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AnnuAl report 2011Responding to the needs of decision-makers

A l l i A n C e f o r H e A l t H p o l i C Y A n d s Y s t e M s r e s e A r C H

© World Health Organization 2012

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A l l i A n C e f o r H e A l t H p o l i C Y A n d s Y s t e M s r e s e A r C H

AnnuAl report 2011Responding to the needs of decision-makers

Alliance HPSR - Responding to the needs of decision-makers - AnnuAl report 2011Alliance HPSR - Responding to the needs of decision-makers - AnnuAl report 2011

tABle of Contents

Message from the Chair of the Board ...................................................................................................1

1. Responding to the needs of decision-makers ....................................................................3

2. Goals and objectives of the Alliance ................................................................................................5

3. Stimulating the generation and synthesis of policy-relevant health systems knowledge ..................................................................6 Achievements: Access to medicines ........................................................................................................6 Achievements: Implementation Research Platform ..............................................................7 Achievements: Health workers’ incentives ......................................................................................9 Achievements: Systematic reviews ........................................................................................................10

Achievements: Universal fi nancial risk protection .............................................................. 12 Achievements: WHO Health Systems Research Strategy ...........................................13 Challenges ............................................................................................................................................................................14

4. Promoting the use of health policy and systems knowledge to improve health system performance ............................................15

Achievements: Sponsoring national processes.......................................................................15 Achievements: Coordination of, and participation in, scientifi c and policy meetings .........................................................................17 Achievements: Developing synthesis methods and platform...............................18 Challenges ............................................................................................................................................................................19

5. Facilitating the development of capacity for the generation, dissemination and use of health policy and systems research ............. 20

Achievements: Enhancing policy-maker capacity ...............................................................20 Achievements: Strengthening health policy and systems research

methodologies and promoting sound teaching of such methodologies ............................................................................................22

Achievements: Methods reader ................................................................................................................ 23 Achievements: Supplemental issue on systems thinking ........................................... 23 Challenges ............................................................................................................................................................................24

6. Advocacy and communications ...........................................................................................................25 Achievements ..................................................................................................................................................................25 Challenges ............................................................................................................................................................................26

7. Management and governance of the Alliance .............................................................28 Achievements: The Alliance Board, STAC and Partners .............................................. 28 Achievements: Secretariat................................................................................................................................29 Achievements: Fundraising .............................................................................................................................29 Challenges ............................................................................................................................................................................30

Annexes Annex 1. Acknowledging those who have supported the Alliance during 2011 .......................................................31 Annex 2. Alliance presentations at, or participation in, meetings 2011 ...32 Annex 3. Alliance publications 2011 .....................................................36 Annex 4. Unpublished grantee reports .................................................39 Annex 5. Alliance grantees 2011 ..........................................................42 Annex 6. Alliance fi nancial management report 2011 ..........................50

Alliance HPSR - Responding to the needs of decision-makers - AnnuAl report 2011

MessAge froM tHe CHAir of tHe BoArd

Once again, it is my pleasure to introduce the Annual Report of the Alliance for Health Policy and Systems Research.

It has been a tremendously productive year for the Alliance. The Alliance made great progress with activities related to its strategic objectives – the generation and synthesis of knowledge, the promotion, dissemination and use of knowledge, and the strengthening of capacity. Notable achievements this year have included:

• completing most of the baseline work on two relatively new programmes of work – Access to Medicines and the Implementation Research Platform;

• initiating work on the WHO Health Systems Research Strategy, including the inaugural meeting of the Advisory Group, a mix of renowned decision-makers and researchers; and

• closing, and critically reflecting on, long-standing programmes of work to establish systematic review centres in low- and middle-income countries and to promote the translation of evidence into policy and practice (under “Sponsoring National Processes”).

The theme for the 2011 Annual Report, “Responding to the needs of decision-makers”, is an appropriate and timely one. There is a long-standing appreciation at the Alliance that health systems research is a means to an end; its value ultimately depends on whether it is available to, understood by, and used by decision-makers. As described in the report, the Alliance is designing and implementing programmes of work in such a way that they are likely to impact on policy and practice. Assessing the impact of efforts to translate evidence into policy and practice is challenging, given, among other things, the complexity of policy processes and long lag-times between knowledge generation, incorporation into policy and implementation on the ground. Increasingly, the Alliance strives to capture such impacts, and to support the field of knowledge translation more broadly.


MessAge froM tHe CHAir of tHe BoArd - 1

dr John-Arne røttingen

2011 AnnuAl report - Responding to the needs of decision-makers - Alliance HPSR

2 - responding to tHe needs of deCision-MAKers

In 2012, the Alliance will continue to work towards its core objectives. The year promises to be an exciting one. Between 31 October and 3 November 2012 the health policy and systems research community will come together in Beijing for the Second Global Symposium on Health Systems Research. As one of the main organizers of the Symposium, the Alliance Secretariat will be highly devoted to preparing for this event, expected to attract up to 2,000 participants. Several major Alliance products will be launched in 2012, including: a supplemental issue of Health Policy and Planning on “Systems Thinking for Health Systems Strengthening”; a Reader on Health Policy and Systems Research Methods; andtogether with the Health Systems and Services cluster of WHO the Alliance will launch the WHO Health Systems Research Strategy.

These are promising and interesting times for health systems research. To deliver on the collective ambitions, stronger stewardship functions and fi nancing opportunities need to be developed both at the national and global levels. The Alliance will support these developments and aims to expand its partnership and funding base to contribute to this.

The Alliance’s work this year could not have been completed without the signifi cant input of many people. Annex 1 provides a list of some of those who participated in and contributed to our work in 2011. We would like to thank everyone who supported the aims and activities of the Alliance during 2011 and hope that we can continue to count on your support as the Alliance continues to pursue its objectives in the years ahead.

Dr John-Arne RøttingenChair, Alliance Board


2 - MessAge froM tHe CHAir of tHe BoArd


Since the Alliance’s inception, one of its primary objectives has been to promote the dissemination and use of health policy and systems knowledge in order to improve the performance of health systems. The Alliance remains committed to supporting work, and working in a manner, that is responsive to the needs of decision-makers – from grassroots implementers, to Ministers of Health and representatives of donor agencies. The Alliance promotes the use of research by: (i) encouraging and supporting researchers to present research such that it is accessible to decision-makers; (ii) building the capacity of decision-makers to use research; and (iii) bringing researchers and decision-makers together to share ideas and to work together in strengthening health systems.

The Alliance has encouraged grantee researchers share their results in formats, and in forums, that are accessible to decision-makers. User-friendly policy briefs – short, succinct papers that provide evidence on a specifi c policy issue – have been produced across many of different programmes of work. The Access to Medicines project has produced briefs on medicines pricing and transparency and good governance for medicines. Under the Sponsoring National Processes (SNP) programme of work, policy briefs have been produced on issues of importance in several different countries, including strengthening health systems for mental health in Zambia and scaling-up malaria control interventions in Cameroon. An Alliance-supported project in Bangladesh has put research right at the fi ngertips of decision-makers, disseminating important fi ndings by mobile telephone text messages, in simple and succinct language!

1. responding to tHe needs of deCision-MAKers

Members of the Health policy Advisory Committee, ebonyi state nigeria, August 2011

responding to tHe needs of deCision-MAKers - 3


4 - responding to tHe needs of deCision-MAKers

The Alliance, through several programmes of work, has developed decision-makers’ capacities to use research. Since 2009, in collaboration with the Wellcome Trust, the Alliance has supported teams to develop and evaluate innovative approaches to enhance policy-maker capacity to use evidence in the policy process. Under this programme of work, activities conducted across six different countries have included: executive-training programmes; shorter capacity-building workshops; having decision-makers work with researchers on the development of policy briefs or health plans; and the development of training modules and tools.

It is hoped that bringing researchers and policy-makers together in “exchange” or “bridging” activities will also promote the use of HPSR knowledge. Exercises aimed at setting research priorities are one such bridging activity. Under the Access to Medicines project, discussions in some of the 19 case study countries have brought together researchers and decision-makers to discuss policy priorities. And a global-level stakeholder meeting scheduled for March 2012 will bring together researchers and decision-makers to defi ne and prioritize research questions and discuss data sources and methods that can be used to address these questions. The Implementation Research Platform has used priority-setting exercises, which have brought together decision-makers and researchers in eleven countries, to establish key implementation research questions. Under the Sponsoring National Processes programme of work, policy dialogues – that is, in-depth discussions between researchers and decision-makers on how best to address specifi c policy issues – have been held in several different countries. At the global level, the Alliance brought together an eminent group of decision-makers and researchers in the inaugural meeting of the Advisory Group for the WHO Health Systems Research Strategy.

This report further elaborates on the programmes of work, and highlights some of the opportunities and challenges faced in taking this user-oriented approach.


This report is structured around the Alliance’s three main objectives, presented in Figure 1, as well as a section on advocacy and communications and a closing section on management and governance.

Figure 1 categorizes the Alliance’s programmes of work. Increasingly, the Alliance is ensuring that all programmes of work that involve the generation and synthesis of knowledge (Objective 1) also fulfi l Objective 2 (i.e. the projects are designed in such a way as to facilitate the translation of this knowledge into policy and practice) and Objective 3 (i.e. they strengthen capacity of stakeholders). This is represented, in Figure 1, by the fi rst «programme of work» column, which extends across all three objectives. Programmes of work that have dissemination and use of HPSR knowledge as a primary objective are designed so as also to include capacity building activities (illustrated by the second «programme of work» column). A third category of work programmes focus on the capacity strengthening objective (illustrated by the third «programme of work» column).

2. goAls And oBJeCtiVes of tHe AlliAnCe

objectives

> 1stimulate the generation and synthesis of policy relevant health systems knowledge (evidence, tools and methods)

> 2promote the dissemination and use of health policy and systems knowledge in order to improve the performance of health systems.

> 3strengthen capacity for the generation, dissemination and use of the Hpsr knowledge among researchers, policy-makers and other stakeholders

programmes of work

Knowledge generation

Knowledge use

• sponsoring national processes

• participation in scientifi c and policy meetings

• developing synthesis methods and platform

Capacity building

• enhancing policy-maker capacity

• Capacity building workshops

• strengthening methodologies

• Hpsr methods reader

• supplemental issue on systems thinking

• Access to medicines

• implementation research platform

• Health worker’s incentives

• systematic reviews

• universal fi nancial risk protection

• WHo Health systems research strategy

Figure 1. Alliance objectives and programmes of work

goAls And oBJeCtiVes of tHe AlliAnCe - 5

3. stiMulAting tHe generAtion And sYntHesis of poliCY-releVAnt HeAltH sYsteMs KnoWledge

Achievements: Access to medicines

In 2010 the Alliance launched a new DFID-funded Access to Medicines (ATM) Policy Research project. The goal of this project is to increase access to and improve the use of medicines in low- and middle -income countries (LMICs), particularly for the poor. The specifi c purpose of the project is to build an evidence-informed policy-making culture around the access to and use of medicines.

