ISSUE N° 21 July 2011



Strengthening access to medicines policy research Update on inception year International collaboration for synthesizing HSR Implementation Research Platform: Results of the call for letters of intent for evidence synthesis Spotlight on Alliance grantees: Sponsoring National Processes Alliance HPSR-EVIPNet Americas workshop Developing policy briefs and deliberative dialogues, Santiago, Chile, March 2011 Bulletin Board

1. Strengthening access to medicines policy
research - Update on inception year
There have been a number of important achievements, challenges and lessons learnt since the launch of the Alliance’s Access to Medicines (ATM) policy research programme in May 2010. Now an essential component of the Alliance’s research initiatives, the ATM programme has made important accomplishments in priority identification, and synthesis work. Among its recent achievements: > the identification of a priority health policy and systems research agenda for ATM in 19 low- and middle-income countries (LMICs) across 5 regions; > the synthesis of existing evidence on access to medicines in relation to medicines governance, financing, medicines for chronic conditions and for maternal health; > the design of a framework providing a system-wide definition for access to medicines highlighting the complex interaction between medicines and other elements of the health system; > the creation of a core network of researchers with the capacity to undertake HPSR to improve access to medicines. Ongoing work includes the production of five policy briefs: medicines’ pricings in low-income countries; medicines’ financing in low-income countries; access to medicines for diabetic patients in Cambodia; good governance in medicines and the use of magnesium sulfate for eclampsia and pre-eclampsia in Pakistan. As a new programme, ATM also faced a number of challenges and learned a variety of important lessons: These included: > adopting a health systems approach to medicines issues is of particular difficulty, and requires new and innovative approaches. A particular challenge lies in accessing or breaking the “pharmaceutical silo”; > the capacity of institutions to undertake this type of research is extremely limited, making the composition of multidisciplinary teams a persistent challenge; > the capacity of researchers to adopt a wider health systems perspective on medicines issues is limited, especially in lower-income countries; > in some countries, broader questions such as stewardship over the private sector, medicines governance or medicines financing are especially sensitive. This situation poses potential obstacles for both field research and knowledge translation approaches.

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the programme intends to strengthen the core network of researchers and policy-makers. . Lastly. exploring the dynamic relationships between medicines and the rest of the health system. November 2009. Representatives of this Working Group summarized 2 JULY 2011 – ISSUE N° 21 the foregoing discussions and preliminary recommendations during a concurrent session at the First Global Symposium on HSR in Montreux. the Alliance organized a session at the Global Forum for Health Research in Cuba. The Alliance should: > play a central role in advancing the science of HSR synthesis by developing and strengthening networks between individuals and institutions.The Alliance intends to build upon its early achievements with the ATM programme. Geneva. April 2011 2. October 2010. Since 2009. collaborations and groups that have an interest in HSR synthesis and knowledge translation. As a first step to this end. understanding and potentially applying the best available evidence. This includes plans to continue generating relevant knowledge in neglected areas of HPSR in the ATM field – knowledge infused with the health systems approach. the Working Group made the following recommendations. navigating through some of the challenges mentioned thus far. Workshop participants. in response to which the Alliance received more than 15 submissions. attracting additional stakeholders and strengthening the ATM community of practice. This document fed into the discussions of the Working Group on HSR Synthesis meeting at the UK’s Department for International Development (DFID) in London. In addition. A consultation document was produced. Researchers gathered in Geneva for a workshop on 19 and 20 April 2011 to discuss the achievements to date and brainstormed on the next phase of the project. the Programme aims to identify existing evidence-to-policy gaps and then support evidence- to-policy and implementation research activities to address these gaps. Following this intensive collaboration. International collaboration for synthesizing HSR A systematic review (or synthesis) on a health system research (HSR) topic can greatly assist policy-makers in accessing. the Alliance has led a consultative process exploring its potential role in generating and facilitating an international collaboration for synthesizing HSR. the Alliance hosted a breakfast meeting with representatives of the Working Group and members of relevant review groups within the Cochrane Collaboration. November 2010. Secondly.

