Evidence Informed Policy Making
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Keywords: health policy, health systems research, policy making, knowledge translation, WHO Alliance for Health Policy and Systems Research As the pressing need for health care systems reform grips many nations of the world, researchers have looked at novel ways to generate and define policies based on available evidence. Recently, investigators have looked to an emerging form of research known as Health Policy Systems Research (HPSR) to inform and develop policy. HPSR is a multidisciplinary form of research which unites the fields of anthropology, sociology, public health and medicine, to examine the way national health systems are structured and how effectively such systems function. HPSR is defined broadly as “the production of knowledge and applications to improve how societies organize themselves to achieve health goals, including how they plan, manage and finance activities to improve health, as well as the roles, perspectives and interests of different actors in this effort.” (1) This field of research focuses specifically on six crucial “building blocks” to evaluate the efficacy of the health system – service delivery, information and evidence, medical products and technologies, health workforce, health financing, and leadership and governance. By focusing on these key areas, researchers are able to clearly see how the health care system functions as a whole and are quickly able to identify areas that need improvement. Since the 1970s, researchers began to see how the dissemination of HPSR evidence proved to be beneficial to the health ministers of low income countries in their quest to formulate better policies for their respective nations. Although the utilization of HPSR research can be beneficial for all countries regardless of their economic status, the utilization of HPSR to develop policy has repeatedly shown to be beneficial especially to the resource poor nations of the world as they share a disproportionate burden of poor health outcomes. HPSR strategies have the potential to have a profound impact on strengthening health systems around the world, which can significantly benefit low and middle income countries (LMIC) in their mission to meet the fourth, fifth, and sixth Millennium Development Goals (MDGs) which target public health. These goals include reducing child mortality, improving maternal health, and combating HIV/AIDS, malaria and other diseases, respectively. Many recent publications have reported that weak health systems are preventing low and middle income countries from reaching the MDGs. (1, 2, 3) Strengthening health systems is currently a key component of WHO’s global health agenda. (4, 5) As stated by the Director-General of WHO, Dr. Margaret Chan, “Public health [today] enjoys commitment, resources, and powerful interventions…….but the power of these interventions is not matched by the power of health systems to deliver them to those in greatest need, on an adequate scale and on time……This arises, in part, from the fact that research on health systems has been so badly-neglected and underfunded…….In the absence of sound evidence, we will have no good way to compel efficient investments in health systems.” [Dr. Margaret Chan, Director-General of WHO, Beijing, China, 29 October, 2007]. The World Health Organization has recognized the potential for HPSR and is committed to health systems strengthening, as evident with its work with the Alliance for Health Policy and Systems Research, Country Cooperation Strategies, Global Health Observatory and Evidence-Informed Policy Network. This report will discuss the role of HPSR, the importance of implementation research and knowledge translation towards developing sustainable health care systems, and examine the various WHO entities as well as other organizations involved with research uptake and evidence-based decision making, and the challenges encountered in this process.