Towards selecting research questions for future Alliance calls for proposals, work to identify policy concerns and related research questions was completed by 12 different institutions across 19 low- and middle-income countries (see Annex 4). Reports were analysed to extract cross-cutting priority issues in ATM, and this list of issues was used to guide a series of global-level key informant interviews. This global-level work, performed in collaboration between the Alliance Secretariat and the University of Utrecht, is currently being completed.

Several studies have been commissioned where it was felt that a small investment by the Alliance could help to address important knowledge gaps (see Annex 4). These include case studies, systematic reviews and analyses of existing databases. Topics covered include medicines fi nancing and governance, and medicines for chronic diseases and maternal mortality. Case study work carried out by a grantee in Cambodia is described in Box 1. Additionally, the Alliance has been collaborating with Health Action International and the Good Governance for Medicines programme (WHO) in producing user-friendly policy briefs on medicines pricing and transparency and good governance for medicines, respectively.

participants, Access to Medicines Workshop,

geneva, April 2011

6 - stiMulAting tHe generAtion And sYntHesis of poliCY-releVAnt HeAltH sYsteMs KnoWledge



Box 1. Improving access to chronic disease treatment through community-based management in Cambodia

MoPoTsyo patient education centre in Cambodia has documented their interesting and unique community approach in the area of access to treatment and care for noncommunicable diseases in a resource-poor setting: a peer educator network managing a group of chronically ill patients in their community. The network is supported by a revolving drug fund also managed by the peer educators, and is linked to an established district referral system. Although this community-led initiative is successful and growing in size, it has so far received little attention from decision-makers in Cambodia.

The Alliance provided funds to document the experience and to formulate a policy brief in local language to be used in policy dialogue with the Ministry of Health and development partners interested in this fi eld. The team’s experience is that the formulation of the policy brief was a learning opportunity in itself and allowed the team to present their data and fi eld lessons in a format readable and usable by decision-makers. In addition, the work was presented at the International Conference for Improving the Use of Medicines in November 2011 in Antalya, Turkey.

stiMulAting tHe generAtion And sYntHesis of poliCY-releVAnt HeAltH sYsteMs KnoWledge - 7

Researchers gathered in Geneva for a workshop on 19 and 20 April 2011 to discuss the achievements to date and brainstormed on the next phase of the project. A global-level stakeholder meeting scheduled for March 2012 will bring together experts to: defi ne and prioritize research questions; and discuss data sources and methods that can be used to address these questions.

Achievements: implementation research platform

Launched in 2010, the Implementation Research Platform (IRP) supports new and ongoing research to improve access to the interventions essential to achieving the health-related Millennium Development Goals (MDGs). The IRP is a collaboration across fi ve WHO Departments: the Alliance; the Department of Maternal, Newborn, Child and Adolescent Health (MCA), the Special Programme for Research and Training in Tropical Diseases (TDR); the Special Programme of Research, Development and Research Training in Human Reproduction (HRP); and the Partnership for Maternal, Newborn and Child Health (PMNCH). The Alliance serves as the secretariat of the IRP, which is overseen by a Scientifi c and Oversight Group.

2011 was a very busy year for the IRP. Nhan Tran joined the Alliance Secretariat staff in April 2011 to manage the work of the IRP. The Alliance is responsible for coordinating and overseeing the work of the IRP, reporting to donors, liaising with partners and disseminating the work of the Platform. In addition to these activities, IRP work conducted at the Alliance in 2011 included:

• Commissioning of 11 evidence syntheses related to IRP (see Annex 4).

• Participating in implementation research priority setting processes – in Democratic Republic of the Congo, Guinea, India, Nigeria and Pakistan by Alliance staff (see Annex 2).



• Coordinating the review of Letters of Intent, and later full proposals, for primary implementation research. Nine implementation research projects were selected for funding. The Alliance directly funds and supervises projects in India (ongoing) and Niger (to commence in 2012).

• Supporting development of a training curriculum in collaboration with TDR, USAID and the National Institutes of Health (USA).

• Promoting the use of implementation research and development of capacity through training at the US National Institutes of Health (North Carolina, August 2011).

• Presenting on the work of the IRP at, for example, the Global Implementation Conference (Washington DC, August 2011), the World Health Summit (Berlin, October 2011), and a WHO meeting on scaling-up interventions (Ankara, December 2011) (see Annex 2).

• Leading the development of implementation research guidelines. Work has included commissioning a review of implementation research defi nitions, and guidance.

implementation research priority-setting Workshop, Zambia, october 2011


Achievements: Health workers’ incentives

During 2009, the Alliance, in collaboration with the Global Health Workforce Alliance (GHWA) and the Human Resources for Health (HRH) Department of WHO, launched a programme of work on incentives to attract and retain qualifi ed health workers to underserved areas within low- and middle-income countries. Four grants were awarded for primary research in China, India, Peru and four countries in the Middle East (Jordan, Lebanon, Qatar and Yemen). During 2011, all four teams produced fi nal reports.

Various dissemination meetings were held at national and local (study setting) level to disseminate the fi ndings and discuss their implications with decision-makers. In Peru, for example, the fi ndings from the study were relevant and timely in informing the fi nal design of PROSALUD, a newly-developed, nationally-endorsed HRH retention strategy. In addition, grantees were involved in several international knowledge sharing activities, such as participation in the Second Global Forum on HRH in Bangkok (January 2011).

Among the main lessons learnt from these studies is that human resource shortages should not be studied in isolation of other health system issues and specifi c contextual challenges. The existing challenges pertaining to HRH in general and underserved areas in particular are the outcome of a range of factors pertaining to the production of HRH, entry into practice, management of the existing workforce and failure to retain qualifi ed and experience health workers through offering proper incentives. Country infrastructure, availability of proper housing, schooling and job opportunities for spouses should also be considered when trying to retain health workers in underserved or disadvantaged areas. The relative importance of these factors was different for doctors and nurses, however, they all played a role in their decision or likelihood to choose to work in an underserved or disadvantaged area.

All teams have plans to submit their work to peer-review journals and several papers have been prepared or submitted. One has been already accepted.



Achievements: systematic reviews

The Alliance has continued to support the four systematic review centres that it helped establish during 2007, in Bangladesh, Chile, China and Uganda. Technical support to the grantees has been provided by three collaborating partners:

• the Oslo Satellite of the Cochrane Effective Practice and Organization of Care (EPOC) Group;

• the EPPI Centre, Institute of Education, London; and

• the Effective Health Care Research Programme Consortium, Liverpool School of Tropical Medicine, Liverpool.

The objectives of these review centres are to: develop capacity in LMICs for the conduct and packaging of systematic reviews of HPSR relevant to these countries; conduct reviews in three main thematic areas (health systems fi nancing, human resources for health and non-state sector service delivery); and develop methodologies relevant to systematic reviews of HPSR in LMICs.

An external evaluation of the programme was conducted during 2011. The review concluded that all four centres met their objectives. The evaluators identifi ed a number of factors that contributed to the success of this programme of work, including: the commitment, vision, leadership and enthusiasm of the Alliance at the start of the project; annual (institutional) funding from the Alliance to allow dedicated research time; annual meetings organized by the Alliance; support from the three collaborating partners; and country-level institutional support.

Some of the challenges identifi ed by the evaluators include: the time required to build and train a team in conducting complex systematic reviews; framing the review question and choosing methods for complex health systems and policy systematic reviews; conducting complex systematic reviews of HPSR; non-constant workfl ow of systematic reviews (e.g. time for editorial feedback,

dr suzanne Kiwanuka, team leader, systematic review Centre, uganda



Table 1. Accomplishments of four systematic review centres during 2011

Bangladesh • Scoping review of social franchising evaluations published on EPPI-Centre web site.

• Protocol on impact of community mobilization on safe motherhood published in Cochrane Database.

Chile • Handbook for health systems systematic reviewers in LMICs published on Alliance web site.

• Database of primary studies in HPSR available at www.epistemonikos.org (and through Alliance web site).

• Produced a briefi ng note on synthesis methods in HPSR.• Published a systematic review on interventions to reduce

emigration of health care professionals from LMICs in the Cochrane Database.

China • Completed a systematic review on means testing for targeting the people in health programme.

• Completed a systematic review on cost-sharing mechanisms in health insurance schemes.

Uganda • Published systematic review of approaches and implementation on dual practice regulatory mechanisms on EPPI-Centre web site.

• Published an effects review on interventions to manage dual practice among health workers in the Cochrane Database.

• Submitted three review protocols: Effects of interventions implemented to manage absenteeism among health workers;

Interventions for managing the movement of health workers between public and private organizations;

Regulatory mechanisms for absenteeism in the health sector: a systematic review of approaches and implementation.

TeamCentre Accomplishments during 2011


screening results); and limited access to some electronic databases and journals.

Table 1 lists key achievements of the four centres during 2011. Principal investigators from all four systematic review centres, representatives of the collaborating partners and the Alliance Secretariat, and external evaluators met face-to-face on 19 October 2011 in Madrid, Spain, during the Cochrane Colloquium. During this meeting, the group discussed accomplishments made under this programme of work, challenges faced and lessons learnt that can be applied to future Alliance work.


Achievements: universal fi nancial risk protection

Since 2010, the Alliance has been supporting in-depth country case-studies identifying factors that have helped or hindered the expansion of universal fi nancial risk protection in low- and middle-income countries. The research question, “how do countries develop and implement universal fi nancial risk protection?” was identifi ed as one of the priority questions in health systems fi nancing. Teams have been conducting work in seven countries – Costa Rica, Georgia, India, Malawi, Nigeria, Thailand and the United Republic of Tanzania – with technical support from Di McIntyre, Ayako Honda and colleagues at the Health Economics Unit, University of Cape Town. Box 2 describes the work done in India and Georgia.

It is anticipated that all seven teams will complete their work in 2012 and it is planned that these will be published as a series of articles in a peer-reviewed journal.