while also achieving the following objectives: 1. > advocate and support a dynamic global database for all types of systematic reviews of HSR.). Feasibility to complete the systematic review. Improve methodologies for the synthesis of evidence on scaling up implementation of interventions. > advocate for and support the prospective registration of all protocols for systematic reviews when they are planned. In response to the call. time frame and budget. 107 LOIs were received. Based on this rigorous assessment. the top 20 LOIs were requested to submit full proposals. Develop improved tools for communicating evidence synthesis documents to stakeholders such as policy makers and the wider public as appropriate. If you have comments on this document. and within.> provide overall support. the Department of Child and Adolescent Health and Development of the WHO. the next table shows the top 11 proposals. which were ultimately selected for funding. please forward them to Kent Ranson at ransonm@who. > pilot a system for producing demand-driven syntheses and systematic reviews of HSR addressing questions beyond effectiveness. information sharing and potential coordination related to: setting priorities for HSR synthesis regionally and globally. and screened by the IRP Secretariat (represented by the Alliance. including the capacity of the team to actually conduct the review. Development and Research Training in Human Reproduction and the Special Programme for Research and Training in Tropical Diseases. a call was issued to promote synthesis of evidence on strategies to implement interventions in October 2010. This criterion sought to assess the clarity of the research questions. especially to accelerate progress towards MDGs 4. the Deparment of HIV/AIDS of WHO. In particular. the Special 3 JULY 2011 – ISSUE N° 21 Programme of Research. The proposal’s relevance to the specific objectives of the call and the general aims of the Implementation Research Platform. 5 or 6.5. A full description of this process and the recommendations are available at: http://www. 2. This criterion weighed the adequacy and appropriateness of the proposed plan. 3. 2. Strengthen institutional research synthesis capacity with an emphasis on low. along with the proposal’s choice of search strategy and methodology for appraising the studies. this criterion sought to assess the proposal’s potential contribution to provide evidence on best ways of scaling up effective interventions and/or services in and innovations to overcome these barriers will contribute to the overall scope of the Implementation Research Platform. Quality of the proposed review/scientific merit. and capacity building in HSR synthesis and knowledge translation (both relevant to. Following the initial screening. LMICs). . Implementation Research Platform: Results of the call for letters of intent for evidence synthesis As part of the Implementation Research Platform (IRP). > explore expanding the range of study designs that can be included in reviews of the effectiveness of HSR interventions.who. These proposals were then reviewed and evaluated by a Scientific Committee of ten external experts on the following criteria: 1. The purpose of the call is to support evidence synthesis that contributes to the understanding of the state of knowledge on strategies for implementation and wider scaling-up of effective health interventions and health services relevant to the Millennium Development Goals (MDGs) 4. 3. These syntheses of studies addressing the various barriers and enablers to the implementation of effective interventions.and middleincome countries. or 6.

