Towards a better understanding of the nomenclature used in information-packaging efforts to support evidence-informed policymaking in low- and middle-income countries

Background: The growing recognition of the importance of concisely communicating research evidence and other policy-relevant information to policymakers has underpinned the development of several information-packaging efforts over the past decade. This has led to a wide variability in the types of documents produced, which is at best confusing and at worst discouraging for those they intend to reach. This paper has two main objectives: to develop a better understanding of the range of documents and document names used by the organizations preparing them; and to assess whether there are any consistencies in the characteristics of sampled documents across the names employed to label (in the title) or describe (in the document or website) them. Methods: We undertook a documentary analysis of web-published document series that are prepared by a variety of organizations with the primary intention of providing information to health systems policymakers and stakeholders, and addressing questions related to health policy and health systems with a focus on low- and middle-income countries. No time limit was set. Results: In total, 109 individual documents from 24 series produced by 16 different organizations were included. The name ‘policy brief/briefing’ was the most frequently used (39%) to label or describe a document, and was used in all eight broad content areas that we identified, even though they did not have obviously common traits among them. In terms of document characteristics, most documents (90%) used skimmable formats that are easy to read, with understandable, jargon-free, language (80%). Availability of information on the methods (47%) or the quality of the presented evidence (27%) was less common. One-third (32%) chose the topic based on an explicit process to assess the demand for information from policy makers and even fewer (19%) engaged with policymakers to discuss the content of these documents such as through merit review. Conclusions: This study highlights the need for organizations embarking on future information-packaging efforts to be more thoughtful when deciding how to name these documents and the need for greater transparency in describing their content, purpose and intended audience

The global stock of research evidence relevant to health systems policymaking

Background: Policymakers and stakeholders need immediate access to many types of research evidence to make informed decisions about the full range of questions that may arise regarding health systems. Methods: We examined all types of research evidence about governance, financial and delivery arrangements, and implementation strategies within health systems contained in Health Systems Evidence (HSE) (http://www.healthsystemsevidence.org). The research evidence types include evidence briefs for policy, overviews of systematic reviews, systematic reviews of effects, systematic reviews addressing other questions, systematic reviews in progress, systematic reviews being planned, economic evaluations, and health reform and health system descriptions. Specifically, we describe their distribution across health system topics and domains, trends in their production over time, availability of supplemental content in various languages, and the extent to which they focus on low- and middle-income countries (LMICs), as well as (for systematic reviews) their methodological quality and the availability of user-friendly summaries. Results: As of July 2013, HSE contained 2,629 systematic reviews of effects (of which 501 are Cochrane reviews), 614 systematic reviews addressing other questions, 283 systematic reviews in progress, 186 systematic reviews being planned, 140 review-derived products (evidence briefs and overviews of systematic reviews), 1,669 economic evaluations, 1,092 health reform descriptions, and 209 health system descriptions. Most systematic reviews address topics related to delivery arrangements (n = 2,663) or implementation strategies (n = 1,653) with far fewer addressing financial (n = 241) or governance arrangements (n = 231). In addition, 2,928 systematic reviews have been quality appraised with moderate AMSTAR ratings found for reviews addressing governance (5.6/11), financial (5.9/11), and delivery (6.3/11) arrangements and implementation strategies (6.5/11); 1,075 systematic reviews have no independently produced user-friendly summary and only 737 systematic reviews have an LMIC focus. Literature searches for half of the systematic reviews (n = 1,584, 49%) were conducted within the last five years. Conclusions: Greater effort needs to focus on assessing whether the current distribution of systematic reviews corresponds to policymakers’ and stakeholders’ priorities, updating systematic reviews, increasing the quality of systematic reviews, and focusing on LMICs

Dialogue Summary: Fostering Leadership for Health-System Redesign in Canada

A summary of what was learned from a stakeholder dialogue that addressed problems related to leadership for health-system redesign, options for addressing these problems, key implementation considerations, and next steps for fostering leadership for health-system redesign in Canada

Issue Brief: Fostering Leadership for Health-System Redesign in Canada

An assessment of what is known about problems related to leadership for health system redesign, options for addressing these problems, and key implementation considerations. The issue brief was an input to a stakeholder dialogue on the topic of fostering leadership for health system redesign in Canada

Dialogue summary: Reducing emergency-department usage in people with inflammatory bowel disease in provincial health systems in Canada

A summary of what was learned from a stakeholder dialogue that addressed problems related to emergency-department usage in people with inflammatory bowel disease, elements of a comprehensive approach for addressing these problems, key implementation considerations, and next steps for reducing emergency-department usage in people with inflammatory bowel disease in provincial health systems in Canada.IMAGINE SPOR Network, which receives funding from the Canadian Institutes of Health Researc

Processes, contexts, and rationale for disinvestment: a protocol for a critical interpretive synthesis

