Guidance for Evidence-Informed Policies about Health Systems: Rationale for and Challenges of Guidance Development

Swiss Tropical and Public Health Institute, Basel, Switzerland.
PLoS Medicine (Impact Factor: 14.43). 03/2012; 9(3):e1001185. DOI: 10.1371/journal.pmed.1001185
Source: PubMed


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

Download full-text


Available from: Rifat Atun,
63 Reads
  • Source
    • "While there are several interpretations of KT [7,8], fundamentally, it seeks to involve multiple actors and processes at multiple junctures to promote the research-policy paradigm. KT is defined by the Canadian Institutes of Health Research as “a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system” [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Local health systems research (HSR) provides policymakers and practitioners with contextual, evidence-based solutions to health problems. However, producers and users of HSR rarely understand the complexities of the context within which each operates, leading to the “know–do” gap. Universities are well placed to conduct knowledge translation (KT) integrating research production with uptake. The HEALTH Alliance Africa Hub, a consortium of seven schools of public health (SPHs) in East and Central Africa, was formed to build capacity in HSR. This paper presents information on the capacity of the various SPHs to conduct KT activities. Methods In 2011, each member of the Africa Hub undertook an institutional HSR capacity assessment using a context-adapted and modified self-assessment tool. KT capacity was measured by several indicators including the presence of a KT strategy, an organizational structure to support KT activities, KT skills, and institutional links with stakeholders and media. Respondents rated their opinions on the various indicators using a 5-point Likert scale. Averages across all respondents for each school were calculated. Thereafter, each school held a results validation workshop. Results A total of 123 respondents from all seven SPHs participated. Only one school had a clear KT strategy; more commonly, research was disseminated at scientific conferences and workshops. While most respondents perceived their SPH as having strong institutional ties with organizations interested in HSR as well as strong institutional leadership, the organizational structures required to support KT activities were absent. Furthermore, individual researchers indicated that they had little time or skills to conduct KT. Additionally, institutional and individual links with policymakers and media were reported as weak. Conclusions Few SPHs in Africa have a clear KT strategy. Strengthening the weak KT capacity of the SPHs requires working with institutional leadership to develop KT strategies designed to guide organizational structure and development of networks with both the media and policymakers to improve research uptake.
    Health Research Policy and Systems 06/2014; 12(1):20. DOI:10.1186/1478-4505-12-20 · 1.86 Impact Factor
  • Source
    • "There is a recognized global commitment to health equity, defined as the absence of avoidable and unfair inequalities in health[1], and social determinants of health[2,3]. Such commitment to action requires careful evaluation of policies, strategies and programmes (hereafter referred to as ‘interventions’), so that their effects on health equity may be understood. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Reporting guidelines can be used to encourage standardised and comprehensive reporting of health research. In light of the global commitment to health equity, we have previously developed and published a reporting guideline for equity-focused systematic reviews (PRISMA-E 2012). The objectives of this study were to explore the utility of the equity extension items included in PRISMA-E 2012 from a systematic review author perspective, including facilitators and barriers to its use. This will assist in designing dissemination and knowledge translation strategies. We conducted a survey of systematic review authors to expose them to the new items in PRISMA-E 2012, establish the extent to which they had historically addressed those items in their own reviews, and gather feedback on the usefulness of the new items. Data were analysed using Microsoft Excel 2008 and Stata (version 11.2 for Mac). Of 151 respondents completing the survey, 18.5% (95% CI: 12.7% to 25.7%) had not heard of the PRISMA statement before, although 83.4% (95% CI: 77.5% to 89.3%) indicated that they plan to use PRISMA-E 2012 in the future, depending on the focus of their review. Most (68.9%; 95% CI: 60.8% to 76.2%) thought that using PRISMA-E 2012 would lead them to conduct their reviews differently. Important facilitators to using PRISMA-E 2012 identified by respondents were journal endorsement and incorporation of the elements of the guideline into systematic review software. Barriers identified were lack of time, word limits and the availability of equity data in primary research. This study has been the first to 'road-test' the new PRISMA-E 2012 reporting guideline and the findings are encouraging. They confirm the acceptability and potential utility of the guideline to assist review authors in reporting on equity in their reviews. The uptake and impact of PRISMA-E 2012 over time on design, conduct and reporting of primary research and systematic reviews should continue to be examined.
    PLoS ONE 10/2013; 8(10):e75122. DOI:10.1371/journal.pone.0075122 · 3.23 Impact Factor
  • Source
    • "We developed these recommendations based on methodology meetings held between 2005 and 2012 by the Campbell and Cochrane Equity Methods Group, methodological recommendations from the Cochrane Public Health Review Group [12], a Cochrane systematic review [13], methods study [14], the WHO Task Force on evidence-informed policies about health systems [2] and a consensus meeting held in Bellagio, Italy, in February 2012 with methodologists, funders, journal editors, clinicians and public health practitioners as part of the development of reporting guidelines for systematic reviews with a focus on health equity to extend the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement (PRISMA-E 2012) [15]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: At the Rio Summit in 2011 on Social Determinants of Health, the global community recognized a pressing need to take action on reducing health inequities. This requires an improved evidence base on the effects of national and international policies on health inequities. Although systematic reviews are recognized as an important source for evidence-informed policy, they have been criticized for failing to assess effects on health equity. This article summarizes guidance on both conducting systematic reviews with a focus on health equity and on methods to translate their findings to different audiences. This guidance was developed based on a series of methodology meetings, previous guidance, a recently developed reporting guideline for equity-focused systematic reviews (PRISMA-Equity 2012) and a systematic review of methods to assess health equity in systematic reviews. We make ten recommendations for conducting equity-focused systematic reviews; and five considerations for knowledge translation. Illustrative examples of equity-focused reviews are provided where these methods have been used. Implementation of the recommendations in this article is one step toward monitoring the impact of national and international policies and programs on health equity, as recommended by the 2011 World Conference on Social Determinants of Health.
    Systematic Reviews 06/2013; 2(1):43. DOI:10.1186/2046-4053-2-43
Show more