Dear Steve,
Many thanks for your latest message on the ability of countries to develop national policy.
You note the 2013 World Health Report which stated that "All nations should be producers of research as well as consumers... Research for universal health coverage requires national and international backing...". I would see these statements as truisms.
For me, it is a given that any coherent national policy or practice guideline must take into account global evidence (especially systematic reviews) as well as local/national evidence. (With regards to the latter HIFA recently discussed in-depth the role of civil society to inform policymaking and published a systematic review on this topic: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015810/full )
The question is not whether local/national research is important. Clearly it is, although it could be argued that much of it is currently wasted, as is the case with global heath research. The primary question for me is: how to strengthen the capacity of member states to develop robust policy and practice guidelines drawing on global and local evidence (and other factors)? In this regard, strengthening national research is just one of the key issues to consider.
Thank you also for your review, which supports the often-held assumption 'that engagement by clinicians and healthcare organizations in research improves healthcare performance at various levels', and that this appears to be mediated largely by research networks. Boaz A et al. If health organisations and staff engage in research, does healthcare improve? https://link.springer.com/article/10.1186/s12961-024-01187-7
In terms of the ability of countries to develop national policy, a further question might be: Which countries have a commitment and capacity to develop policy and practice guidelines informed by global and local evidence synthesis? To what extent does this approach result in more robust guidelines? And health outcomes?
Improving health outcomes might be expected to result from better policy and practice guidelines, although it would also be highly dependent on the level of uptake of such guidelines.
The challenge for national health policymakers is not only to develop robust guidelines but also to enable their uptake.
This is also a challenge for WHO international guideline developers. They need to develop guidelines that are not only robust, but maximally useful for member states to adapt.
This publication from WHO is especially relevant:
Strengthening countries’ capacities to adopt and adapt evidence-based guidelines: a handbook for guideline contextualization (WHO/Europe, 2023) https://www.who.int/publications/i/item/9789289060028
Has anyone been involved in the development of this publication or used it in practice?
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org