for policymakers, allowing them to create policy models and obtain analytical results for evidence-based decisions and evaluations. Conclusions: The hierarchical structure of the Public Health Policy Model offers versatility in the creation and handling of the policies, resulting in Health Analytics Tools Results Objects which offer quantitative policy support and provide the basis for meta-analytic operations.
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21
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Bharatan T, Devi R, Huang PH, Javed A, Jeffers B, Lansberg P, Sidhu K, Subramaniam K. A Methodology for Mapping the Patient Journey for Noncommunicable Diseases in Low- and Middle-Income Countries. J Healthc Leadersh 2021; 13:35-46. [PMID: 33542673 PMCID: PMC7853412 DOI: 10.2147/jhl.s288966] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/10/2021] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are responsible for 71% of all worldwide mortality each year, and have an exceptionally large impact in low- and middle-income countries (LMICs). However, there is often a lack of local data from these countries to inform practice and policy improvements. Generating locally contextualized evidence base for NCDs that can help identify gaps, aid decision-making and improve patient care in LMICs needs an innovative approach. The approach used in Mapping the Patient Journey Towards Actionable Beyond the Pill Solutions (MAPS) is designed to quantitatively map different stages of the patient journey in four critical NCDs, ie, hypertension, dyslipidemia, depression, and pain (chronic and neuropathic) across selected LMICs in Africa, the Middle East, South East Asia, and Latin America. The key touchpoints along the patient journey include awareness, screening, diagnosis, treatment, adherence, and control or remission. MAPS employs an evidence mapping methodology that follows a three-step semi-systematic review: 1) systematic peer-reviewed database search; 2) unstructured searches of local or real-world data; and 3) expert opinion. Evidence generation and visualization is based on locally validated and deduplicated data published over the last 10 years. This approach will be the first to provide quantitative mapping of the different stages of the patient journey for selected NCDs in LMICs. By focusing on local, patient-centric data, the goal of the MAPS initiative is to address and prioritize local research and knowledge gaps, then contribute to evidence-based, high-quality, and affordable advances in the management of NCDs in LMICs. This will ultimately improve patient outcomes and contribute towards the achievement of global NCD targets.
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Affiliation(s)
- Tanaya Bharatan
- Research Development & Medical, Upjohn Division, Pfizer Ltd, Mumbai, India
| | - Ratna Devi
- Executive Office, Daksham A Health and Education, Gurgaon, India
- International Alliance of Patient Organizations, London, UK
| | | | - Afzal Javed
- Warwick Medical School, University of Warwick, Warwick, UK
| | | | - Peter Lansberg
- Department of Pediatrics, University Medical Center, Groningen, the Netherlands
| | - Kaveri Sidhu
- Research Development & Medical, Upjohn Division, Pfizer Ltd, Mumbai, India
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22
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Vega J, Shroff ZC, Sheikh K, Agyepong IA, Tilahun B, Tangcharoensathien V, Hafeez A, Bhushan I, Ghaffar A, Peters D. Capacity, committed funding and co-production-institutionalizing implementation research in low- and middle-income countries. Health Policy Plan 2020; 35:ii7-ii8. [PMID: 33156931 PMCID: PMC7646729 DOI: 10.1093/heapol/czaa120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Zubin Cyrus Shroff
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
| | - Kabir Sheikh
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
| | | | - Binyam Tilahun
- University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | | | | | | | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
| | - David Peters
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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23
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Inguane C, Sawadogo-Lewis T, Chaquisse E, Roberton T, Ngale K, Fernandes Q, Dinis A, Augusto O, Covele A, Hicks L, Gremu A, Sherr K. Challenges and facilitators to evidence-based decision-making for maternal and child health in Mozambique: district, municipal and national case studies. BMC Health Serv Res 2020; 20:598. [PMID: 32605564 PMCID: PMC7329398 DOI: 10.1186/s12913-020-05408-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 06/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need for evidence-based decision-making in the health sector is well understood in the global health community. Yet, gaps persist between the availability of evidence and the use of that evidence. Most research on evidence-based decision-making has been carried out in higher-income countries, and most studies look at policy-making rather than decision-making more broadly. We conducted this study to address these gaps and to identify challenges and facilitators to evidence-based decision-making in Maternal, Newborn and Child Health and Nutrition (MNCH&N) at the municipality, district, and national levels in Mozambique. METHODS We used a case study design to capture the experiences of decision-makers and analysts (n = 24) who participated in evidence-based decision-making processes related to health policies and interventions to improve MNCH&N in diverse decision-making contexts (district, municipality, and national levels) in 2014-2017, in Mozambique. We examined six case studies, at the national level, in Maputo City and in two districts of Sofala Province and two of Zambézia Province, using individual in-depth interviews with key informants and a document review, for three weeks, in July 2018. RESULTS Our analysis highlighted various challenges for evidence-based decision-making for MNCH&N, at national, district, and municipality levels in Mozambique, including limited demand for evidence, limited capacity to use evidence, and lack of trust in the available evidence. By contrast, access to evidence, and availability of evidence were viewed positively and seen as potential facilitators. Organizational capacity for the demand and use of evidence appears to be the greatest challenge; while individual capacity is also a barrier. CONCLUSION Evidence-based decision-making requires that actors have access to evidence and are empowered to act on that evidence. This, in turn, requires alignment between those who collect data, those who analyze and interpret data, and those who make and implement decisions. Investments in individual, organizational, and systems capacity to use evidence are needed to foster practices of evidence-based decision-making for improved maternal and child health in Mozambique.