Box 2. Case studies from Georgia and India

insurance for the poor: georgia’s path to universal Coverage. A Case study

The Georgia case study assessed the impact of new health fi nancing initiatives on equity of access to essential health care services and fi nancial protection against health care costs - two key dimensions of universal coverage. From this perspective, the study focused on the national programme for Medical Assistance to the Poor (MAP) - developed by the Georgian government in 2007. The overall study approach was an exploratory and partially explanatory, holistic single case study design. A range of quantitative and qualitative methods were used. The study fi ndings showed that the MAP was moderately successful in improving equity of access and fi nancial protection of the insured poor and had limited overall effect on the same dimensions for the general population. The qualitative research fi ndings described and explained how and to what extent the policy content, context, actors and processes of the MAP design and implementation have affected the observed outcomes. There is evidence that the study results and policy recommendations helped to inform policy-makers in determining the future design of the MAP. The Georgian experience presented in this paper may also be useful for other LMICs that are contemplating ways to ensure universal coverage for their populations.

study of the rashtriya swasthya Bima Yojana (national Health insurance scheme) in india

The study aims to assess the impact of Rashtriya Swasthya Bima Yojana (RSBY), a national health insurance scheme launched by the Government of India in 2007 to enhance the access to quality hospital care by families living below poverty line (BPL). In this study, the impact of RSBY is measured vis-à-vis its enrolment rates, effect on access to quality hospital care, and fi nancial protection offered to BPL families. This study goes one step further and attempts to understand reasons behind this by identifying issues with performance, governance, and monitoring of the scheme.

This cross-sectional study was conducted in Gujarat using mixed methods. A household survey involved 3,080 BPL households generating data on 17,209 individuals while focused group discussions and interviews were conducted with stakeholders. The data is currently undergoing analysis. Triangulation of data from the different sources and different methods will help to acquire a better understanding of factors facilitating and/or hampering the performance of the scheme from all perspectives.

An important goal of this study is to provide feedback to scheme managers and policy-makers to improve the effectiveness and effi ciency of RSBY. The researchers conducting this study hope that fi ndings will provide important insight about RSBY to strengthen India’s movement towards universal health coverage.


Achievements: WHo Health systems research strategy

At the First Global Symposium on Health Systems Research in November, 2010, the Assistant Director-General (ADG) - Health Systems and Services, Carissa Etienne, expressed the need for, and commitment to, “work with the Alliance to use WHO’s convening power to build a comprehensive strategy for health systems research”. The Alliance has been tasked with developing the WHO HSR Strategy, the overall goal of which is to promote the generation and use of HSR in order to accelerate improvements in health systems and outcomes.

The development of this Strategy is being guided by an Advisory Group, co-chaired by Julio Frenk, Dean of the Harvard School of Public Health and Sujatha Rao, Former Secretary of Health, Government of India. The advisory group met on 7-8 June, 2011.

Based on the workplan developed in Boston, several pieces of work were commissioned by the Alliance in 2011:

• a conceptual paper that will underpin the Strategy;

• a paper reviewing select WHO documents for relevance to the Strategy;

• a paper on country examples of research “embedded” in policy-making processes;

• an HSR mapping exercise – looking at practices, priorities and capacities – across 30 LMICs, using a young researcher network.


dr sujatha rao and dr Julio frenk, Advisory group Meeting, Boston, June 2011



As well the Alliance is collaborating with the Partnership for Maternal Newborn and Child Health and the World Bank on case studies on factors that have helped scale-up towards addressing MDGs.

An outline of the Strategy was circulated among Alliance Partners and to participants in the First Global Symposium on Health Systems Research (August-September, 2011) and their feedback was collected through a web-based survey. Responses were received from 23 individuals or organizations and incorporated into the outline. The Strategy will be launched at the Second Global Health Systems Research Symposium in Beijing, China, in November 2012.

Challenges

Tremendous progress was made during 2011 on these ambitious programmes of work. Challenges faced during the year have included:

• A long-standing challenge is that much of the primary or synthesis research supported by the Alliance requires cross-disciplinary work, for example, by encouraging a “systems approach” to research, by encouraging the coupling of qualitative and quantitative research, and by encouraging researchers to look not only at whether interventions work, but why (or why not) and how these interventions can most effectively be implemented. Teams that possess the broad range of skills required may be hard to fi nd at single institutions in LMICs. Innovative approaches to building capacity (see section 6) or encouraging work across institutions and countries have been employed, but require additional work in establishing links, and providing support and supervision, by the Alliance Secretariat.

• As highlighted in the 2010 Annual Report, the Alliance is increasingly working with partner organizations, both within and external to WHO. Experience to date suggest that this approach reaps great rewards, for example, in terms of avoiding duplication, providing grantees with a rich and diverse network of technical advisers, and increasing the likelihood that the research questions addressed are of concern to a broad constituency. Working with and through partners poses challenges in terms of maintaining standardization (e.g. of methodologies), quality and timeliness of work.

• Interruptions or changes in the fl ow of work. In many ways, 2011 was a transition year. Some new programmes of work (e.g. IRP and WHO HSR Strategy) were getting under way, with the volume of work mounting throughout the year. Other programmes of work were gradually closing (e.g. health workers’ incentives and systematic review centres). New work under ATM was held for much of the year as funding was secured for all post-inception-year activities.


proMoting tHe use of HeAltH poliCY And sYsteMs KnoWledge to iMproVe HeAltH sYsteM perforMAnCe - 15

Achievements: sponsoring national processes

In 2008, the Alliance issued a call for proposals for Sponsoring National Processes in order to support projects on evidence-informed policy-making in low- and middle-income countries (LMICs). The objectives of this programme of work were to:

• positively infl uence the development of policies at the country level;

• contribute to evidence-informed policy-making through: a) promoting exchange between researchers, advocacy groups and policy-makers in HPSR; and/or b) establishing mechanisms that encourage policy-makers to seek and apply evidence; and/or c) encourage researchers and other civil society representatives to package and promote the use of evidence in a policy-friendly manner;

• add to the knowledge base about what strategies appear most promising to promote evidence-informed policy.

Five countries were selected based on the call: Argentina, Bangladesh, Cameroon, Nigeria and Zambia. The grants started in 2009 and have ended in 2011. Key achievements by grantees are summarized in Table 2. Since 2010, work under these grants has been monitored by Fadi El-Jardali (Lebanon) and Tomas Pantoja (Chile), under the supervision of Professor John Lavis and colleagues at McMaster University. Data have been collected, and a fi nal monitoring and evaluation report is to be fi nalized for June 2012.

4. proMoting tHe use of HeAltH poliCY And sYsteMs KnoWledge to

iMproVe HeAltH sYsteM perforMAnCe

participants, policy dialogue Workshop, Cameroon, october 2011


Table 2. Accomplishments of fi ve Sponsoring National Processes grantees during 2011

Argentina: Promoting the generation of coordinated provincial health protection. A collective process.

• Prepared a fi nal document based on the eight policy briefs and fi ve policy dialogues conducted during the course of the project.

Bangladesh:Bridging the Know-Do Gap: Strategies to Enhance the Capacity to Apply Health Policy and Systems Research into Evidence-Informed Policy-Making in Bangladesh.

• Prepared two policy briefs on dual practice and urban street dwellers.

• Conducted policy dialogues with the Directorate General of Health Services.

• Conducted end-line assessment by conducting 15 interviews.

Cameroon: Transition towards a Health SWAp in Cameroon: Supporting Evidence Use for Decentralization and District Development.

• Prepared a policy brief on scaling-up malaria control interventions and held a policy dialogue on this issue.

• Produced a bulletin on maternal and child health.

Nigeria: Development, implementation, and evaluation of individual staff skills and institutional incentives for capacity enhancement in health policy and systems research evidence use in policy-making in Nigeria.

• Conducted a mentorship programme for decision-makers.• Evaluated the project using questionnaire and key

informant interviews. Results show signifi cant improvement in knowledge and skills.

• Established the Ebonyi State Health Policy Advisory Committee (ESHPAC) which will play an advisory role to the Health Ministry.

• Started an Executive Training Programme in Health Policy/Health Systems in the university.

Zambia: Developing a knowledge translation platform for health policy and systems research in Zambia.

• Prepared three policy briefs on: strengthening health systems for mental health; implementation of health workers retention strategies; and preventing post-partum haemorrhage.

• Conducted three policy dialogues.

Country team Achievements

16 - proMoting tHe use of HeAltH poliCY And sYsteMs KnoWledge to iMproVe HeAltH sYsteM perforMAnCe



Achievements: Coordination of, and participation in, scientifi c and policy meetings

During the course of the year the Alliance staff participated in, or presented at, more than 25 meetings or conferences, to audiences including: research organizations, research funders, bilateral and multilateral development agencies, and expert committees (see Annex 2 for a full list).

In follow-up to the First Global Symposium on Health Systems Research, which brought together more than 1,200 participants between the 16-19 November 2010 (Montreux, Switzerland), the Alliance and partners are now busy organizing the second such Symposium. The “Second Global Symposium on Health Systems Research: Inclusion and Innovation Towards Universal Health Coverage” will take place in Beijing, China, from 31 October to 3 November, 2012. Aside from the Alliance, organizing partners are the World Health Organization including the Innovation, Information, Evidence and Research cluster and the Health Systems and Services cluster, TDR, BRAC University School of Public Health and Peking University Health Sciences Centre (the local “host”).

The Alliance is coordinating all Geneva-based staff working on the Symposium. Alliance staff are leading the programme development for the Symposium, and helping to oversee communications, logistics and budgeting/fi nancing activities. Alliance staff also participate actively in the Symposium’s external oversight groups, the Steering Committee and Executive Committee. Alliance staff travelled to Beijing twice during 2011: fi rst for a preliminary planning meeting of the organizing partners (as well as representatives of the Ministry of Health, China and the WHO Country Offi ce; May 2011) and second to work with colleagues at the University of Peking Health Sciences Centre in selecting the Symposium venue and logistician. By the end of 2011, the Second Symposium web site and call for abstracts had been launched.

participants, implementation research proposal development Workshop, india, April 2011


Achievements: developing synthesis methods and platform

Since 2009 the Alliance has been coordinating meetings and discussions of a Working Group on Health Systems Research Synthesis with the primary goal of developing stronger and better international collaboration for synthesizing health systems evidence.

Early in 2011, a set of recommendations for the Alliance STAC were fi nalized by the Working Group. Recommendations for the Alliance included:

• play a central role in advancing the science of HSR synthesis by developing and strengthening networks between individuals and institutions, collaborations and groups that have an interest in HSR synthesis and translation;

• provide overall support, information sharing and potential coordination related to: setting priorities for HSR synthesis regionally and globally; and increasing the capacity building in HSR synthesis and translation (both relevant to, and within, LMICs);

• advocate and support a common global database for all types of systematic reviews of HSR;

• explore expansion of the range of study designs that can be included in reviews of the effectiveness of HSR interventions;

• pilot a system for producing demand-driven syntheses/systematic reviews of HSR addressing questions other than effectiveness;

• advocate for and support prospective registration of all protocols for systematic reviews when they are planned.

