Regional initiatives to promote Regional initiatives to promote evidence-informed evidence-informed

policymakingpolicymaking

Dr. Reijo SalmelaDr. Reijo Salmela

WHO Regional Office for the WHO Regional Office for the Western PacificWestern Pacific

Evidence-Informed Policy Network (EVIPNet)Evidence-Informed Policy Network (EVIPNet)

Regional rapid response mechanism to support Regional rapid response mechanism to support policymaking policymaking

Asia Pacific Observatory on Health Systems and Asia Pacific Observatory on Health Systems and Policies Policies

OverviewOverview

What isWhat is

Promote systematic use of evidence in policy-Promote systematic use of evidence in policy-making in low and middle-income countries.making in low and middle-income countries.

Promotes partnerships at country level Promotes partnerships at country level between policy-makers, researchers and civil between policy-makers, researchers and civil society to facilitate policy development and society to facilitate policy development and implementation through use of the best implementation through use of the best scientific evidence available.scientific evidence available.

EVIDENCE-INFORMED POLICY NETWORK

EVIPNet's originEVIPNet's origin

WHO HQAdvisory

Committee on Health Research

58th World Health Assembly 2005Mexico Summit 2004

EVIPNet – 58th WHA ResolutionEVIPNet – 58th WHA ResolutionMay 2005May 2005

[…] calls for establishing or strengthening […] calls for establishing or strengthening

mechanisms to transfer knowledge in support mechanisms to transfer knowledge in support

of evidence-based public health care delivery of evidence-based public health care delivery

systems and evidence-based health-related systems and evidence-based health-related

policies.policies.

Translates into EVIPNet

1. Research competes with many other factors in the 1. Research competes with many other factors in the policymaking processpolicymaking process

2. Research isn’t valued as an information input [Climate for 2. Research isn’t valued as an information input [Climate for research use]research use]

3.3. Research isn’t relevant [Production]Research isn’t relevant [Production]

4.4. Research isn’t understandable [Translation]Research isn’t understandable [Translation]a. Research isn’t communicated effectively [Push]a. Research isn’t communicated effectively [Push]b. Research isn’t available when policymakers need it b. Research isn’t available when policymakers need it

and in a form that they can use [Facilitating pull]and in a form that they can use [Facilitating pull]c. Policymakers lack mechanisms to prompt them to use c. Policymakers lack mechanisms to prompt them to use

research in policymaking [Pull]research in policymaking [Pull]d. Policymakers lack forums where policy challenges can d. Policymakers lack forums where policy challenges can

be discussed with key stakeholders [Exchange]be discussed with key stakeholders [Exchange]

Addressing the challenges inAddressing the challenges inlinking research to policylinking research to policy

Network’s main Network’s main functionsfunctions

• Acquire, assess & adapt evidence to establish Acquire, assess & adapt evidence to establish a robust knowledge basea robust knowledge base

• Provide decision makers with a "rapid Provide decision makers with a "rapid response" and "one stop shopping" for high response" and "one stop shopping" for high quality evidencequality evidence

• Enhance interactive linkages among Enhance interactive linkages among producers & users of research to promote the producers & users of research to promote the uptake of evidenceuptake of evidence

• Provide trainingProvide training

EVIPNet building blocks

Research synthesis &

Policy briefs

Capacity

development &

empowerment

Country dialogues(safe harbor)

Monitoring and evaluation - Development of new methodologies

Country teams and

regional and global

support structures

EVIPNet AsiaEVIPNet Asia 7 teams in five countries: [China (Beijing, Shandong, 7 teams in five countries: [China (Beijing, Shandong,

Sichuan), Lao PDR, Malaysia, Philippines, Viet Nam)Sichuan), Lao PDR, Malaysia, Philippines, Viet Nam) Steering group: overall planning and strategic Steering group: overall planning and strategic

guidanceguidance

Secretariat, annual coordination meetings Secretariat, annual coordination meetings Joint trainingsJoint trainings WebsitesWebsites

Interactive communication between health policy Interactive communication between health policy makers and researchersmakers and researchers

Support from WHO, Alliance for Health Policy and Support from WHO, Alliance for Health Policy and Systems Research (AHPSR) and governments Systems Research (AHPSR) and governments

EVIPNet as global initiativeEVIPNet as global initiative

EVIPNet Asia 2005EVIPNet Asia 2005 EVIPNet Africa 2006EVIPNet Africa 2006 EVIPNet America 2007EVIPNet America 2007

Global steering groupGlobal steering group

Global resource group Global resource group

Monitoring and evaluation of EVIPNetMonitoring and evaluation of EVIPNet

What is systematic review?What is systematic review?

Systematic reviews are summarizing the Systematic reviews are summarizing the best available evidence. best available evidence.

A systematic review is a clearly formulated A systematic review is a clearly formulated question that uses systematic and explicit question that uses systematic and explicit methods to identify, select and critically methods to identify, select and critically appraise relevant research, and to collect appraise relevant research, and to collect and analyse data from the studies that are and analyse data from the studies that are included in the review. included in the review.