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Affiliation(s)
- Celso Inguane
- Department of Global Health, University of Washington, 1107 45th Street. NE, Suite 350, Seattle, WA, 98105, USA.
| | | | - Eusébio Chaquisse
- National Directorate of Public Health, Ministry of Health, Maputo City, Mozambique
| | - Timothy Roberton
- Institute for International Programs, Johns Hopkins University,, Baltimore, MD, USA
| | - Kátia Ngale
- Institute for International Programs, Johns Hopkins University, Maputo City, Mozambique
| | - Quinhas Fernandes
- Department of Global Health, University of Washington, 1107 45th Street. NE, Suite 350, Seattle, WA, 98105, USA.,National Directorate of Public Health, Ministry of Health, Maputo City, Mozambique
| | - Aneth Dinis
- Department of Global Health, University of Washington, 1107 45th Street. NE, Suite 350, Seattle, WA, 98105, USA.,National Directorate of Public Health, Ministry of Health, Maputo City, Mozambique
| | - Orvalho Augusto
- Department of Global Health, University of Washington, 1107 45th Street. NE, Suite 350, Seattle, WA, 98105, USA.,Department of Community Health, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo City, Mozambique
| | | | | | - Artur Gremu
- Health Alliance International, Maputo City, Mozambique
| | - Kenneth Sherr
- Department of Global Health, University of Washington, 1107 45th Street. NE, Suite 350, Seattle, WA, 98105, USA.,Health Alliance International, Seattle, Washington, USA
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24
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Hanney SR, Kanya L, Pokhrel S, Jones TH, Boaz A. How to strengthen a health research system: WHO's review, whose literature and who is providing leadership? Health Res Policy Syst 2020; 18:72. [PMID: 32571364 PMCID: PMC7308111 DOI: 10.1186/s12961-020-00581-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/21/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health research is important for the achievement of the Sustainable Development Goals. However, there are many challenges facing health research, including securing sufficient funds, building capacity, producing research findings and using both local and global evidence, and avoiding waste. A WHO initiative addressed these challenges by developing a conceptual framework with four functions to guide the development of national health research systems. Despite some progress, more is needed before health research systems can meet their full potential of improving health systems. The WHO Regional Office for Europe commissioned an evidence synthesis of the systems-level literature. This Opinion piece considers its findings before reflecting on the vast additional literature available on the range of specific health research system functions related to the various challenges. Finally, it considers who should lead research system strengthening. MAIN TEXT The evidence synthesis identifies two main approaches for strengthening national health research systems, namely implementing comprehensive and coherent strategies and participation in partnerships. The literature describing these approaches at the systems level also provides data on ways to strengthen each of the four functions of governance, securing financing, capacity-building, and production and use of research. Countries effectively implementing strategies include England, Ireland and Rwanda, whereas West Africa experienced effective partnerships. Recommended policy approaches for system strengthening are context specific. The vast literature on each function and the ever-growing evidence-base are illustrated by considering papers in just one key journal, Health Research Policy and Systems, and analysing the contribution of two national studies. A review of the functions of the Iranian system identifies over 200 relevant and mostly national records; an analysis of the creation of the English National Institute for Health Research describes the key leadership role played by the health department. Furthermore, WHO is playing leadership roles in helping coordinate partnerships within and across health research systems that have been attempting to tackle the COVID-19 crisis. CONCLUSIONS The evidence synthesis provides a firm basis for decision-making by policy-makers and research leaders looking to strengthen national health research systems within their own national context. It identifies five crucial policy approaches - conducting situation analysis, sustaining a comprehensive strategy, engaging stakeholders, evaluating impacts on health systems, and partnership participation. The vast and ever-growing additional literature could provide further perspectives, including on crucial leadership roles for health ministries.
