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Background
Questions to Consider
Conclusion
References

Health Research Policy and Systems BioMed Central Guide

Profile image of Nathan M . SouzaNathan M . Souza

2009

https://doi.org/10.1186/1478-4505-7-S1-S9
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Abstract

SUPPORT Tools for evidence-informed health Policymaking (STP) 9: Assessing the applicability of the findings of a

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Evidence based policies in public health are receiving increasing attention and importance for organizing, funding and delivering the health services. The world health organization's, task force report on health system research states, "millennium development goals will not be attained without new research addressing health system constraints to delivering effective interventions" (World Health Organization, 2005), "research is an essential component of strong health systems for informed and knowledgeable action to improve people' s health and accelerate the rate of global, regional and national development" (The Ministerial Summit on Health Research, 2004), evidence-based policy relies on the principle that policy decisions must involve comprehensive analysis of health issues, testing of newer strategies or possible health interventions and mechanism to deliver those health interventions. Health system would be better able to deal with existing challenges if interventions that adopted are based on sound evidences. High quality research has an important part to play in strengthening these interventions and subsequently health systems. Public health agencies should exercise its responsibilities in the development of comprehensive public health policies by promoting the use of the scientific knowledge in decision-making about public health and to serve the public interest. Currently, there is insufficient use of research evidence by decision-makers attempting to improve health systems performances (World Health Organization, 2006; Thomsom et al., 2007). With this background we look at the range of issues related to linking research evidence into health policy and practice, especially in Indian context that can also be true for other low and middle income countries.

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References (29)

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Response: 1. Topic -Is the topic relevant to policymakers (and those who support them) in contexts like yours? very helpful for briefing new elected officials in power. It helps support the need for evidenceision making; reminds researchers and policy here are decision makers they have to take 2. General approach to the topic -Does the general approach to the topic make sense in contexts like yours? Very pragmatic; covers in a very direct way key points that all engaged need to be aware of 3. Questions -Do the 'questions to consider' provide a useful set of steps to use in approaching the topic in contexts like yours? These questions framed the topic succinctly and to the point.

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SUPPORT Tools for evidence-informed health Policymaking (STP) 9: Assessing the applicability of the findings of a systematic review
Nathan M . Souza

Health Research Policy and Systems, 2009

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Differences between health systems may often result in a policy or programme option that is used in one setting not being feasible or acceptable in another. Or these differences may result in an option not working in the same way in another setting, or even achieving different impacts in another setting. A key challenge that policymakers and those supporting them must face is therefore the need to understand whether research evidence about an option can be applied to their setting. Systematic reviews make this task easier by summarising the evidence from studies conducted in a variety of different settings. Many systematic reviews, however, do not provide adequate descriptions of the features of the actual settings in which the original studies were conducted. In this article, we suggest questions to guide those assessing the applicability of the findings of a systematic review to a specific setting. These are: 1. Were the studies included in a systematic review conducted in the same setting or were the findings consistent across settings or time periods? 2. Are there important differences in on-the-ground realities and constraints that might substantially alter the feasibility and acceptability of an option? 3. Are there important differences in health system arrangements that may mean an option could not work in the same way? 4. Are there important differences in the baseline conditions that might yield different absolute effects even if the relative effectiveness was the same? 5. What insights can be drawn about options, implementation, and monitoring and evaluation? Even if there are reasonable grounds for concluding that the impacts of an option might differ in a specific setting, insights can almost always

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SUPPORT Tools for evidence-informed health Policymaking (STP) 17: Dealing with insufficient research evidence
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This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers and those supporting them may find themselves in one or more of the following three situations that will require them to characterise the costs and consequences of options to address a problem. These are: 1. A decision has already been taken and their role is to maximise the benefits of an option, minimise its harms, optimise the impacts achieved for the money spent, and (if there is substantial uncertainty about the likely costs and consequences of the option) to design a monitoring and evaluation plan, 2. A policymaking process is already underway and their role is to assess the options presented to them, or 3. A policymaking process has not yet begun and their role is therefore to identify options, characterise the costs and consequences of these options, and look for windows of opportunity in which to act. In situations like these, research evidence, particularly about benefits, harms, and costs, can help to inform whether an option can be considered viable. In this article, we suggest six questions that can be used to guide those involved in identifying policy and programme options to address a high-priority problem, and to characterise the costs and consequences of these options. These are: 1. Has an appropriate set of options been identified to address a problem? 2. What benefits are important to those who will be affected and which benefits are likely to be achieved with each option? 3. What harms are important to those who will be affected and which harms are likely to arise with each option? 4. What are the local costs of each option and is there local evidence about their cost-effectiveness? 5. What adaptations might be made to any given option and could they alter its benefits, harms and costs? 6. Which stakeholder views and experiences might influence an option's acceptability and its benefits, harms, and costs?

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Background: Poor reporting of medical trials has triggered the development of trial reporting standards within the scientific community. In addition to a description of the proposed intervention, adequate information about the trial setting and the group of health workers (cadre) delivering the intervention would allow a better understanding of the generalizability of the trial findings, facilitate replication of trial interventions and assist with assessment of trials for inclusion in systematic reviews. This study aims to determine the completeness of reporting for trial setting and cadre among trials included in two Cochrane reviews on iron and folic acid supplementation for women during pregnancy. Methods: From the 81 trials included in the two Cochrane reviews, we extracted data on the trial setting, including the facility type and geographic location, facility descriptors (i.e. level of care) and population descriptors (i.e. socioeconomic status); and the cadre, including professional qualifications, training and supervision. Results: Almost all studies reported the facility type and location (96%). However, only 68% included this information in the "methods" section of the report. Facility descriptors and population descriptors were less commonly reported (26% and 54% respectively). For 34% of the trials, we found some account of the type of health worker that delivered the intervention. Only 4% of the trials reported any training procedures.

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The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Al...

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