Structured process involving several steps:Structured process involving several steps: Well formulated questionWell formulated question Comprehensive data searchComprehensive data search Unbiased selection and abstraction Unbiased selection and abstraction

processprocess Critical appraisal of dataCritical appraisal of data Synthesis of dataSynthesis of data Structured reportStructured report Regularly updatedRegularly updated

Systematic review processSystematic review process

What is policy brief?What is policy brief?

The EVIPNet policy briefsThe EVIPNet policy briefs• research syntheses in a user-friendly research syntheses in a user-friendly

format (1:3:25)format (1:3:25)• involve systematic and transparent efforts involve systematic and transparent efforts

to link global evidence from systematic to link global evidence from systematic reviews and local evidencereviews and local evidence

• offer evidence informed policy optionsoffer evidence informed policy options

Health Systems Information Health Systems Information for Policy Makers for Policy Makers in Asian Countriesin Asian Countries

Report to the Alliance for Health Policy and Report to the Alliance for Health Policy and Systems Research, Systems Research,

World Health OrganizationWorld Health Organization

http://www.who.int/alliance-hpsr/en/http://www.who.int/alliance-hpsr/en/

Aims of the feasibility studyAims of the feasibility study

To explore interest by health systems policy To explore interest by health systems policy makers in a regional rapid response mechanismmakers in a regional rapid response mechanism

To explore research capacity in regionTo explore research capacity in region

To identify possible models for a health system To identify possible models for a health system information mechanisminformation mechanism

Policy makers want large range of Policy makers want large range of health systems evidencehealth systems evidence

StructureStructure: public-private mix, decentralisation, : public-private mix, decentralisation, services distribution, comparative studiesservices distribution, comparative studies

FundingFunding: sources, health insurance, user-pays, : sources, health insurance, user-pays, budget allocation, payment mechanismsbudget allocation, payment mechanisms

Human resourcesHuman resources: workforce structure, skillmix, : workforce structure, skillmix, training, management, professional training, management, professional development, incentives development, incentives

Policy makers want large range of Policy makers want large range of health systems evidence (2)health systems evidence (2)

RegulationRegulation: technology assessment, prices, : technology assessment, prices, safety and quality, patient safetysafety and quality, patient safety

InformationInformation: technology, performance indicators, : technology, performance indicators, clinical guidelines, patient informationclinical guidelines, patient information

Population healthPopulation health: disease prevention & control, : disease prevention & control, disease patterns, ageing populationsdisease patterns, ageing populations

Health service deliveryHealth service delivery: service planning, needs : service planning, needs of poor, evaluationof poor, evaluation

Findings and conclusionsFindings and conclusions Both policy makers and researchers generally Both policy makers and researchers generally

support the idea of a regional mechanismsupport the idea of a regional mechanism

Varying levels of research capacity and expertise Varying levels of research capacity and expertise across the regionacross the region

Need and demand for reader-friendly productsNeed and demand for reader-friendly products

Need for increasing engagement with policy Need for increasing engagement with policy makers through “knowledge brokers” makers through “knowledge brokers”

Response is usually not rapidResponse is usually not rapid

Information mechanisms offer information and Information mechanisms offer information and (global) evidence, never offer specific advice since (global) evidence, never offer specific advice since policy-making is country-specificpolicy-making is country-specific

Policy makers in Asia and Pacific have less Policy makers in Asia and Pacific have less access to relevant evidence-based access to relevant evidence-based information in health systems information in health systems

Increase capacity for country specific analysisIncrease capacity for country specific analysis

Need for comparative analysis and Need for comparative analysis and information on health systemsinformation on health systems

Rapid changeRapid change in the Asia Pacific Region: in the Asia Pacific Region: eeconomic, demographic, disease patterns and conomic, demographic, disease patterns and rising health care costsrising health care costs

Asia Pacific Observatory on Health Asia Pacific Observatory on Health

Systems and PoliciesSystems and Policies

Country health systems profiles (HiT); Country health systems profiles (HiT); systematic approach allowing country systematic approach allowing country comparisonscomparisons

Policy briefs Policy briefs

Dissemination, including policy dialogueDissemination, including policy dialogue

Capacity building in health systems analysis Capacity building in health systems analysis & policy making& policy making

Strengthened research network in health Strengthened research network in health systemssystems

Functions of an ObservatoryFunctions of an Observatory

Current status and plansCurrent status and plans1.1. Regional Committee request for Regional Committee request for

development of Asia Pacific Observatory on development of Asia Pacific Observatory on Health Systems and Policies Health Systems and Policies

2.2. First planned products are a few HiTs and First planned products are a few HiTs and policy briefspolicy briefs

3.3. Quality products important for long term Quality products important for long term credibilitycredibility

4.4. Focus on functions, institutionalFocus on functions, institutional

5.5. WHO should facilitate and work with WHO should facilitate and work with partnerspartners

Thank you!Thank you!