Background: Practical solutions are needed to support the appropriate use of available health system resources as countries are continually pressured to ‘do more with less’ in health care. Increasingly, health systems and organizations are exploring the reassessment of possibly obsolete, inefficient, or ineffective health system resources and potentially redirecting funds to those that are more effective and efficient. Such processes are often referred to as ‘disinvestment’. Our objective is to gain further understanding about: 1) whether how and under what conditions health systems decide to pursue disinvestment; 2) how health systems have chosen to undertake disinvestment; and 3) how health systems have implemented their disinvestment approach. Methods/Design We will use a critical interpretive synthesis (CIS) approach, to develop a theoretical framework based on insights drawn from a range of relevant sources. We will conduct systematic searches of databases as well as purposive searches to identify literature to fill conceptual gaps that may emerge during our inductive process of synthesis and analysis. Two independent reviewers will assess search results for relevance and conceptually map included references. We will include all empirical and non-empirical articles that focus on disinvestment at a system level. We will then extract key findings from a purposive sample of articles using frameworks related to government agendas, policy development and implementation, and health system contextual factors and then synthesize and integrate the findings to develop a framework about our core areas of interest. Lastly, we will convene a stakeholder dialogue with Canadian and international policymakers and other stakeholders to solicit targeted feedback about the framework (e.g., by identifying any gaps in the literature that we may want to revisit before finalizing it) and deliberating about barriers for developing and implementing approaches to disinvestment, strategies to address these barriers and about next steps that could be taken by different constituencies. Discussion Disinvestment is an emerging field and there is a need for evidence to inform the prioritization, development, and implementation of strategies in different contexts. Our CIS and the framework developed through it will support the actions of those involved in the prioritization, development, and implementation of disinvestment initiatives. Systematic review registration PROSPERO CRD42014013204 Electronic supplementary material The online version of this article (doi:10.1186/2046-4053-3-143) contains supplementary material, which is available to authorized users

Evidence briefs and deliberative dialogues : perceptions and intentions to act on what was learnt

Includes abstracts in French, Spanish, Arabic, Chinese, and RussianEvidence briefs and deliberative dialogues aimed at policy-makers and stakeholders appear to be useful, highly regarded, and lead to intentions to act. The present study is an early attempt to develop better understanding about these relatively new strategies to support the use of research evidence in policymaking. Respondents to the survey generally reported strong intentions to act on what they had learned from evidence briefs. Overall, “not concluding with recommendations” and “not aiming for a consensus” were identified as the least helpful features of briefs and dialogues, respectively

Evidence brief: Achieving greater impact from investments in medicine in Canada

An assessment of what is known about problems related to investments in medicine, options for addressing these problems, and key implementation considerations. The evidence brief was an input to a stakeholder dialogue on the topic of achieving greater impact from investments in medicine in Canada.The evidence brief and the stakeholder dialogue it was prepared to inform were funded by the Ontario SPOR SUPPORT Unit, the Canadian Institute for Health Research and the St. Michael’s Hospital Foundation. Nav Persaud, the principal investigator on these grants, also receives salary support from the Canada Research Chair program, the Department of Family and Community Medicine of St Michael’s Hospital, and the University of Toronto Department of Family and Community Medicine

Examining and Contextualizing Approaches to Establish Policy Support Organizations – A Mixed Method Study

Background: There has been an increase in the number of policy support organizations (PSOs) that have been created to foster the systematic use of evidence in health system policymaking. Our aim was to identify approaches for establishing a PSO or similar entities by soliciting insights from those with practical experience with developing and operationalizing PSOs in real-world contexts. Methods: We used a sequential mixed method approached. We first conducted a survey to identify the views and experiences of those who were directly involved in the establishment of PSOs that have been developed and implemented across a variety of political-, health-and research-system contexts. The survey findings were then used to develop a purposive sample of PSO leaders and refine an interview guide for interviews with them. Results: We received 19 completed surveys from leaders of PSOs in countries across the WHO regions and that operate in different settings (eg, as independent organization or within a university or government department) and conducted interviews with 15 senior managers from nine PSOs. Our findings provide in-depth insights about approaches and strategies across four stages for establishing a PSO, which include: (i) building awareness for the PSO; (ii) developing the PSO; (iii) assessing the PSO to identify potential areas for enhancement; and (iv) supporting maturation to build sustainability in the long-term. Our findings provide rich insights about the process of establishing a PSO from leaders who have undertaken the process. Conclusion: While all PSOs share the same objective in supporting evidence-informed policy-making (EIPM), there is no single approach that can be considered to be the most successful in establishing a PSO, and each country should identify the approach based on its context. © 2022 The Author(s)

Insights from system leaders about operationalising a knowledge translation department in the Oman Ministry of Health

Background: Oman has prioritised enhanced efforts for supporting evidence-informed policymaking (EIPM), including establishing a knowledge translation department in the Omani Ministry of Health (MOH). Aim and objective: Our aim was to gather insights to guide the process of activating this department. Methods: We conducted a document review and in-depth, semi-structured interviews with policymakers, researchers, and stakeholders who are familiar with the Omani system. Findings: We conducted 17 interviews, which highlighted that policymakers in Oman use multiple sources of data and evidence to inform policymaking about health systems. However, several challenges to using evidence were identified, including low quality and limited availability of local evidence, system fragmentation, low interest in research, and lack of skills, capacity and time for finding, synthesising and using research evidence. Five possible activities for the department were refined with participants: building capacity, finding evidence, sparking action, embedding supports, and evaluating innovations. Participants viewed each of these activities as equally important and they should be pursued simultaneously. However, when asked to rank the most important option, participants identified capacity building as the most important to enable cultural changes needed within the MOH. Discussion and conclusions: This study provides insights for activating the knowledge translation department in the Omani MOH. Fully operationalising the department will require convening a codesign process to reach consensus on the scope of the activities undertaken by the department. Implementation will also require capitalising on the relevant experience of highly qualified staff and existing infrastructure as well as continuing to foster a supportive climate for EIPM. © Policy Press 2022