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Affiliation(s)
- Stephen R. Hanney
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
| | - Lucy Kanya
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Subhash Pokhrel
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
| | - Teresa H. Jones
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
| | - Annette Boaz
- Faculty of Health, Social Care and Education, a partnership between Kingston University and St George’s, University of London, London, United Kingdom
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25
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Masefield SC, Megaw A, Barlow M, White PCL, Altink H, Grugel J. Repurposing NGO data for better research outcomes: a scoping review of the use and secondary analysis of NGO data in health policy and systems research. Health Res Policy Syst 2020; 18:63. [PMID: 32513183 PMCID: PMC7278191 DOI: 10.1186/s12961-020-00577-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/19/2020] [Indexed: 11/26/2022] Open
Abstract
Background Non-governmental organisations (NGOs) collect and generate vast amounts of potentially rich data, most of which are not used for research purposes. Secondary analysis of NGO data (their use and analysis in a study for which they were not originally collected) presents an important but largely unrealised opportunity to provide new research insights in critical areas, including the evaluation of health policy and programmes. Methods A scoping review of the published literature was performed to identify the extent to which secondary analysis of NGO data has been used in health policy and systems research (HPSR). A tiered analytical approach provided a comprehensive overview and descriptive analyses of the studies that (1) used data produced or collected by or about NGOs; (2) performed secondary analysis of the NGO data (beyond the use of an NGO report as a supporting reference); and (3) analysed NGO-collected clinical data. Results Of the 156 studies that performed secondary analysis of NGO-produced or collected data, 64% (n = 100) used NGO-produced reports (mostly to a limited extent, as a contextual reference or to critique NGO activities) and 8% (n = 13) analysed NGO-collected clinical data. Of these studies, 55% (n = 86) investigated service delivery research topics and 48% (n = 51) were undertaken in developing countries and 17% (n = 27) in both developing and developed countries. NGOs were authors or co-authors of 26% of the studies. NGO-collected clinical data enabled HPSR within marginalised groups (e.g. migrants, people in conflict-affected areas), albeit with some limitations such as inconsistent and missing data. Conclusion We found evidence that NGO-collected and produced data are most commonly perceived as a source of supporting evidence for HPSR and not as primary source data. However, these data can facilitate research in under-researched marginalised groups and in contexts that are hard to reach by academics such as conflict-affected areas. NGO–academic collaboration could help address issues of NGO data quality to facilitate their more widespread use in research. The use of NGO data use could enable relevant and timely research in the areas of programme evaluation and health policy and advocacy to improve health and reduce health inequalities, especially in marginalised groups and developing countries.
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Affiliation(s)
- Sarah C Masefield
- Department of Health Sciences, University of York, York, YO10 5DD, United Kingdom. .,Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.
