A major obstacle to the progress of the Millennium Development Goals has been the inability of health systems in many low- and middle-income countries to effectively implement evidence-informed interventions. This paper looks at the relationships between implementation research and knowledge translation and identifies the role of implementation research in the design and execution of evidence-informed policy. After a discussion of the benefits and synergies needed to translate implementation research into action, the authors consider how implementation research can be used along the entire continuum of the use of evidence to inform policy. The paper provides specific examples of the use of implementation research in national level programmes by looking at the scale up of zinc for the treatment of childhood diarrhoea in Bangladesh and the scaling up of malaria treatment in Burkina Faso. A number of tested strategies to support the transfer of implementation research results into policy-making are provided to help meet the standards that are increasingly expected from evidence-informed policy-making practices.
Monitoring equity and research policy
Online, open access (OA) medical publishing has provided new opportunities for increased transparency and innovation in clinical trial reporting, which if widely adopted can ultimately help enhance the quality and reliability of evidence, argue the authors of this article. They discuss the OA movement’s role in medical research and provide an up-to-date analysis of recent initiatives and trends. Access to original research remains the driving force behind OA, recently exemplified in the United States by a Whitehouse petition for open access publication of tax-funded research as well as the negative reaction to the controversial Research Works Act, which would restrict sharing data between researchers. Meanwhile the British government has also announced its support for OA. Improving availability of data, increasing access to research in developing countries and creating new services for easier location and reuse of clinical information are all priorities for the future and can contribute to the advancement of clinical medicine, according to the article.
In the past few years there has been an ongoing debate as to whether the proliferation of open access (OA) publishing would damage the peer review system and put the quality of scientific journal publishing at risk. The aim of this study was to inform this debate by comparing the scientific impact of OA journals with subscription journals, controlling for journal age, the country of the publisher, discipline and (for OA publishers) their business model. A total of 610 OA journals were compared with 7,609 subscription journals using Web of Science citation data, while an overlapping set of 1,327 OA journals were compared with 11,124 subscription journals using Scopus data. Results showed that average citation rates were about 30% higher for subscription journals. However, after controlling for discipline (medicine and health versus other), age of the journal and the location of the publisher (four largest publishing countries versus other countries) the differences largely disappeared in most subcategories except for journals that had been launched prior to 1996. In medicine and health, OA journals founded in the last 10 years are receiving about as many citations as subscription journals launched during the same period.
The 20th anniversary of the report of the Commission on Health Research for Development inspired a Symposium to assess progress made in strengthening essential national health research capacity in developing countries and in global research partnerships. Significant aspects of the health gains achieved in the 20th century are attributed to the advancement and translation of knowledge, and knowledge continues to occupy center stage amidst growing complexity that characterizes the global health field. The way forward is argued to entail a reinvigoration of research-generated knowledge as a crucial ingredient for global cooperation and global health advances. The authors argue that this needs to overcome in the divides between domestic and global health, among the disciplines of research (biomedical, clinical, epidemiological, health systems), between clinical and public health approaches, public and private investments, and between knowledge gained and action implemented.
As the urban population of the planet increases, putting new stress on infrastructure and institutions and exacerbating economic and social inequalities, public health and other disciplines are being forced to find new ways to address urban health equity. The authors propose that urban indicator processes focused on health equity can promote new modes of healthy urban governance, where the formal functions of government combine with science and social movements to define a healthy community and direct policy action. An inter-related set of urban health equity indicators that capture the social determinants of health, including community assets, and to track policy decisions, can help inform efforts to promote greater urban health equity. Adaptive management, a strategy used globally by scientists, policy makers, and civil society groups to manage complex ecological resources, is a potential model for developing and implementing urban health equity indicators. While urban health equity indicators are lacking and needed within cities of both the global north and south, the authors warn that universal sets of indicators may be less useful than context-specific measures accountable to local needs.
This document presents the context, including mapping of key actors and their capacity in relation to health policy and systems analysis (HPSA) research and teaching and their potential implications on capacity of the University of Ghana School of Public Health (UG-SPH) in HPSA research and teaching, networking and getting research into policy and practice (GRIPP). It assesses the capacity needs at the organizational and individual levels within the UG-SPH in relation to HPSA research and teaching and getting research into policy and practice.
Coinciding with the International Day against Drug Abuse and Illicit Trafficking, the WHO launched its Global Health Observatory Database – Resources for the Prevention and Treatment of Substance Use Disorders. This global information system maps and monitors health system resources at the country level to respond to the health problems due to substance use. The system provides data for each of the assessed countries, such as funding, staff and services, and thereby complements already available information on the scope and associated harms of substance use disorders. The country profiles included in the new system cover 147 countries, which is 88 per cent of the world’s population. Current estimates indicate that worldwide, about 230 million adults aged 15-64 – or five per cent of the world’s adult population – used an illicit drug at least once in 2010, including about 27 million people with severe drug problems.
For many sub-Saharan African countries, a National Health Research System (NHRS) exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, the authors discuss the ongoing development of Zambia's NHRS. They reflect on their experience in the ongoing consultative development of Zambia's NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. Their critical argument is that three streams of concurrent activity are central to developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system's boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonise, unify and strengthen the overall capacities of the research community.
Health system resilience and capacity for emergency risk management are critical to effective disaster management supporting sustainability goals. That is one of the key messages emerging from this paper by the World Health Organisation (WHO). WHO also found that monitoring and reporting on the human health aspects of disasters are important for strengthening disaster risk management, and should be included in government measures to improve risk assessment, prevention, preparedness response and recovery from disasters. This will help reduce health impacts, particularly the loss of human lives, WHO argues. Building health system resilience and capacity for emergency risk management, particularly at a community level, is also critical to effective disaster management, which also supports wider sustainability objectives. Indicators of health system resilience to natural disasters include the proportion of health facilities, new and improved, to withstand hazards, including access to reliable clean energy and water supplies, daily and in emergencies.
Many food-related diseases and conditions – including undernutrition, micronutrient deficiency, and obesity as well as food safety risks and farmworker health – are interlinked, according to this report. Sustainable food policies that place the promotion and protection of health at the core of strategies from the farm field to the dinner plate can help advance the provision of sustainable, quality foods for all, across the supply chain and the human life-cycle, the World Health Organisation (WHO) argues. WHO offers three health indicators that can be used to monitor progress. 1. Health outcomes: prevalence of anaemia in women of reproductive age; prevalence of stunting in children under 5 years; and prevalence of obesity in children under five and in adults. 2. Food access and dietary quality in association with sustainable foods production: adequate access to protein supply; excessive adult saturated fat consumption; household dietary diversity; and prevalence/incidence of foodborne disease outbreaks. 3. Food market/trade policies supporting health and sustainability: foods that comply with international food safety standards, including hormone, pesticides and antibiotic residues; number of countries that have phased out use of antibiotics as growth promoters; and assessment of health and sustainability impacts in agricultural trade negotiations, policies and plans.