Translating the discoveries of clinical research into practice is vital, as the UK’s Academy of Medical Sciences says in a recent report. But what do doctors in developing countries face in trying to keep up with the task? In this article, the authors say the challenges are legion. Medical academics in the developing world tend to work far from clinics. They often teach huge classes and bear heavy workloads, and struggle with poor salaries and little access to new findings in biomedicine. The research they conduct is all too often underfunded and irrelevant to national needs.
Monitoring equity and research policy
Medical research: a third-world casualty?
The Ugandan success story? Evidence and claims
Uganda is widely regarded as an HIV/AIDS success story, but the reality of this claim has rarely been critically investigated. Although evidence-based medicine is increasingly important, analysis of the Ugandan epidemiological situation shows that the so-called proof accepted for policy recommendations can be subject to creative interpretation. There are several policy lessons that can be learned from the response to HIV/AIDS in Uganda, where declining prevalence rates of HIV-1 have been reported in a number of surveillance sites around the country since 1992. (This article requires registration.)
how to bridge the gap between research results and provider practices
Network Vol. 23, No. 1 is now online. This issue of Family Health International\'s (FHI) scientific bulletin focuses on how to bridge the gap between research results and provider practices
A gap often exists between research findings and the desired outcome of putting them into use to improve health service delivery, policies, and practices. But this issue of Network highlights several factors that can facilitate the speed and ease of moving research to practice. How various factors can coincide to produce rapid utilization of research findings is illustrated by acceptance of the antiretroviral nevirapine to prevent mother-to-child transmission of HIV in the developing world.
non-communicable diseases ignored by policy makers
The growing global burden of non-communicable diseases in poor countries and poor populations has been neglected by policy makers, major multilateral and bilateral aid donors, and academics. Despite strong evidence for the magnitude of this burden, the preventability of its causes, and the threat it poses to already strained health care systems, national and global actions have been inadequate. A full range of policy responses is required from government and non-governmental agencies, but unfortunately the capacity and resources for this response are insufficient, and governments need to respond appropriately.
The Ugandan success story? Evidence and claims
Uganda is widely regarded as an HIV/AIDS success story, but the reality of this claim has rarely been critically investigated. Although evidence-based medicine is increasingly important, analysis of the Ugandan epidemiological situation shows that the so-called proof accepted for policy recommendations can be subject to creative interpretation. There are several policy lessons that can be learned from the response to HIV/AIDS in Uganda. (registration needed)
An Annotated Bibliography on Policy Processes
Overseas Development Institute
The term 'policy process' is based on the notion that policies are formulated and implemented in particular social and historical contexts, and that these contexts matter - for which issues are put on the policy agenda, for the shape of policies and policy institutions, for budget allocations, for the implementation process and for the outcome of the policies. The idea of 'policy process' stands opposed to that of 'policy as prescription', which assumes that policies are the result of a rational process of problem identification by a benevolent agency (usually the state). While the 'policy as prescription' approach is still important - both in much of the public administration literature as well as in the heads of many policy-makers - there is a fast expanding body of literature that analyses, explains or conceptualises the process dimensions of policy. This literature is a blend of political science, sociology and anthropology. It does not assume that policies are 'natural phenomena' or 'automatic solutions' resulting from particular social problems and it does not privilege the state as an actor fundamentally different from other social actors. The why, how and by whom questions are treated as empirical questions; it is only concrete empirical research that can generate the answers. It is this body of literature that is included in this bibliography.
POWER, KNOWLEDGE AND POLITICAL SPACES IN THE FRAMING OF POVERTY POLICY
This paper explores the dynamics of the making and shaping of poverty policy. It begins with a critique of linear versions of policy-making, highlighting the complex interplay of power, knowledge and agency in poverty policy processes, arguing that the policy process involves a complex configuration of interests whose interactions are shaped by power relations.
MAINSTREAMING THE POVERTY-REDUCTION AGENDA
Several African governments have in recent years set themselves ambitious poverty reduction strategies. What impact have the institutional mechanisms had for mainstreaming the goal of poverty-reduction into processes of government decision-making? Preliminary findings from current research on institutional and process issues in national poverty policy at IDS suggests that practice on policy processes and institutions relating to poverty reduction has improved. In many sub-Saharan African countries, there has been considerable progress in information collection about poverty levels, characteristics and trends and, increasingly, an attempt to find mechanisms to ensure that the evidence on poverty informs the design of policy. Perhaps the most fundamental evidence of a heightened focus on poverty reduction in policy concerns the extent to which it is identified as a priority in a country’s national development strategy.
ADHERENCE TO LONG-TERM THERAPIES: EVIDENCE FOR ACTION
World Health Organisation - 2003
Adherence to therapies is an indicator of inequities as well as access to drugs. In average, 50% of patients in developed countries do not take their prescribed medicines after one year, despite having full access to medicines. In developing countries it is even worse, due to poor access to health services, medicines, lack of education and unhealthy lifestyles, which especially affects the poorest populations. Intended for policy-makers, health managers, and clinical practitioners, this report provides a concise summary of the consequences of poor adherence for health and economics. It also discusses the options available for improving adherence, and demonstrates the potential impact on desired health outcomes and health care budgets. It is hoped that this report will lead to new thinking on policy development and action on adherence to long-term therapies.
Assessing capacity for health policy and systems research in low and middle income countries
Health Research Policy and Systems 2003 1:1
Health policy and systems research (HPSR) is increasing in prominence in low and middle income countries, stimulated by social and political pressure towards health system equity and efficiency. Yet the institutional capacity to fund and produce quality research and to have a positive impact on health system development has been little examined and touches mainly on specific areas such as malaria research or the impact of research on health reforms. This paper seeks to develop an empirical basis for assisting decisions on what are likely to be good investments to increase capacity in health policy and systems research (HPSR) in developing countries.