These recommendations were discussed by the STAC (May 2011) and endorsed, conditional on the availability of fi nancial resources. A small advisory group (a sub-group of the larger Working Group) was formed. During the latter half of 2011, the advisory group met regularly (every second month) by teleconference. Among other things, the advisory group:

18 - proMoting tHe use of HeAltH poliCY And sYsteMs KnoWledge to iMproVe HeAltH sYsteM perforMAnCe


• organized a preliminary meeting on synthesis of evidence from econometric analysis at the Cochrane Colloquium (22 October 2011);

• is preparing a proposal for a three day meeting on quasi-experimental study designs (to be held early 2013);

• is in communications with PROSPERO (an international prospective register of systematic reviews: http://www.crd.york.ac.uk/prospero/) to encourage them to register protocols for non-effectiveness reviews;

• is having preliminary discussions about the production of a synthesis methods reader and is planning for dissemination of the Working Group’s recommendations and evolving workplan;

• is looking at how the Working Group can help in following up on recommendations of the Task Force on Health Systems Guidance;

• is developing a proposal for a consortium to produce, edit and publish diverse and complex systematic reviews for strengthening health systems.

Challenges

Progress in this area of work continued to mature as the work across fi ve countries on Sponsoring National Processes reached its conclusion. A major challenge continues to be assessing the distal outcomes of work aimed at promoting the use of knowledge in policy-making and in practice. Achievements in this area, as can be seen above, have been documented largely in terms of processes (e.g. number of meetings attended or policy dialogues organized) or outputs (e.g. policy briefs produced). Supporting the development of methodologies to assess the impact of evidence-to-policy processes remains an area of great interest to the Alliance. Furthermore, the Alliance will continue to ensure rigorous monitoring and evaluation of these activities, and to refl ect and learn from this work.



20 - FACILITATING THE DEVELOPMENT OF CAPACITY FOR THE GENERATION, DISSEMINATION AND USE OF HEALTH POLICY AND SYSTEMS RESEARCH

5. fACilitAting tHe deVelopMent of CApACitY for tHe generAtion, disseMinAtion And use of HeAltH poliCY And sYsteMs reseArCH

Achievements: enhancing policy-maker capacity

In 2009, the Alliance initiated support to teams for developing and evaluating innovative approaches to enhance policy-maker capacity to use evidence in the policy process. In the fi rst round, most proposals and all three selected grantees (Colombia, Georgia and Mexico) were from middle-income countries. The Alliance, together with the Wellcome Trust, launched a second round of grants in 2010, this time with a focus on low-income countries. Grantees from Bangladesh, India and Nigeria were selected. Work in the three middle-income countries has now concluded while work in the three low-income countries is ongoing, anticipated to fi nish in 2012.

These projects have a shared goal of promoting the use of health policy and systems research and improving the use of research evidence to support the design and implementation of health policies. Select achievements of work carried out in 2011 are listed in Table 3.

participants, policy briefs and deliberative dialogues Workshop, santiago, Chile,

March 2011


fACilitAting tHe deVelopMent of CApACitY for tHe generAtion, disseMinAtion And use of HeAltH poliCY And sYsteMs reseArCH - 21

Table 3. Accomplishments under «enhancing policy-maker capacity» during 2011

Bangladesh Enhancing Capacity to Apply Research Evidence in Policy-making for Reproductive Health in Bangladesh.

• Baseline study done to understand the barriers to evidence use in policy-making: results fed into executive training programme for policy-makers and programme managers.

• First executive training programme given 22 to 24 November, 2011.

• Web page launched (http://nasmis.dghs.gov.bd.rpcc/) to host policy briefs and other information.

• Network created to disseminate important research evidence to 73 decision-makers by mobile phone, using simple, user-friendly language.

Colombia Attempting to close the gap between knowledge production and knowledge use in Colombia.

• Internship programmes across three cities – Bogota, Cali and Manizales – provided training to 45 participants in: how to access databases; how to formulate research questions; how to analyze quantitative and qualitative data; and how to write a policy brief.

• Twenty-eight policy briefs produced, with topics including: primary health care, women’s health care and urban population policies.

India Developing capacities for using community oriented evidence towards strengthening district health planning in Maharashtra state, India.

• Capacity-building workshop conducted in the state of Maharashtra, one at state-level and fi ve at district-levels, on using community evidence in decentralized planning.

• A course on evidence-based decentralized planning of health services was conducted among representatives of NGOs.

• Subsequent to workshops and training, sub-district health plans were prepared based on the evidence generated from community monitoring, and were presented in sub-district level orientation workshops.

Mexico Supporting evidence-informed health policy-making in Mexico: Targeted training and tools to address contrasting state-level contexts.

• Offi cials at various levels in four states – Guerrero, Oaxaca, Veracruz and Mexico – were provided with training in: formulate a policy problem and policy option; accessing databases; analyzing research evidence; and using virtual knowledge management platforms.

• A teaching module was produced on «Knowledge management for decision-making in state health systems».

• Created tools and guidelines which have been conducive during the whole process and that will be of value when tackling other policy problems.

Nigeria Policy Research Evidence for Effective Working of Nigerian Health Systems.

• Conducted a two-day capacity building workshop in the state of Lagos for 33 policy-makers and other stakeholders.

• Conducted a policy dialogue on malaria.• Prepared a draft training module for decision-makers.

project goal Key Achievements


Achievements: strengthening health policy and systems research methodologies and promoting sound teaching of such methodologies

During 2011, the Alliance continued to support three grants designed to support methodological refi nement and the development of teaching materials in the areas of (i) comparative qualitative research, (ii) comparative and synthesis analysis as part of health policy analysis research, and (iii) search strategies for health systems research, particularly for non-English language publications.

The team at Tashkent Medical Academy, School of Public Health, Uzbekistan (in collaboration with researchers at Curatio Foundation, Georgia and the London School of Hygiene and Tropical Medicine, LSHTM, United Kingdom of Great Britain and Northern Ireland,UK) conducted qualitative research in Georgia and Uzbekistan aimed at exploring “physician and patient perspectives on quality of care for heart failure”. Based on this work, web-based learning modules on qualitative methods of data collection for health services research in central Asia and the Former Soviet Union have been developed (http://curatiofoundation.org/qualitativemethods/). Furthermore, the researchers who conducted this work are planning to incorporate the module into teaching at the School of Public Health, Uzbekistan and the LSHTM.

The second research team at the School of Public Health and Family Medicine, University of Cape Town (UCT), developed several outputs related to strengthening health policy analysis research and training through a focus on approaches to comparative and synthesis analyses. Most notably, the team drafted six papers to be published as a special issue in the Health Policy and Planning; and methodological guidance notes which will be available by open access through the UCT web site (and linked to the Alliance web site). The draft papers and guidance notes were discussed and reviewed by a group of experts during a workshop in September 2010 in Oxford, UK. This work served as a foundation to the multi-year European Union funded Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA) project to strengthen health policy and systems analysis in Africa, where several teaching materials will be developed and made available online.

The third research team at the School of Medicine, Pontifi cia Universidad Católica de Chile conducted several activities related to search strategies for health systems research. One of their main outputs include an internet-based, free-access, searchable database of primary studies including overviews, systematic reviews, structured summaries and primary studies on topics related

22 - fACilitAting tHe deVelopMent of CApACitY for tHe generAtion, disseMinAtion And use of HeAltH poliCY And sYsteMs reseArCH


to HPSR (available on: www.epistemonikos.org ). The database is searchable in nine languages. Other outputs include the development and testing of a Medline search strategy for retrieving systematic reviews on Health Policy and Systems Research as well as one poster presentation at the Cochrane Colloquium, Madrid, and a manuscript for publication.

Achievements: Methods reader

In 2009, the Alliance commissioned the Health Economics Unit (HEU) at the University of Cape Town to develop a Reader on Health Policy and Systems Research Methods. The intention is to assemble a collection of papers that demonstrate the high quality application of different HPSR methods with related commentary. The reader is intended for use in training, and more broadly to support HPSR.

During 2011, original text for the reader was fi nalized and journals were contacted for permission to reproduce previously-published papers in the Reader. The reader will be published in March 2012, and an electronic version will be available for download, free of charge, on the Alliance web site.

Achievements: supplemental issueon systems thinking

A supplemental issue of Health Policy and Planning was developed in response to the demand generated by the Alliance’s 2009 Flagship Report “Systems Thinking for Health Systems Strengthening”, stemming from the perceived predominance of mostly theoretical, northern-driven, applications of systems thinking concepts for health systems, and the lack of experience with, or applications of, these concepts in LMICs. The supplemental issue, to be published in 2012, is comprised of nine papers:

1. State-of the art in applying systems thinking principles for health systems in LMICs

2. Evaluating health system strengthening interventions in low-income and middle-income countries: Are we asking the right questions?

3. Constraints to applying systems thinking concepts in health systems: A regional perspective from Eastern Mediterranean Countries

fACilitAting tHe deVelopMent of CApACitY for tHe generAtion, disseMinAtion And use of HeAltH poliCY And sYsteMs reseArCH - 23


4. When “the solutions of yesterday become the problems of today”: A Case Study of Crisis Ridden Decision-Making in a Complex Adaptive System (CAS) – The Additional Duty Hours Allowance in Ghana

5. Introducing Vouchers for Malaria Prevention in Ghana and the United Republic of Tanzania: A comparison of contexts for sustainable integration in health systems

6. Systems thinking and primary health care development in Iran (Islamic Republic of): a narrative analysis

7. Exploring the effects of task shifting for HIV through a systems thinking lens: The case of Burkina Faso

8. Expecting the unexpected: applying the Develop-Distort Dilemma to maximize positive market impacts in health

9. An invited commentary on the supplement papers by Kara Hanson, Head of the Department of Global Health and Development, London School of Hygiene and Tropical Medicine

Challenges

Work related to capacity building, both of researchers and decision-makers, is an increasingly important part of the Alliance portfolio. And despite the fact that some relatively large, multi-year grant programmes have been supported, this is probably an area in which monitoring of outcomes is relatively weak. Work on “enhancing policy-maker capacity” and “strengthening health policy and systems research methodologies” will be based largely on outputs: no plan is yet in place to evaluate longer-term impacts on the work of researchers or decision-makers involved in the capacity strengthening work. While objectives of workshops and publications (including the methods reader and supplemental issue) are clearly stated, no plan was made, ex ante, to monitor their impacts. In this area of work, in particular, the Alliance will invest greater thought and resources to monitoring and evaluation in future years.

24 - fACilitAting tHe deVelopMent of CApACitY for tHe generAtion, disseMinAtion And use of HeAltH poliCY And sYsteMs reseArCH


Achievements

Priority activities in the year included: (i) work towards the development of the WHO Health Systems Research Strategy ; (ii) launching the redesigned Alliance web site; and (iii) strengthening the Alliance’s relationship with partner institutions and other stakeholders.

