Conference Health and social protection: Meeting the needs of the poor Vientiane 2008Goran.Tomson@ki.se

Research to Policy

www.povill.com

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Suggested topics for Health Systems Research

Financial and human resources -Community-based financing and national health insurance-Human resources for health at the district level and below-Human resource requirements at higher management levels

Organisation and delivery of health services

-Community involvement-Equitable, effective and efficient health care-Private sector and approaches to the organization of health services-Drug and diagnostic policies

Governance, stewardship, knowledge management

-Governance and accountability-Health information systems-Priority setting and evidence-informed policy making-Effective approaches for intersectoral engagement in health

Global influences Effects of global initiatives (GHI) on health systems

World Report on Knowledge for Better Health – WHO 2004

• Strengthen Health Systems• Health Systems Research

Bookorders@who.inthttp://www.who.int/rpc/meetings/pub1/en/

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Function/action-based view on health system

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Health goals Health actions Health system functions

Enhancing responsiveness to the expectations

of population

Improving health

Ensuring fairness in financial

contribution

Respect for persons-Dignity-Confidentiality-Autonomy

Client orientation-Attention to health needs-Basic amenities (mainly in facilities)-Access to social support networks-Choice of providers

Improving average level of population

health

Alleviating health distribution inequalities

within population

Pooling financial

risks

Poor pay less than affluent

STEWARDSHIPSTEWARDSHIP FINANCINGFINANCING

SERVICE PROVISION

SERVICE PROVISION

RESOURCE GENERATION

RESOURCE GENERATION

Health Policy Models

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• Rationalist

• Incrementalist (“muddling through”)

• Walt's “Stages” Model

1. Problem identification

2. Policy formulation

3. Policy implementation

4. Policy evaluation

Evidence

Research

Health care policy

System-adaptation

Implementation

Follow up

Feedback

(Muir Gray:2001)

”Translating”

Evidence

Action

Factors influencing the use of research evidence

(adapted from Rehnqvist)

The weak evidence that exist on policy makers use of evidence suggests that to increase use researchers should:• Have personal and close two-way communication with decision makers• Provide decision makers a brief summary with policy recommendations• Ensure that research is perceived as timely, relevant and of high quality• Include effectiveness data• Argue that research are relevant to the demands of policy makers and the community

Innvaer et al:2002