which is leading this project has conducted two capacity building workshops. University of Cape Town Health Care Department of Interdisciplinary Health Sciences Faculty of Health Sciences. Colombo Center for Evidence-based Global Health Country Iran Project Title Task-shifting to improve access to health care providers: systematic review of qualitative research on barriers and facilitators to the substitution of doctors with nurses Task-shifting to improve access to health care providers: Systematic review of qualitative research on barriers and facilitators to the implementation of lay health worker programmes Home. The Aga Khan University Karachi University of Jayewarenpura. Spotlight on Alliance grantees: Sponsoring National Processes Background One of the Alliance’s core objectives is to promote the dissemination and use of health policy and systems knowledge. the Alliance supported six projects in low. Taryn Young South Africa Luis Huicho Stephen Mutwiwa Peru Kenya Systematically synthesizing IMCI implementation: what works for whom and in what circumstances? Effectiveness of mobile telephone services to improve maternal and neonatal health in low. School of Public Health and Family Medicine. Peking University Hope International College. The following table lists these projects.and middleincome countries to achieve Millennium Development Goals (Review) What are the strategies for implementation and up–scaling of Innovative Community Interventions (ICI) for prevention. Cameroon The specific objective of this project is to promote the use of relevant HPSR-based evidence to inform the transitioning towards a Health Sector-Wide Approach (SWAp) in Cameroon. This Newsletter puts the spotlight on the projects from Cameroon and Nigeria. which purposes were to increase the participant’s skills in writing 4 JULY 2011 – ISSUE N° 21 . Affiliate Centre of the Joanna Briggs Institute Department of Obstetrics and Gynaecology. care and referral of Maternal and Neonatal Health (MNH) services in fragile states? Yeetey Enuameh Ghana Nadeem Faiyaz Zuberi Kumudu Wijewardena Olalekan Uthman. The Centre for Development of Best Practices in Health. Kenya Kintampo Health Research Centre.and middle-income countries Facilitators and barriers to interventions aimed at reducing unintended pregnancies among adolescents in low. Stellenbosch University. Cape Town Universidad Peruana Cayetano Heredia The great Lakes of Kisumu (Gluk).and middle-income countries Quality of care: effectiveness of strategies for health systems responsiveness (HSR) during intrapartum care in low.and middle-income countries Synthesis of evidence on strategies applied to optimize health worker roles (task shifting/sharing) to address MDG 5 in Small Island States Comparative Efficacy of Behavioural Interventions for the prevention of Heterosexual Acquisition of HIV in sub-Saharan Africa: A systematic review and Bayesian network meta analysis Strategies for improving attraction and retention of health workers in rural and remote areas in low. in December 2009 and June 2010. Satdobato China Sarita Panday Nepal 4. Lalitpur. 1.Name of the PI Affiliation Arash Rashidian National Institute of Health Research. Tehran University of Medical Sciences Centre for Infectious Disease Epidemiology and Research.or community based treatment of malaria with ACTs in malaria endemic areas Christopher Colvin South Africa Charles Okwundu.and middleincome countries under the programme of “Sponsoring National Processes”. To fulfil this objective. University of Yaoundé. Bolaji Emmanuel Egbewale Xiaoyun Liu Pakistan Sri Lanka Nigeria China Centre for Health Development Studies.

implementation and evaluation of individual staff skills and institutional incentives for capacity enhancement in health policy and systems research evidence use in policy making in Nigeria Developing a knowledge translation platform for health policy and systems research in Zambia Prospective evaluation of evidence-informed decision making Duration June 2009January 2011 March 2009November 2011 March 2009April 2011 April 2009November 2011 Centre for the Implementation of Argentina Public Policies Promoting Equity and Growth (CIPPEC) ICDDR. The project team synthesized and packaged research evidence on identified priority topics. > Scaling up malaria control interventions. > Fostering stakeholders’ involvement for better governance and speeding up district development. Centre for Health System Zambia March 2009July 2011 July 2007April 2011 Kyrgyzstan policy briefs and using evidence. Yaoundé. College of health Sciences. scaling up malaria control activities and scaling up enrolment in community-based Workshop participants. Cameroon. These briefs were then shared with the Ministry of Health and the technical Secretariat of the Steering Committee of the health sector strategy. The titles of the policy briefs are as follows: > Scaling up enrolment in community based health insurance.Name of the PI Affiliation Dr Daniel Maceira Dr Alejandro Cravioto Country Project Title Promoting the generation of coordinated provincial health protection: A collective process Bridging the know-do gap: Strategies to enhance the capacity to apply health policy and systems research into evidenceinformed policy making in Bangladesh Transition towards a health SWAP in Cameroon: Supporting evidence use for decentralization and district development Development.B Bangladesh Dr Pierre Ongolo-Zogo Dr Chigozie Uneke Centre for Development of best practices in health (CDBPH). The Centre also convened a priority setting workshop in March 2010 to identify the priority issues relevant to Cameroon. researchers and civil society representatives. Workshops’ participants included Ministry of Health officials. University of Yaoundé Innovative Health Research Group. These policy briefs were discussed in two deliberative forums which focused on two main priority issues. with four policy briefs developed in both English and French. > Improving health system information for district development. March 2010 5 JULY 2011 – ISSUE N° 21 . Ebonyi State University Cameroon Nigeria Dr Joseph Kasonde The Zambian Forum for Health Research (ZAMFOHR) Dr Gulgun Murzalieva Health Policy Analysis Unit.