Web site launch

The restructured Alliance web site was launched in March 2011. The goal of the restructuring is to showcase the work of the Alliance in a more readable and user-friendly way, more prominently featuring Alliance projects and partners. Elements of the new web site include:

• profi les of Alliance partner organizations;

• one-page overviews of projects funded by the Alliance since 2005;

• an inventory of short courses and tutorials related to HPSR, with links to external sites;

• an expanded array of HPSR publications and resources.

6. AdVoCACY And CoMMuniCAtions

AdVoCACY And CoMMuniCAtions - 25

participants, Advisory group Meeting, Boston, June 2011


The web site remains a key portal for profi ling the Alliance’s areas of work and resources as well as HPSR relevant events and publications. Select technical reports and policy briefs developed by grantees have been posted on the web site project’s pages and the Second Global Symposium and the WHO HSR Strategy have dedicated web pages. The Access to Medicines Policy Research project was also profi led during 2011.

Communicating with Alliance partners and other stakeholders

Partners include members from research institutions, universities, national and local governments, multilateral and bilateral agencies, international organizations, NGOs, foundations etc. During 2011, Alliance’s partners received a Newsletter (July 2011) and periodic electronic newsletters. Partners were actively engaged in several ways. For example, web-based surveys were circulated among all partners seeking their comments on an overview of the WHO HSR Strategy and on an overview of the programme for the Second Global Symposium on HSR.

As well, the Secretariat took advantage of opportunities, as they presented themselves, to raise the profi le of the Alliance and advocate for health systems research. For example, the Alliance showcased its most recent publications and products in a booth during the World Health Assembly (May 2011). The Alliance organized a lunchtime seminar for all WHO staff, during which John Lavis presented on “Supporting Evidence-to-Policy Processes: Preliminary lessons learned from a multi-country study”.

Challenges

The job of communicating the Alliance’s activities has become a more complex job due to the increased volume and diversity of work carried out by the Alliance. For example, both the IRP and the Second Global Symposium for Health Systems Research have their own communications strategies and web sites, and it poses a challenge to (rightly) present these as key activities of the Secretariat and at the same time avoid duplication of efforts. Similarly, as the Alliance has diversifi ed away from work in three key thematic areas (i.e. health systems fi nancing, human resources in health and non-state sector service delivery) to include work in many other areas (e.g. ATM, implementation research, WHO HSR Strategy) it has become increasingly diffi cult to communicate the Alliance’s objectives and (particularly) activities in a manner short and succinct.

26 - AdVoCACY And CoMMuniCAtions


A longer standing challenge is that advocacy activities among health systems decision-makers (outside of specifi c programmes of work, like SNP) remain fairly limited. For example, more could be done in advocating the use of HPSR evidence and existing tools. It is hoped that the WHO HSR Strategy will provide a opportunity and mechanism through which to advocate among decision-makers.

AdVoCACY And CoMMuniCAtions - 27

Achievements: the Alliance Board, stAC and partners

the Alliance Board and stAC

There were several changes to membership in the Alliance Board during 2008. Saul Walker from the UK Department of International Development was replaced by Malcolm McNeil. Viveka Persson, representing Norway and Sweden, was replaced by Maria-Teresa Bejarano. New board members Alex Ezeh (Nigeria) and Maimunah Hamid (Malaysia) were appointed in 2011, fi lling seats left vacant the previous year.

The Board continues to function in an effective manner, providing oversight of, and sound guidance to, the Secretariat. The Board met together with the STAC on 27 October, and independently on 28 October. As well the Board met by teleconference on 30 June, 13 September and 21 November.

The Alliance STAC met twice during the year – 30-31 May and 26-27 October – to provide scientifi c and technical advice to the Alliance. STAC members have also provided substantive input to Alliance activities throughout the year – supporting meetings, reviewing papers and proposals, and acting as ambassadors for the Alliance. John Lavis and Göran Tomson rotated off the STAC and were replaced by Simon Lewin and Jeanette Vega.

7. MAnAgeMent AndgoVernAnCe of tHe AlliAnCe

28 - MAnAgeMent And goVernAnCe of tHe AlliAnCe



strategic plan (2011-2015) and workplan 2012-2013

In 2010, in consultation with the Board and STAC, the Alliance Secretariat developed an updated fi ve-year strategic plan for the period 2011-2015. This was fi nalized and disseminated during 2011. During the year, the Secretariat developed a detailed workplan and budget for the next biennium, 2012-2013. The workplan and budget were presented to, and discussed with, the Alliance Board during the October face-to-face meeting, and approved during the subsequent Board teleconference.

Achievements: secretariat

The size of the Alliance secretariat decreased from eleven to ten people (including both technical and administrative staff). This decrease was due to the anticipated departure of a research assistant, whose position has kept vacant, to be fi lled at a later date. During the course of 2011, the Alliance secretariat managed almost 70 grants (ranging from approximately 5,000 to 340,000 USD; see Annex 4), a number of consultants, the secretariats of the Second Global Symposium on HSR and the Implementation Research Platform, plus the array of activities described under advocacy and communications, management and governance.

Achievements: fundraising

The fi nancial report for 2011 is presented in Annex 5. The strength and relevance of the Alliance’s work is refl ected in the renewal of core funding from the UK Department of International Development (DFID), covering the fi ve-year period 2011 through 2016. As well, the Alliance continues to receive core funding from the Government of Norway (NORAD) and the Swedish International Development Cooperation Agency (Sida). All three donors also provide funding for the Implementation Research Platform. During 2011, funding earmarked for the Second Global Symposium on HSR has been received (or committed) from: Abt Associates, China Medical Board, the Global Health Research Initiative, Open Society Foundation, Results for Development and Wellcome Trust. Members of the Secretariat and Board continued, during 2011, to meet with representatives of funding agencies, towards diversifying the Alliance’s sources of funding.

MAnAgeMent And goVernAnCe of tHe AlliAnCe - 29


Challenges

• The relatively strong Swiss Franc has meant that staff costs, as a percentage of total Alliance costs, were relatively high during 2011. To address this, Alliance management plans not to increase staff size despite a relatively heavy workload. Where necessary, select work which would otherwise have been carried out by staff may need to be contracted out to consultants.

• The Alliance continues to rely largely on three main donors. During 2012, the Alliance will continue to make efforts to expand the number of funding sources.

• Despite strong and long-standing relationships with our main donors, the Secretariat is aware the global economic situation and exchange-rate fl uctuations have left many development organizations in precarious situations. The Alliance continues to operate with a small budget surplus – in part due to efforts to reduce human resources expenditures – but the Secretariat will need to continue to monitor and manage fi nances carefully.

30 - MAnAgeMent And goVernAnCe of tHe AlliAnCe


ANNEX 1. ACKnoWledging tHose WHo HAVe supported tHe AlliAnCe

during 2011

funding agencies

The Alliance gratefully acknowledges the fi nancial support of the Norwegian Agency for Development Cooperation (Norad), the Swedish International Development Cooperation Agency (Sida) and the UK Department for International Development (DFID). The International Development Research Centre (Canada) and Wellcome Trust provided support on particular programmes of work.

the Alliance Board

• Maria-Teresa Bejarano • Sara Bennett• Somsak Chunharas • Carissa Etienne• Alex Ezeh (new) • Maimunah A. Hamid (new)• Malcolm McNeil • Sania Nishtar• John-Arne Røttingen (Chair) • Saul Walker (outgoing)

the Alliance scientifi c and technical Advisory Committee (stAC)

• Irene Akua Agyepong (Chair) • Lucy Gilson• Sennen Hounton • Soonman Kwon• John Lavis (outgoing) • Simon Lewin (new)• Prasanta Mahapatra • Göran Tomson (outgoing)• Jeanette Vega (new)

Collaborating institutions and individuals

The Alliance would like to thank its many partner institutions and grantees. During 2011, a number of institutions provided signifi cant support to our programme of work. We would like to thank and convey our appreciation to all those who supported our grantees and the mission of the Alliance; those who provided training; those who participated in workshops; and those who reviewed technical reports and proposals.

AnneX 1. ACKnoWledging tHose WHo HAVe supported tHe AlliAnCe during 2011 - 31


ANNEX 2. AlliAnCe presentAtions At, or pArtiCipAtion in, Meetings 2011

To present and moderate a session on “capacities of research users for increased uptake of evidence” during the Prince Mahidol Award Conference and Second Global Forum on Human Resource for Health.

Around 90 participants mostly from LMICs, Bangkok, Thailand

Abdul Ghaffar, 25-29 Jan.

To facilitate a workshop on prioritization of implementation research questions, which was jointly hosted by MOH, Pakistan and Implementation Research Platform.

Policy-makers, programme managers and researchers from throughout Pakistan

Abdul Ghaffar, 19 Feb.-27 Mar.

To chair/facilitate roundtable discussions on barriers to access to magnesium sulfate for women suffering from eclampsia and pre-eclampsia in Pakistan.

Policy-makers and other stakeholders (e.g. OBGYN, pharmaceutical manufacturers, civil society and donors) able to infl uence use of magnesium sulfate in country, Islamabad, Pakistan

Abdul Ghaffar and Maryam Bigdeli, 24 Feb.

To discuss collaborative work with the Dean of Ecole des Hautes Etudes en Santé Publique (EHESP), and a meeting with senior offi cials of MoFA to explore the funding opportunities.

Senior offi cials of MoFA and leadership of Ecole des Hautes Etudes en Santé Publique (EHESP), Paris, France

Abdul Ghaffar and Maryam Bigdeli, 7-8 Mar.

To participate in the Global Health Metrics and Evaluation Conference and facilitate a strategic discussion with HSR leaders on development of the Global WHO Health System Research Strategy.

Health Strategy Group, Seattle, Washington

Abdul Ghaffar 14-16 Mar.

To discuss issues around medicines pricing policies towards developing policy briefs relevant for weak pharmaceutical systems.

Policy-makers from six low-income countries in Africa, Kampala, Uganda

Maryam Bigdeli, 22-25 Mar.

To present and discuss the role of a proposed international collaboration for synthesizing health systems research.

Network of Networks on Impact Evaluation (NONIE), Paris, France

Kent Ranson, 28-29 Mar.

Objective Audience (or participants) and location

Presenter and date

32 - AnneX 2. AlliAnCe presentAtions At, or pArtiCipAtion in, Meetings 2011


To discuss the Pakistan country priority setting for access to medicines and participate in the stakeholders meeting, where results of KII were presented and priorities ranked.

Stakeholders from all groups consulted through KII for the priority-setting process: policy-makers, researchers, private sector, civil society, Agha Khan University, Karachi, Pakistan

Maryam Bigdeli, 11-13 Apr.

To meet with Chinese MOH authorities and Peking University leadership to fi nalize planning and organization of the Second Global Symposium on HSR.

Members of the Secretariat, Steering Committee, seniors offi cials of MOH China and Peking University, Beijing, China

Abdul Ghaffar and Kent Ranson, 1-2 May

To present in a lunchtime seminar on access to medicines from a health system perspective.

