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EVIPNet’s pragmatic efforts to directly support evidence-informed health systems have focused primarily on regional and national capacity-building activities to produce and plan the evaluation of policy briefs and secondarily on organizing and planning for the evaluation of national policy dialogues at which the policy briefs are discussed. In keeping with a ‘learning by doing’ approach and learning together to better work together in a sustainable, empowered way, both a senior policymaker or programme officer and a researcher from each country team produce a draft policy brief about how to address one of many current policy challenges. For instance, representatives of six EVIPNet Africa countries (Burkina Faso, Cameroon, Central African Republic, Ethiopia, Mozambique, and Zambia) and from the East African Community participated in a workshop in February 2008, in Addis Ababa to produce a draft policy brief about how to address one of many current policy challenges: how to support the widespread use of artemisinin-based combination therapies (ACT) to treat uncomplicated falciparum malaria in their respective countries. They are currently in the process of reviewing and finalizing the policy brief.
EVIPNet country teams and expert members of its Resource Group provide opportunities for:
- identifying priority policy issues and questions;
- checking the quality of available systematic reviews, guidelines, and other relevant research results to help identify and/or formulate policy options that better address health systems issues. In this process, country teams then move on to consider whether to confirm or change delivery, financial, and governance arrangements that must be put in place to address a priority issue. Finally, country teams may consider how best to support the necessary changes to the behaviour of those involved in the implementation of the policy at all levels (policy makers, public health managers, care-givers, community health workers, and communities of users of the health system). The country teams draw on several overviews of systematic reviews, including ones examining the effects of alternative delivery, financial and governance arrangements, supporting behaviour change, and many single studies that had been conducted in their own country or region.
- Each country team prepares a policy brief presenting at least three viable policy options for addressing the selected priority issue. each comprising different “bundles” of the aforementioned delivery, financial and governance arrangements within their respective health systems, and potential strategies for supporting the implementation of the policy options. Also helpful is the identification of ‘policy paths,’ that facilitate the understanding of who are the main stakeholders in the implementation of these specific policies (including in other sectors outside the health sector). Each policy option is accompanied by an assessment about what can reasonably be expected (in terms of both costs and consequences) in the country’s health system by pursuing each of the policy options, as well as a description of any gaps in our understanding about what can be expected. The assessments are based on the best available research evidence that had been examined for its quality and local applicability and for equity and scaling up considerations.
- Another key step in the EVIPNet knowledge translation process is that each country team convene a national policy dialogue, and invite senior government officials and key stakeholders (including civil society groups) to participate in a discussion about how both the public and private sector can best support addressing the selected priority issue. The policy brief will be a key input to this discussion, but so too will be local information about on-the-ground realities and constraints, values, interest group dynamics, tacit knowledge, best practices, and institutional constraints.
- The whole process is monitored and evaluated to make sure we learn and disseminate best practices in evidence-informed policy-making.