equipments and technologies in Nigeria. to promote dialogue and discussion between policy-makers. The titles of the policy briefs are as follows: > Strengthening the generation/ strategic use of health information and evidence for health systems operations and policy-making in Nigeria. efficiency and performance of the health workforce in Nigeria. researchers and other major stakeholders in Ebonyi to allow access to the resources on research evidence. availability and efficiency in the use of health financial resources. civil society organizations. These policy briefs were discussed with the policymakers. Nigeria In Nigeria.cdbph. 2. Identified strategies and solutions were to improve both individual and organizational capacity. December 2009 6 JULY 2011 – ISSUE N° 21 .int/alliance-hpsr. 3. The research team organized a workshop in July 2009 with 73 participants including high. The policy briefs are available for download on the Alliance web site: http://www. > A group based mentorship programme. The specific aim of the project is to build the capacity of policy-makers to make critical choices by promoting the transfer and uptake of research evidence into policy and practice. a multidisciplinary health policy and systems research team based in Ebonyi State University is leading the Alliance project in Nigeria.who. The Centre produced a web site: http://www. Policy briefs: The research team produced six policy briefs corresponding to WHO’s health systems “building blocks”. stakeholders. the team used two strategies to address these: > A series of six capacity building workshops. For more information on these projects. > Enhancing the distribution. media and other stakeholders. > Ensuring availability and equitable access to essential medical products. Nigeria. particularly in promoting networking among Workshop participants. > Ensuring effective leadership and governance to enhance the performance of the health systems in Nigeria. The primary issues identified included capacity constraints for evidence uptake and weak organizational capacity in information technology. An assessment of individual staff skills. > Strengthening the organization. > Improving national_processes/en/index. health professional insurance. access and quality of health service delivery in Nigeria. and presenting research evidence to policy-makers to facilitate its utilization.and mid-level health policy-makers. The main activities done by the centre are the following: 1. researchers.html 2. The policy briefs were later presented to the government through the Honourable Commissioner for Health. the Knowledge Translation (KT) Platform. mobilizing resources for research. Further to the identification of the participants’ capacity constraints. dissemination of research results and getting feedback. institutional incentives and organizational capacity in health policy and systems research evidence use was done using both a quantitative and qualitative survey.who. Ebony State. see the web site: http://www.

each country team worked on the production of a draft policy brief. Bolivia. Chile. 7 JULY 2011 – ISSUE N° 21 . and Trinidad & Tobago) participated in the workshop.Developing policy briefs and deliberative dialogues. The topics identified in the policy briefs were based on countries health priority needs. the draft policy briefs will be refined and virtual support will be carried out by the group of facilitators and the EVIPNet Secretariat. March 2011 Workshop participants. Mexico-USA border. Eight EVIPNet teams (Bolivia. Santiago. Ecuador. The finalized briefs will be presented to relevant policy-makers by country teams. A web platform has been developed at http://evipnet. > support the teams to convene and evaluate national policy dialogues where the policy briefs could be further discussed . The evaluation showed the workshop to be very to support the teams. The deliberations during the workshop resulted in approving a policy brief template that will be used by the teams and a common evaluation framework. As a follow-up to the workshop. The workshop was organized by the Health Policy and Systems Research Unit of the Pontificia Universidad Católica de Chile and by the EVIPNet Americas. Paraguay. The workshop aimed to: > strengthen the skills and capacities of EVIPNet Americas teams to produce and evaluate policy briefs. March 2011 The Alliance HPSR supported a capacity building workshop from 7 to 11 March 2011 in Santiago. The general approach to capacity building was “learning by doing”. Brazil. Chile. Chile. Each team aims to deliver policy briefs in the coming months and organize policy dialogues. Brazil and Ecuador worked on the reduction of maternal mortality. Alliance HPSR . For instance. Chile. It is expected that through this Alliance-supported workshop.ning. participating countries will increasingly demonstrate interest in collating evidence and presenting it to policy and decision-makers of their respective countries. Peru. and > develop a “train-the trainer” strategy to build capacity in the region. Santiago.Evidence-Informed Policy Network (EVIPNet) Americas Workshop .5. During the workshop.

