Academic journal article Bulletin of the World Health Organization

Assessing Country-Level Efforts to Link Research to Action/ Evaluation a L'echelle D'un Pays Des Efforts Pour Lier Recherche et action/Evaluar Los Esfuerzos Realizados En Los Paises Para Vincular Las Investigaciones a la Accion

Academic journal article Bulletin of the World Health Organization

Assessing Country-Level Efforts to Link Research to Action/ Evaluation a L'echelle D'un Pays Des Efforts Pour Lier Recherche et action/Evaluar Los Esfuerzos Realizados En Los Paises Para Vincular Las Investigaciones a la Accion

Article excerpt

Introduction

The idea of linking research to action in the health sector has captured a great deal of international attention. In late 2004 WHO issued the World report on knowledge for better health, with a chapter devoted to linking research to action. (1) Shortly thereafter WHO convened the Ministerial Summit on Health Research in Mexico City, and the resulting Mexico statement on health research called on "all major stakeholders to strengthen or to establish activities to communicate, improve access to, and promote the use of reliable, relevant, unbiased and timely health information." (2) In May 2005 the World Health Assembly called on WHO Member States to "establish or strengthen mechanisms to transfer knowledge in support of evidence-based public health and healthcare delivery systems, and evidence-based health-related policies"; it also called on WHO's Director-General to "assist in the development of more effective mechanisms to bridge the divide between ways in which knowledge is generated and ways in which it is used, including the transformation of health-research findings into policy and practice." (3)

But statements and resolutions are easier made than acted on. Those who want to take meaningful steps to link research to action would ideally be able to draw on high quality, locally applicable research to inform their efforts. Those interested in linking research to action in clinical environments can draw on an overview of systematic reviews of randomized trials of interventions designed to better align health-care professionals' practise with research (4) as well as a systematic review of randomized controlled trials of strategies for guideline dissemination and implementation) Most of the studies included in these reviews were conducted in high-income countries. However, these interventions should also be evaluated in low- and middle-income countries) Those interested in linking research to action in the areas of health management and policy-making have to deduce the attributes of potential interventions from systematic reviews of observational studies that examine the factors that influence the use of research. (7,8) For example, interactions between researchers and health-care policy-makers and the timing or timeliness of research being made available appear to increase the likelihood that research will be used by policy-makers. Hence, interventions such as interactive workshops that bring together researchers and health-care policy-makers and web sites that provide "one-stop shopping" for systematic reviews have been promoted (but not yet evaluated).

Health-care professionals, managers and policy-makers are not the only people who may use research. The full range of potential users (outside the research community itself) includes the general public, patients, health-care professionals, health managers, executives of biomedical companies and public policy-makers. (While being someone who uses research may be a small role for members of these groups, we use the term "research user" throughout as shorthand for these groups.) Some intermediary groups--by which we mean the media, civil society groups, professional associations and other groups that work at the interface between researchers and users of research--may also have critically important roles in linking research to action.

In this paper we develop a framework for assessing country-level efforts to link research to action. The main purpose of the framework is to inform country-level dialogues about the domains to which attention could be directed in order to link research to action. Countries provide a natural unit for assessment given that there may be a division of labour within a country (for example, among research funders). A country's capacities and constraints will affect the initial focus of their efforts (for example, creating a demand for research may be one of the first steps for some countries whereas integrating and building on existing efforts may be among the first steps for others). …

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