Students and faculty of the school, School of Public Health, University of Brussels, Belgium

Maryam Bigdeli, 5 May

To attend the Southern African Regional Programme on Access to Medicines InfoHub conference.

Large group of stakeholders involved in establishing the SARPAM InfoHub, Windhoek, Namibia

Maryam Bigdeli, 24-27 May

To develop the aims, objectives and workplan towards the WHO-HSR Strategy.

WHO-HSR Strategy Advisory Group, Boston, USA

Abdul Ghaffar and Nhan Tran, 7-8 Jun.

To meet with the IRP Scientifi c and Oversight Group on the workplan.

IRP Scientifi c and Oversight Group, Boston, USA

Nhan Tran, 9 Jun.

To attend the research prioritization workshop on implementation research at Indian Council of Medical Research and a meeting with President of the Public Health Foundation of India a course on increased use of research evidence.

Around 60 researchers and implementers from all over India and President of Public Health Foundation. New Delhi, India

Abdul Ghaffar, 2-8 Jul.

To participate in the IRP Priority Setting Workshop.

Ministry of Health, Researchers, and implementing agencies, Abuja, Nigeria

Nhan Tran, 27-29 Jul.

To present the scope, activities and plans of Implementation Research Platform in the Global Implementation Conference, Washington DC, USA, 15-17 Aug. 2011, visit to US Aid 18-19 Aug. 2011 and a meeting Director of Health at Open Society Institute.

Washington DC & New York, USA

Abdul GhaffarWashington DC 15-20 Aug.New York 22-23 Aug.


Ministry of Health, Researchers, and implementing agencies, Conakry, Guinea

Nhan Tran, 20-21 Sep.


Presenter and date

AnneX 2. AlliAnCe presentAtions At, or pArtiCipAtion in, Meetings 2011 - 33


To moderate a session on role and relevance of HSR in BMJ Global Policy Conference and discussion with Editor of BMJ on publication of a special issue around the 2nd Global HSR Symposium.

London, UK Abdul Ghaffar, 29-30 Sep.

To present on access to medicines from a health system perspective at a meeting organized by the ATM Index and targeted towards the pharmaceutical industry / access to medicines departments.

Responsible offi cers of access to medicines programmes of major pharmaceutical industry, Leiden, The Netherlands

Maryam Bigdeli, 5 Oct.

To participate in the 19th Cochrane Colloquium and conduct a business meeting for Alliance-supported Systematic Review Centres.

Participants in the Cochrane Colloquium, including principal investigators, Northern Collaborators and external reviewers of the Alliance-supported SRCs, Madrid, Spain

Bhupinder Aulakh, 19-20 Oct.

To support the organizers of the World Conference on Social Determinants of Health and promote the Second Global Symposium on HSR.

Over 1000 participants representing 125 Member States, Rio de Janeiro, Brazil

Kent Ranson, 19-21 Oct.

To participate and present the Implementation Research activities in the Second Stakeholders’ meeting in the World Health Summit. Also had sideline meetings on potential collaborative work with the UNICEF (Mickey Chopra) and IDRC (Sharmila Mhatre).

Berlin, Germany Nhan Tran & Ghaffar, 20-22 Oct


Ministry of Health, Researchers, and implementing agencies, Kinshasa, DRC

Nhan Tran, 7-9 Nov.

To present work conducted under the Access to Medicines Programme.

Participants in the International Conferences on Improving Use of Medicines (ICIUM) including 13 Alliance grantees, Antalya, Turkey

Abdul Ghaffar and Maryam Bigdeli, 14-18 Nov.

To teach masters students on Systems Thinking and its application to health systems.

Around 25 Masters students from at least 10 different countries, Karolinska Institutet, Stockholm, Sweden

Taghreed Adam, 2 Dec.

Half day teaching on access to medicines from a health systems perspective.

Around 25 Masters students from at least 10 different countries, Karolinska Institute, Stockholm, Sweden

Maryam Bigdeli, 7 Dec.


Presenter and date

34 - AnneX 2. AlliAnCe presentAtions At, or pArtiCipAtion in, Meetings 2011


AnneX 2. AlliAnCe presentAtions At, or pArtiCipAtion in, Meetings 2011 - 35

To lead a discussion panel on role and relevance of HSR and experience of the Alliance in development of networks in the meeting on Strengthening Primary Care Systems to Scale- up Treatment for Common Mental disorders through a learning network

Abu Dhabi, UAE Abdul Ghaffar, 11-12 Dec.

To participate at the Health Policy Project Meeting on Gender and Scale up

USAID support programmes, Researchers, Washington DC, USA

Nhan Tran, 12-15 Dec.

To present the Alliance work (on sponsoring national processes) and participate in panel (on capacity strengthening) in the workshop on health systems research in low- and middle-income countries: the role of global health research funders in the UK.

London, UK Abdul Ghaffar, 13-14 Dec.


Presenter and date


ANNEX 3. AlliAnCe puBliCAtions 2011

secretariat peer-reviewed publications

Adam, T., S. Ahmad, M. Bigdeli, A. Ghaffar and J. A. Rottingen (2011). “Trends in health policy and systems research over the past decade: still too little capacity in low-income countries.” PLoS One 6(11): e27263.

Adam, T. and A. Ghaffar (2011). “Strategies for increasing the impact of research on human resources for health policy development.” Rev Peru Med Exp Salud Publica 28(2): 323-6.

Annear, P. L., M. Bigdeli and B. Jacobs (2011). “A functional model for monitoring equity and effectiveness in purchasing health insurance premiums for the poor: evidence from Cambodia and the Lao PDR.” Health Policy 102(2-3): 295-303.

Jacobs, B., P. Ir, M. Bigdeli, P. L. Annear and W. Van Damme (2011). “Addressing access barriers to health services: an analytical framework for selecting appropriate interventions in low-income Asian countries.” Health Policy Plan.

Meessen, B., M. Bigdeli, K. Chheng, K. Decoster, P. Ir, C. Men and W. Van Damme (2011). “Composition of pluralistic health systems: how much can we learn from household surveys? An exploration in Cambodia.” Health Policy Plan 26 Suppl 1: i30-44.

Ranson, M. K., R. Jayaswal and A. J. Mills (2011). “Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India.” Health Policy Plan.

grantee peer-reviewed publications

Cheung, A., J. N. Lavis, A. Hamandi, F. El-Jardali, J. Sachs and N. Sewankambo (2011). “Climate for evidence-informed health systems: A print media analysis in 44 low- and middle-income countries that host knowledge-translation platforms.” Health Res Policy Syst 9: 7.

El-Jardali, F., M. Alameddine, N. Dumit, H. Dimassi, D. Jamal and S. Maalouf (2011). “Nurses’ work environment and intent to leave in Lebanese hospitals: implications for policy and practice.” Int J Nurs Stud 48(2): 204-14.

El-Jardali, F., D. Jamal, N. Ataya, M. Jaafar, S. Raouf, C. Matta, S. Michael and C. Smith (2011). “Health Policy and Systems Research in Twelve Eastern

36 - AnneX 3. AlliAnCe puBliCAtions 2011


Mediterranean Countries: a stocktaking of production and gaps (2000-2008).” Health Res Policy Syst 9: 39.

El-Jardali, F., J. N. Lavis, N. Ataya and D. Jamal (2011). “Use of health systems and policy research evidence in the health policymaking in eastern Mediterranean countries: views and practices of researchers.” Implement Sci 7(1): 2.

Gonzalez-Block, M. A., M. Rouvier, V. Becerril and P. Sesia (2011). “Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico.” BMC Public Health 11: 164.

Kiwanuka, S. N., E. Rutebemberwa, C. Nalwadda, O. Okui, F. Ssengooba, A. A. Kinengyere and G. W. Pariyo (2011). “Interventions to manage dual practice among health workers.” Cochrane Database Syst Rev(7): CD008405.

Law, T., J. Lavis, A. Hamandi, A. Cheung and F. El-Jardali (2011). “Climate for evidence-informed health systems: a profi le of systematic review production in 41 low- and middle-income countries, 1996-2008.” J Health Serv Res Policy.

Meng, Q., B. Yuan, L. Jia, J. Wang, B. Yu, J. Gao and P. Garner (2011). “Expanding health insurance coverage in vulnerable groups: a systematic review of options.” Health Policy Plan 26(2): 93-104.

Penaloza, B., T. Pantoja, G. Bastias, C. Herrera and G. Rada (2011). “Interventions to reduce emigration of health care professionals from low- and middle-income countries.” Cochrane Database Syst Rev 9: CD007673.

Rouvier, M., M. A. Gonzalez-Block, V. Becerril-Montekio, P. Sesia, M. B. Duarte and E. Flores-Collins (2011). “[Problem mapping by state and federal actors for maternal health attention].” Salud Publica Mex 53(1): 48-56.

Yuan, S., Q. Meng, L. Jia and B. Yuan (2011). “Enlightenment from the method of Geographical Targeting on Chinese public health projects [Chinese language].” Chinese Health Service Management(2): 17-21.

Zhang, X., P. Miege and Y. Zhang (2011). “Decentralization of the provision of health services to people living with HIV/AIDS in rural China: the case of three counties.” Health Res Policy Syst 9: 9.

Zhang, Y., X. Zhang, T. Hanko Aleong and E. Fuller-Thomson (2011). “Impact of HIV/AIDS on Social Relationships in Rural China.” Open AIDS J 5: 67-73.

reports available by internet

Alliance for Health Policy and Systems Research (2011). Newsletter, Issue No. 21, July 2011 (http://www.who.int/alliance-hpsr/alliancehpsr_newsletter21.pdf). Geneva, World Health Organization.

AnneX 3. AlliAnCe puBliCAtions 2011 - 37


Alliance for Health Policy and Systems Research (2011). Strategic Plan 2011-2015: Bridging the worlds of research and policy (http://www.who.int/alliance-hpsr/alliancehpsr_strategicplan2011.pdf). Geneva, World Health Organization.

Curatio International Foundation and London School of Hygiene and Tropical Medicine (2011). Using qualitative approaches to health systems research (http://curatiofoundation.org/qualitativemethods/). Tbilisi, Curatio International Foundation.

Evidence-Based Medicine Unit and Health Policy and Systems Research Unit (2011). Epistemonikos Project: Database of primary studies in health policy and systems research useful for reviewers in the fi eld (http://www.who.int/alliance-hpsr/projects/alliancehpsr_dbseprimarystudieschile.pdf). Santiago, Faculty of Medicine, Pontifi cia Universidad Católica de Chile.

Health Policy and Systems Research Unit (2011). Handbook: How to conduct systematic reviews of health policy and systems research in low- and middle-income countries (http://www.who.int/alliance-hpsr/projects/alliancehpsr_handbooksystematicreviewschile.pdf). Santiago, School of Medicine, Pontifi cia Universidad Católica de Chile.

