Health impact assessment differs from other purposes for which evidence is collated in a number of ways. This has implications for commissioning and conducting reviews. Methods must be developed to: facilitate comprehensive searching across a broad range of disciplines and information sources; collate appropriate quality criteria to assess a range of study designs; synthesise different kinds of evidence; and facilitate timely stakeholder involvement. Good practice standards for reviews are needed to reduce the risk of poor quality recommendations. Advice to decision makers must make explicit limitations resulting from absent, conflicting, or poor quality evidence.
Monitoring equity and research policy
"...As studies have shown, evidence is rarely applied to decision making in accordance with a rational, linear model. In practice, evidence is often generated through doing – in the enactment of policy. Evidence may be only one component of any decision making process, but it can be made an integral part of a culture of inquiry based on continual learning and development. Leaders and managers need to appreciate the complex relationship between research evidence and practice, and to ensure the right conditions are created to allow practitioners to reflect on, and learn from, the practice of what they do and how they do it. In this way, learning becomes a supply of evidence to be drawn on as practitioners continue to implement and reshape policy..."
How do health policies spread from one country to the next? Transfer without ownership may make implementation difficult. Researchers from the London School of Hygiene and Tropical Medicine look at the development of international policy on tuberculosis (TB) control over the last two decades. Do policy-makers adopt and adapt health policies voluntarily, after learning about experiences in other countries, or do international organisations or donors more often impose policies? The researchers posed these and other questions during interviews with 40 key players in TB policy development.
Lessons from medical research may take years to get through to the frontline of healthcare. This is exacerbated in developing countries where there are difficulties in dissemination and barriers that prevent healthcare providers acting on new findings. Furthermore, most biomedical research is in high-income countries, and the results are not necessarily applicable in low-income countries. This is a according to a meeting at the Royal College of Physicians in London in January that explored these issues under the topics of ‘Dynamics and barriers; Systematic reviews: do they have a role?’; and ‘Recent changes in healthcare information and emerging challenges’.
The objective of this World Health Organisation report is to describe strategies to reduce global disparities in health through improvements in health research systems at national and international levels and systematic application of evidence-based knowledge. The Report focuses on bridging of the "know do" gap, the gulf between what we know and what we do in practice, between scientific potential and health realization. The bridging of this gap is central to achieving the health-related Millennium Development Goals (MDG’s) by 2015. The gap exists for each of the MDG’s and represents a fundamental and pragmatic knowledge translation challenge that must be addressed to strengthen health systems performance towards achieving the MDG’s.
This article explores how health research can be improved to ensure that its results are translated into action. It is based on the author's experience of health research on HIV/AIDS in South Africa. The article argues that the question of how to translate health research into action should be broken down into four questions: How relevant is the project to health sector development in the short and in the long-term? Are all relevant stakeholders integrally involved in all stages of the research process? Are there skills development or capacity building aspects in the project? What are the strategies for dissemination of the research results?
How do health policies spread from one country to the next? Transfer without ownership may make implementation difficult. Researchers from the London School of Hygiene and Tropical Medicine look at the development of international policy on tuberculosis (TB) control over the last two decades. Do policy-makers adopt and adapt health policies voluntarily, after learning about experiences in other countries, or do international organisations or donors more often impose policies? The researchers posed these and other questions during interviews with 40 key players in TB policy development.
Decision-makers in countries around the world face a series of common problems as they aim to make appropriate choices to improve the performance of their health systems. With eight per cent of the world's economic output invested in health systems, the way these systems are organized to collect resources and transform them into services for people in need can profoundly influence health outcomes for populations. Yet the scientific evidence-base to inform critical health system decisions is much weaker than the evidence-base to inform individual clinical decisions. This volume reports on a large body of work led by the World Health Organisation that is intended to strengthen the foundations for evidence-based policies aimed at health systems development.
This article explores how health research can be improved to ensure that its results are translated into action. It is based on the author's experience of health research on HIV/AIDS in South Africa. The article pays particular attention to dissemination, and it argues that the most common approach to information dissemination adopted by research organisations, passive dissemination of information in the form of research reports and policy recommendations, is largely ineffective.
The purpose of this report was to assess the application of clinical predictors for the diagnosis of the HIV infections, including AIDS, among TB-positive subjects enrolled within an urban heterosexual sero-discordant couple (one partner HIV-positive and the other HIV-negative) cohort study at an HIV prevention and research centre in Lusaka, Zambia. The report documents the relative effectiveness of the World Health Organisation clinical case definition for HIV/AIDS (WHOCCDA) in predicting HIV/AIDS cases and discusses the health and policy implications.