1 to 3 November 2012. the Alliance has revamped its web site to showcase its work in a more user-friendly format. Ghana Health Service. United Nations Population Fund. United Kingdom Sennen Hounton.inrud. Accra. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. while also providing a more in-depth and accessible look at its projects and partners. Hamilton. Bangkok. Stockholm. Designed by paprika-annecy. Errors and omissions excepted. especially for vulnerable populations. World Health Organization. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. Stockholm. 1211 Geneva 27. Karolinska Institute. Publications of the World Health Organization can be obtained from WHO Press. Heartfile. It is expected that more than 2. France Printed in Switzerland 3rd International Conference for Improving Use of Medicines The Third International Conference for Improving Use of Medicines. Turkey from 14 to 18 November 2011. 20 Avenue Appia. funders and other stakeholders will attend. > a section dedicated to promoting HPSR Calls for Proposals. Ghana Lucy Gilson. Johns Hopkins Bloomberg School of Public Health. Norwegian Knowledge Centre for the Health Services. entitled “Informed Strategies. Switzerland Tel. city or area or of its authorities. China. Save the date! Beijing. > an expanded array of HPSR publications and resources. Norway Maria-Teresa Bejarano. Department for International Development. McMaster University. email: bookorders@who. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Fax : +41 22 791 48 17 E-mail: or concerning the delimitation of its frontiers or boundaries. South Africa. Call for abstracts will open 1 November BOARD John-Arne Røttingen (Chair). United States of America Soonman Kwon. School of Public Health. India Göran Tomson. South Korea John Lavis. Switzerland Malcom McNeil. Following extensive consultation with its partners and stakeholders. In no event shall the World Health Organization be liable for damages arising from its use. visit: http://www. Effective Policies. World Health Organization. Lasting Solutions” will take place in : +41 22 791 29 73. Islamabad. from peer-reviewed papers to policy briefs and multimedia. Swedish International Development Cooperation Agency. Canada Prasanta Mahapatra. London School of Hygiene and Tropical Seoul National University. Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press. Bulletin Board New web site The Alliance is pleased to announce its restructured web site (http://www. New York. Its focus will remain on presenting and summarizing knowledge about ways to improve medicines use and health. > an inventory of HPSR short courses and tutorials. Switzerland (tel: +41 22 791 3264. For more information.who. Alliance HPSR web site: www. ALLIANCE FOR HEALTH POLICY AND SYSTEMS RESEARCH WORLD HEALTH ORGANIZATION World Health Organization CH-1211 Geneva 27. United States of America Somsak Chunharas. the names of proprietary products are distinguished by initial capital letters. Pakistan SCIENTIFIC TECHNICAL ADVISORY COMMITTEE (STAC) Irene Akua Agyepong (Chair). Institute of Health Systems. at the above address (fax: +41 22 791 4806. The conference will be highly interactive and designed to produce actionable results.who.6. the published material is being distributed without warranty of any kind. 2nd Global Symposium on Health Systems Research: Inclusion and Innovation Towards Universal Health Coverage. Sweden Sara Bennett. The sequence of half-day sessions will be organized around different levels of the health care system. email: permissions@who. National Health Foundation. Participants will help to shape evidence-based policy recommendations and a future research agenda on these topics. fax: +41 22 791 4857. territory. Watch our web site for more information! . The responsibility for the interpretation and use of the material lies with the reader. University of Cape Town. Geneva. Sweden ISSN 1819-4648 © WORLD HEALTH ORGANIZATION 2011 All rights reserved. Oslo. However. either expressed or implied. United Kingdom Sania Nishtar. Thailand Carissa Etienne.000 participants including researchers. The new web site now includes: > overviews of all Alliance-funded projects since 2005. > profiles of Alliance partner organizations.

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