Kiwanuka, S., A. Kinengyere, E. Rutebemberwa, C. Nalwadda, F. Ssengooba, Olico-Okui and G. Pariyo (2011). “Dual practice regulatory mechanisms in the health sector: a systematic review of approaches and implementation.” (http://eppi.ioe.ac.uk/cms/LinkClick.aspx?fi leticket=0rig59OoMn8%3d&tabid=2963&language=en-US). London, EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.

Koehlmoos, T., R. Gazi, S. Hossain and M. Rashid (2011). “Social franchising evaluations: a scoping review” (http://eppi.ioe.ac.uk/cms/LinkClick.aspx?fi leticket=9x-E3kGWGmE%3d&tabid=3085&language=en-US). London, EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.

Meng, Q. (2011). “Means testing for targeting the people in health programs: A systematic review.” Shandong University, Jinan, China.

Pantoja, T. (2011). Synthesis methods in Systematic reviews of Health Policy and Systems Research (http://www.who.int/alliance-hpsr/projects/alliancehpsr_briefi ngnotesynthesismethodschile.pdf). Santiago, School of Medicine, Pontifi cia Universidad Católica de Chile.

38 - AnneX 3. AlliAnCe puBliCAtions 2011


ANNEX 4. unpuBlisHed grAntee reports

AnneX 4. unpuBlisHed grAntee reports - 39

Ahmedov, M. and J. Green (2011). “Developing methods and capacities for qualitative research in LMICs on health systems research.” Tashkent Medical Academy, Tashkent, Uzbekistan.

El-Jardali, F., S.F. Murray, R. AbuAlRub, N.Y. Dumit, K.A. Surimi, M.E. Clinton, D. Jamal and M. Jaafar. (2011).”Exploring the problem of scarcity of nurses in underserved areas in the Middle- East: Factors, reasons and incentives for recruitment and retention.” American University of Beirut, Beirut, Lebanon.

González-Block, M.A. (2011). Final technical report to the Alliance AHPSR on Supporting evidence-informed health policy-making in Mexico. National Institute of Public Health (INSP), Mexico.

Haffez, A. and S. Rizwan(2011).”Barriers to the use of magnesium sulfate in Pakistan.” Health Systems Academy, Islamabad, Pakistan.

Hamra R., A. Ferrario, M. Bigdeli and G. Baghdadi-Sabeti (2011). “Good governance for medicines programme.” Transparency monitoring study. A rapid assessment of transparency in key functions of pharmaceutical services in 15 countries.

Huicho, L., J. Miranda and F. Diez Canseco. (2011). “Incentives and employment preferences in an underserved area of Peru: a combined qualitative study and discrete choice experiment.” Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.

Jabbour, S. and R. Yamout (2011). “Access to Medicines: identifying policy concerns and policy research questions in Lebanon.” American University of Beirut, Lebanon.

Kasonde, J. (2011). “Developing a knowledge translation platform for health policy and systems research in Zambia.” Zambian Forum for Health Research, Lusaka, Zambia.

Koehlmoos, T. (2011). “Bridging know-do gap: Strategies to enhance the capacity to apply health policy and systems research into evidence-informed policy-making in Bangladesh”. ICDDRB, Dhaka, Bangladesh.


40 - AnneX 4. unpuBlisHed grAntee reports

Lingui, L. (2011). “Job satisfaction based incentives to attract and retain qualifi ed health workers to underserved areas in Western China”. Ningxia Medical University, Ningxia, China.

Luiza, V.L., I.C. Emmerick, T.B. Axaredo, M.A. Oliveira, G.C. Zuluaga, P. da Silva Freitas (2011). “Identifi cation of priority policy research questions on access to medicines in low- and middle- income countries in Latin America and Caribbean (LAC).” Fiocruz National Institute of Public Health, Rio de Janeiro, Brazil.

Maceira, D. (2011). “Promoting the generation of coordinated provincial health protection: A collective process.” Center for the Implementation of Public Policies Promoting Equity and Growth (CIPPEC), Buenos Aires, Argentina.

Men, C.R. (2011). “Identifi cation of priority policy research questions in the area of access to health care services and medicine in Cambodia.” Centre for Advanced Studies, Phnom Penh, Cambodia.

Meng, Q. (2011). “Cost sharing mechanisms in health insurance schemes: A systematic review.” Shandong University, Jinan, China.

Murzalieva, G. (2011). “Prospective evaluation of evidence-informed decision-making.” Health Policy Analysis Unit, Bishkek, Kyrgyz Republic.

Nguyen, T.K.C. (2011). “Identifi cation of priority policy research questions in the area of access to and use of medicines in Viet Nam.” Hanoi Medical University, Viet Nam.

Ntsama Essomba, C., J.B.Makoko, J. Ndong Ekorezock, K.Guirsimi and C.Tiwoda (2011). « Identifi cation des questions de recherche prioritaires en matière de politique d’accès et d’usage des médicaments dans des pays francophones d’Afrique Centrale, à revenus faibles ou intermédiaires.» Synthèse régionale. Université des Sciences, Yaoundé, Cameroun.

Ongolo-Zogo, P. (2011). “Transition towards a health SWAP in Cameroon: Supporting evidence use for decentralization and district development.” University of Yaounde, Cameroon.

Lkhagvasuren, O. (2011). “Priority-setting for future investments in health systems research”. Department of Health, Government of Mongolia, Ulaanbaatar, Mongolia.

Rashidian, A., N. Jahanmehr, F. Soleymani, and R.Dinarvand (2011). “Access to Medicines: identifying policy concerns and policy research questions in Iran.” Tehran University of Medical Sciences, Iran.


AnneX 4. unpuBlisHed grAntee reports - 41

Rashidian, A., S. Zaidi, S. Jabbour, F. Soleymani, and N. Jahanmehr (2011).” Identifi cation of priority policy research questions in the area of access to and use of medicines in EMRO countries: focusing on Iran, Pakistan and Lebanon.” Regional synthesis. Tehran University of Medical Sciences, Iran.

Selvaraj, S. (2011). “Identifi cation of priority policy research questions on access to medicines in India.” Public Health Foundation of India, New Delhi, India.

Semali, I. (2011). “Effects of global health initiatives on health systems of recipients: the case study of global HIV/AIDS funding initiatives on human resource in the United Republic of Tanzania.” School of Public Health and Social Sciences, Dar es Salaam, United Republic of Tanzania.

Serumaga, B., D. Ross-Degnan, M. Bigdeli, R. LeCates, A. Wagner and C. Vialle-Valentin (2011). “Evidence on access to and use of medicines to treat chronic diseases in low- and middle-income countries.” Report presenting preliminary results from a secondary analysis of fi ve medicines household surveys. Harvard Medical School / Harvard Pilgrim Healthcare Institute, USA.

Syhakhang, L., M. Chanthanom, S. Sounantha and B. Keohavong (2011).” Identifi cation of priority policy research questions in the area of access to health care services and medicine in Lao PDR”. Ministry of Health, Lao PDR.

Uneke, C.J. (2011). “Development, implementation and evaluation of individual staff skills and institutional incentives for capacity enhancement in health policy and systems research evidence use in policy-making in Nigeria.” Ebonyi State University, Abakaliki, Nigeria.

van Pelt. M. (2011). “Peer educator networks for people with diabetus melllitus and/or high blood pressure in Cambodia”. MoPoTsyo Patient Education Centre, Phnom Penh, Cambodia.

Wirtz, V., W. Kaplan, Y. Santa-Ana Tellez and R. Lopez Ridaura (2011). “Affordable, quality, long-term care and pharmacotherapy of chronic diseases: a framework for low- and middle- income countries”. National Institute of Public Health, Mexico.

Zhang, X. (2011). “The impact of the Global Fund on equity, fi nancial protection and social assistance policy development on HIV/AIDS families in China.” Beijing Normal University, Beijing, China.

Zaidi, S. (2011). “Access to Medicines: identifying policy concerns and policy research questions in Pakistan.” Agha Khan University, Karachi, Pakistan.


Grant programme Recipient Recipient’s country

Research title Start End Range of grant amounts

Health worker incentives to locate to underserved areas

Universidad Peruana Cayetano Heredia

Peru Incentives and employ-ment preferences in an underserved area of Peru: a combined qualitative study and discrete choice experiment

2009 2011 174,376 to199,000USD

American University of Beirut, Faculty of Health Sciences, Department of Health Management and Policy

Lebanon Exploring the Problem of Scarcity of Nurses in Underserved Areas in the Middle East: Factors, Reasons and Incentives for Recruitment and Retention

2009 2012

Universal Financial Coverage

International Health Policy Programme (IHPP), Ministry of Public Health

Thailand Assessing policy formulation of universal coverage scheme in Thailand

2010 2012 50,951 to 96,727 USD

Institute of Public Health, Bangalore

India Study of Rashtriya Swasthya Bima Yojana health insurance scheme in India

2010 2012

Health Policy Research Group, College of Medicine, University of Nigeria, Enugu-campus

Nigeria National health insurance scheme in Nigeria: an analysis of constraints and enabling factors to adoption and implementation

2010 2012

Health Systems Research Group Ifakara Health Institute, Dar es Salaam

United Republic of Tanzania

Understanding the effect of the takeover of an informal sector health insurance scheme by a formal sector scheme on universal coverage (UC) in terms of risk pooling and purchasing in Tanzania.

2010 2012

Curatio International Foundation

Georgia Insurance for Poor: Georgia’s Path to Universal Coverage. A Case Study.