| | - Alice Megaw
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom
| | - Matt Barlow
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of Politics, University of York, York, YO10 5DD, United Kingdom
| | - Piran C L White
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of Environment and Geography, University of York, York, YO10 5NG, United Kingdom
| | - Henrice Altink
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of History, University of York, York, YO10 5NH, United Kingdom
| | - Jean Grugel
- Interdisciplinary Global Development Centre, University of York, York, YO10 5DD, United Kingdom.,Department of Politics, University of York, York, YO10 5DD, United Kingdom
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González Block MA, Arroyo Laguna J, Cetrángolo O, Crocco Ábalos P, Guerrero R, Riva Knauth D, Ghaffar A, Pavón León P, Del Rocío Saénz M, González McQuire R, Martínez Zavala B, Gutiérrez Calderón E. Health policy and systems research publications in Latin America warrant the launching of a new specialised regional journal. Health Res Policy Syst 2020; 18:59. [PMID: 32503569 PMCID: PMC7275341 DOI: 10.1186/s12961-020-00565-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 04/28/2020] [Indexed: 01/08/2023] Open
Abstract
Background Scientific journals play a critical role in research validation and dissemination and are increasingly vocal about the identification of research priorities and the targeting of research results to key audiences. No new journals specialising in health policy and systems research (HPSR) and focusing in the developing world or in a specific developing world region have been established since the early 1980s. This paper compares the growth of publications on HPSR across Latin America and the world and explores the potential, feasibility and challenges of innovative publication strategies. Methods A bibliometric analysis was undertaken using HPSR MeSH terms with journals indexed in Medline. A survey was undertaken among 2500 authors publishing on HPSR in Latin America (LA) through an online survey, with a 13.1% response rate. Aggregate indicators were constructed and validated, and two-way ANOVA tests were performed on key variables. Results HPSR publications on LA observed an average annual growth of 27.5% from the years 2000 to 2018, as against 11.4% worldwide and yet a lag on papers published per capita. A total of 48 journals with an Impact Factor publish HPSR on LA, of which 5 non-specialised journals are published in the region and are ranked in the bottom quintile of Impact Factor. While the majority of HPSR papers worldwide is published in specialised HPSR journals, in LA this is the minority. Very few researchers from LA sit in the Editorial Board of international journals. Researchers highly support strengthening quality HPSR publications through publishing in open access, on-line journals with a focus on the LA region and with peer reviewers specialized on the region. Researchers would support a new open access journal specializing in the LA region and in HPSR, publishing in English. Open access up-front costs and disincentives while waiting for an Impact Factor can be overcome. Conclusion Researchers publishing on HPSR in LA widely support the launching of a new specialised journal for the region with a vigorous editorial policy focusing on regional and country priorities. Strategies should be in place to support English-language publishing and to develop a community of practice around the publication process. In the first years, special issues should be promoted through a priority-setting process to attract prominent authors, develop the audience and attain an Impact Factor.
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Affiliation(s)
| | - Juan Arroyo Laguna
- Facultad de Ciencias Sociales, Escuela de Gobierno y Políticas Públicas, Pontificia Universidad Católica del Perú, Lima, Peru
| | - Oscar Cetrángolo
- Facultad de Ciencias Económicas de la UBA, Buenos Aires & Instituto Interdisciplinario de Economía Política, Buenos Aires, Argentina
| | | | - Ramiro Guerrero
- Centro de Estudios en Protección Social y Economía de la Salud, Universidad ICESI, Cali, Colombia
| | - Daniela Riva Knauth
- Departamento de Medicina Social, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Patricia Pavón León
- Instituto de Ciencias de la Salud, Universidad Veracruzana, Xalapa, Veracruz, Mexico
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27
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Murunga VI, Oronje RN, Bates I, Tagoe N, Pulford J. Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries. Health Res Policy Syst 2020; 18:16. [PMID: 32039738 PMCID: PMC7011245 DOI: 10.1186/s12961-019-0524-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Knowledge translation (KT) is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to yield beneficial outcomes for society. Effective KT requires researchers to play an active role in promoting evidence uptake. This paper presents a systematised review of evidence on low- and middle-income country (LMIC) researchers' KT capacity, practice and interventions for enhancing their KT practice (support) with the aim of identifying gaps and informing future research and interventions. METHODS An electronic search for peer-reviewed publications focusing on LMIC researchers' KT capacity, practice and support across all academic fields, authored in English and from the earliest records available to February 2019, was conducted using PubMed and Scopus. Selected studies were appraised using the Mixed Methods Appraisal Tool, data pertaining to publication characteristics and study design extracted, and an a priori thematic analysis of reported research findings completed. RESULTS The search resulted in 334 screened articles, of which 66 met the inclusion criteria. Most (n = 43) of the articles presented original research findings, 22 were commentaries and 1 was a structured review; 47 articles reported on researchers' KT practice, 12 assessed the KT capacity of researchers or academic/research institutions and 9 reported on KT support for researchers. More than half (59%) of the articles focused on sub-Saharan Africa and the majority (91%) on health research. Most of the primary studies used the case study design (41%). The findings suggest that LMIC researchers rarely conduct KT and face a range of barriers at individual and institutional levels that limit their KT practice, including inadequate KT knowledge and skills, particularly for communicating research and interacting with research end-users, insufficient funding, and inadequate institutional guidelines, structures and incentives promoting KT practice. Furthermore, the evidence-base on effective interventions for enhancing LMIC researchers' KT practice is insufficient and largely of weak quality. CONCLUSIONS More high-quality research on researchers' KT capacity, practice and effective KT capacity strengthening interventions is needed. Study designs that extend beyond case studies and descriptive studies are recommended, including better designed evaluation studies, e.g. use of realist approaches, pragmatic trials, impact evaluations, implementation research and participatory action research.
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Affiliation(s)
- Violet Ibukayo Murunga
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 3BX United Kingdom
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
- African Institute for Development Policy, 6th Floor, Block A, Westcom Point Bldg, Mahiga Mairu Ave Off Waiyaki Way, Westlands, Nairobi, Kenya
| | - Rose Ndakala Oronje
- African Institute for Development Policy, 6th Floor, Block A, Westcom Point Bldg, Mahiga Mairu Ave Off Waiyaki Way, Westlands, Nairobi, Kenya
| | - Imelda Bates
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
| | - Nadia Tagoe
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Office of Grants and Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justin Pulford
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
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Javadi D, Tran N, Ghaffar A. Building a Workforce for Future Health Systems: Reflections from Health Policy and Systems Research. Health Serv Res 2018; 53 Suppl 2:4024-4033. [PMID: 29797708 PMCID: PMC6149357 DOI: 10.1111/1475-6773.12978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The era of the Sustainable Development Goals calls for multidisciplinary research and intersectoral approaches to addressing health challenges. This presents a unique opportunity for multidisciplinary fields concerned with complex systems. Those working in system-oriented fields such as health policy and systems research (HPSR) and health services research must be forward-thinking in optimizing their collective ability to address these global challenges. OBJECTIVES The objective of this commentary was to share reflections on challenges and strategies in managing the HPSR workforce in order to stimulate dialogue and cross-learning across similar fields. STRATEGIES/FINDINGS The following strategies are discussed here: definitional clarity of expected competencies and coordination across HPS researchers, national investment in HPSR, institutional capacity for coproduction of knowledge across different types of actors, and participatory leadership. CONCLUSIONS Creative approaches in training, financing, developing, and leading the diverse workforce required to strengthen health systems can pave the way for its full-time and part-time members to work together.
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Affiliation(s)
- Dena Javadi
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
| | - Nhan Tran
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
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29
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Hanney SR, González-Block MA. 'Knowledge for better health' revisited - the increasing significance of health research systems: a review by departing Editors-in-Chief. Health Res Policy Syst 2017; 15:81. [PMID: 28965493 PMCID: PMC5623979 DOI: 10.1186/s12961-017-0248-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 01/22/2023] Open
Abstract
How can nations organise research investments to obtain the best bundle of knowledge and the maximum level of improved health, spread as equitably as possible? This question was the central focus of a major initiative from WHO led by Prof Tikki Pang, which resulted in a range of developments, including the publication of a conceptual framework for national health research systems - Knowledge for better health - in 2003, and in the founding of the journal Health Research Policy and Systems (HARPS). As Editors-in-Chief of the journal since 2006, we mark our retirement by tracking both the progress of the journal and the development of national health research systems. HARPS has maintained its focus on a range of central themes that are key components of a national health research system in any country. These include building capacity to conduct and use health research, identifying appropriate priorities, securing funds and allocating them accountably, producing scientifically valid research outputs, promoting the use of research in polices and practice in order to improve health, and monitoring and evaluating the health research system. Some of the themes covered in HARPS are now receiving increased attention and, for example, with the assessment of research impact and development of knowledge translation platforms, the journal has covered their progress throughout that expansion of interest. In addition, there is increasing recognition of new imperatives, including the importance of promoting gender equality in health research if benefits are to be maximised. In this Editorial, we outline some of the diverse and developing perspectives considered within each theme, as well as considering how they are held together by the growing desire to build effective health research systems in all countries.From 2003 until mid-June 2017, HARPS published 590 articles on the above and related themes, with authors being located in 76 countries. We present quantitative data tracing the journal's growth and the increasing external recognition of its role. We thank the many colleagues who have kindly contributed to the journal's success, and finish on an exciting note by welcoming the new Editors-in-Chief who will take HARPS forward.
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Affiliation(s)
- Stephen R. Hanney
- Health Economics Research Group, Institute of Environment, Health and Societies, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH United Kingdom
| | - Miguel A. González-Block
- Universidad Anáhuac, Av. Universidad Anáhuac 46, Lomas Anáhuac, 52786 Huixquilucan Mexico City, Mexico
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