2010 2012

1. Knowledge generation

42 - AnneX 5. AlliAnCe grAntees 2011

ANNEX 5. AlliAnCe grAntees 2011




AnneX 5. AlliAnCe grAntees 2011 - 43

Universal Financial Coverage

Project Economics, Population and Health (PEPH) – Central American Population Center (CPC) both from the University of Costa Rica

Costa Rica Universal fi nancial risk protection through social health insurance: The Costa Rican Health System and the role of the Government ID Number

2010 2012 50,951 to 96,727 USD

College of Medicine, University of Malawi

Malawi An Investigation into the Public Subsidization of Non-State Health Facilities to Expand Access and Financial Risk Protection: The Experiences of and Lessons Learnt from Malawi

2010 2012

Identifi cation of priority policy research questions in the area of access to medicines

National School of Public Health at the Oswaldo Cruz Foundation (NAF/NESP/Fiocruz)

Brazil Brazil case study 2010 2011 6,900 to 46,236 USD

Université de Yaoundé Cameroon Cameroon, Chad, Congo and Gabon case studies

2010 2011

National Institute of Health Research, Tehran University of Medical Sciences

Iran, (IslamicRepublic of)

Iran case study and regional coordination countries of the Eastern Mediterranean Region

2010 2011

Center for Advanced Studies

Cambodia Cambodia case study and regional coordination of Western Pacifi c countries

2010 2011

Ministry of Health, Food and Drug Department

Lao PDR Lao PDR case study 2010 2011

Hanoi Medical University

Viet Nam Viet Nam case study 2010 2011

Chulalongkorn University

Thailand Thailand case study 2010 2011

Agha Khan University Pakistan Pakistan case study 2010 2011

Public Health Foundation of India

India India case study 2010 2011

American University of Beirut

Lebanon Lebanon case study 2011 2011

Identifi cation of priority policy research questions in the area of access to medicines

Noguchi Memorial Institute for Medical Research

Ghana Ghana case study 2011 2011 6,900 to 46,236 USD

National University of Rwanda

Rwanda Rwanda case study 2011 2011

Access to Medicines Policy Research

Ministry of Health, Lebanon

Lebanon Good Governance for Medicines: Analysis of baseline and follow-up transparency assessment in 26 countries participa-ting in the Good Gover-nance for Medicines programme

2010 2011 4,600 to 25,000 USD

MoPoTsyo Cambodia Access to Medicines as part of a Community Based Peer Educator Programme for Patients with Diabetes and High Blood Pressure (Cambodia)

2010 2011

Ministry of Health, Pakistan

Pakistan Barriers to the Use of Magnesium Sulphate in Pakistan: A study to develop informed policy

2010 2011

National Public Health Institute Mexico (INSP)

Mexico Access to Medicines for Patients living with a Chronic Condition in Low- and Middle-Income Countries

2010 2011

Harvard Medical School

Uganda Access to and Use of Medicines to Treat Chronic Diseases in Low- and Middle- Income Countries: Analysis of Baseline MeTA - WHO Household Surveys

2010 2011

Vera Lucia Luiza Brazil Access to Medicines Policy Research Update of the Systematic Review on «Effects of Caps and Copayments on rational drug use»

2011 2011

Arash Rashidian (National Institute of Health Research, Tehran University of Medical Sciences)

Iran (IslamicRepublic of)

Access to Medicines Policy Research Update of the Systematic Review on «Financial incentive for prescribers»

2011 2011






Centres for Systematic Reviews

ICDDR,B Bangladesh Centre for Systematic Reviews on the Non-state sector

2007 2012 291,437 to 335,990 USD

Shandong University China Centre for Systematic Reviews on Health Financing

2007 2011

Makerere Institute of Public Health

Uganda Centre for Systematic Reviews on the Human Resources for Health

2007 2012

Pontifi cia Universidad Católica de Chile (Catholic University of Chile)

Chile Methodology Centre for Systematic reviews of HPSR

2007 2011

Studies commissioned for WHO-HSR Strategy

Institute of Tropical Medicine

Belgium Country case studies: mapping the health systems research landscape

2011 2012 58,000 USD


2. Evidence to policy



Sponsoring National Processes for Evidence-Informed Policy

The Zambian Forum for Health Research (ZAMFOHR)

Zambia Developing a knowledge translation platform for health policy and systems research in Zambia

2009 2011 80,655 to 189,885 USD

ICDDR,B Bangladesh Bridging the Know-Do Gap: Strategies to Enhance the Capacity to Apply Health Policy and Systems Research into Evidence-Informed Policy-making in Bangladesh

2009 2011

Center for the Development of Best Practices in Health – Yaoundé Central Hospital

Cameroon Transition towards a Health SWAp in Cameroon: Supporting Evidence Use for Decentralization and District Development

2009 2011

Center for the Implementation of Public Policies Promoting Equity and Growth (CIPPEC)

Argentina Promoting the generation of coordinated provincial health protection. A collective process

2009 2011

Sponsoring National Processes for Evidence-Informed Policy

Innovative Health Research Group (IHRG), Faculty of Clinical Medicine, College of Health Sciences, Ebonyi State University, Abakaliki Nigeria.

Nigeria Development, implementation, and evaluation of individual staff skills and institutional incentives for capacity enhancement in health policy and systems research evidence use in policy-making in Nigeria.

2009 2011 80,655 to 189,885USD

Health Policy Analysis Unit

Kyrgyzstan Country Grant for evidence-informed policy work: Prospective Evaluation of Evidence-In-formed Decision-Making

2007 2011

Innovative strategies to enhance capacity to apply health policy and systems research evidence in policy-making

Asociación Colombiana de la Salud - ASSALUD

Colombia Attempting to close the gap between knowledge production and knowledge use in Colombia.

2009 2011 140,502 to 180,011 USD

Curatio International Foundation

Georgia Strengthening Capacity of Civil Society for Promoting Research Evidence into Policy Development in Georgia

2009 2011

National Institute for Public Health (INSP)

Mexico Supporting evidence-informed health policy-making in Mexico: Targeted training & tools to address contrasting state-level contexts

2009 2010

Enhancing policy-maker capacity

Anusandhan Trust & State Health Systems Resource Centre (SHSRC)

India Developing capacities for using community oriented evidence towards strengtheningdistrict health planning in Maharashtra state, India

2010 2012 74,845 to 191,000 USD

The Nigerian Academy of Science

Nigeria Policy Research Evidence for Effective Working of Nigerian Health Systems

2010 2012

ICDDR,B Bangladesh Enhancing Capacity to Apply Research Evidence in Policy-making for Reproductive Health in Bangladesh

2010 2012



3. Capacity development




Direct research Public Health Foundation of India

India A scalable approach to improve the coverage, quality and impact of MNCH care in the urban slums of Dehli: Developing a package of MNCH care facilities through an urban community health worker: The ANCHUL project (Ante Natal and Child Health care in Urban Slums).

2010 2013 300,000 USD



4. Implementation Research Platform


Strengthening HPSR methodologies

Tashkent Medical Academy, School of Public Health

Uzbekistan Exploring providers’ and patients’ perspectives on barriers to quality of care for chronic heart failure (CHF) in Uzbekistan and Georgia

2008 2011 91,280 to 185,875 USD

School of Public Health and Family Medicine, University of Cape Town

South Africa

Strengthening health policy analysis research and training through a focus on approaches to comparative and synthesis analyses

2009 2011

Escuela de Medicina, Pontifi cia Universidad Católica de Chile

Chile Searching databases for systematic reviews (SR) in Health Policy and Systems Research (HPSR).

2009 2011

Health Policy and Planning supplement on health systems thinking

Institute de recherche en Sciences de la sante (IRSS)

Burkina Faso

Exploring the system-wide effects of task shifting in Burkina Faso

2011 2010 1,500 to 13,500USD

Augustina Koduah Ghana Policy resistance and implementation chal-lenges: When “the solutions of yesterday become the problems of tomorrow” – A Case study of the Additional Duty Hours Allowance (ADHA) intervention in Ghana

2011 2010

Justine Hsu United Kingdom

To update and expand on an existing annotated bibliography of evaluations of system-level interven-tions and initiatives

2011 2011

David Peters United States of America

The Develop-Distort Dilemma and use of Health Systems Research

2011 2011

Evidence Synthesis

National Institute of Health Research (NIHR) at the Tehran University of Medical Sciences (TUMS)

Iran Task-shifting to improve access to health-care providers: systematic review of qualitative research on barriers and facilitators to the substitution of doctors with nurses

2011 2012 30,000 to 42,322USD

Centre for Infectious Disease Epidemiology and Research (CIDER), School of Public Health and Family Medicine, University of Cape Town

South Africa

Task-shifting to improve access to health-care providers: Systematic review of qualitative research on barriers and facilitators to the implementation of lay health worker programmes

2011 2012

Centre for Evidence-based Health Care Department of Interdisciplinary Health Sciences Faculty of Health Sciences, Stellenbosch University, Tygerberg, Cape Town

South Africa

Home- or community-based treatment of malaria with ACTs in malaria endemic areas

2011 2012

Universidad Peruana Cayetano Heredia

Peru Systematically synthesizing IMCI implementation: what works for whom and in what circumstances?

2011 2012

The Great Lakes of Kisumu (GLUK), Kenya

Kenya Effectiveness of mobile telephone services to improve maternal and neonatal health in developing countries

2011 2012

The Kintampo Health Research Centre: An Affi liate Centre of the Joanna Briggs Institute

Ghana Facilitators and Barriers to Interventions Aimed at Reducing Unintended Pregnancies among adolescents in Low- and Middle-Income Countries

2011 2012

Department of Obstetrics and GynaecologyThe Aga Khan University, Karachi

Pakistan Quality of Care: Effectiveness of Strategies for Health Systems Responsiveness (HSR) during Intrapartum Care in Low- and Middle-In-come countries

2011 2012









University of Jayewarenpura Colombo

Sri Lanka Synthesis of evidence on strategies applied to optimize health worker roles (task shifting/sharing) to address MDG 5 in Small Island States

2011 2012

Center for Evidence-based Global Health

Nigeria Comparative Effi cacy of Behavioural Interventions for the prevention of Heterosexual Acquisition of HIV in sub-Saharan Africa: A systematic review and Bayesian network metaanalysis

2011 2012

China Centre for Health Development Studies (CCHDS), Peking University

China Strategies for improving attraction and retention of health workers in rural and remote areas in low- and middle-income countries to achieve Millennium Development Goals (Review)

2011 2012

Hope International College, Lalitpur, Satdobato

Nepal What are the strategies for implementation and up–scaling of Innovative Community Interventions (ICI) for prevention, care and referral of Maternal and Neonatal Health (MNH) services in fragile states?

2011 2012

IRP CapacityStrengthening

Health Services Academy

Pakistan Country support to strengthen capacity and leverage funds for implementation research to scale up maternal, newborn and child health interven-tions to achieve MDG4 and MDG5

2011 2010 22,800USD

Contribution DFID 3,682,911

Contribution Sida 2,063,218

Contribution Norway 3,490,401

Contribution Results for Development 30,000

Contribution China Medical Board 250,000

TOTAL Contributions 9,516,530

PSC (programme support costs) 1,094,822

TOTAL Net Contributions 8,421,708

TeamContributions Received 1 Jan 2011-31 Dec 2011

A. Knowledge Generation & Synthesis 1,107,103

B. Dissemination, Use of Knowledge & Evidence to Policy

717,149

C. Capacity Development (of researchers & users)

290,126

D. Advocacy & Communication 59,265

E. Governance & Management 145,077

Staff Costs 2,716,714

Subtotal (Activity & Staff) 5,035,434

Commitments* 2,594,337

TOTAL 7,629,771

Team Use of Contributions*

TeamAvailable surplus for 2011 791,937

* includes encumbrances and also net obligations for Implementation Research,Symposium and core commitments in 2011

All fi gures in USD

50 - AnneX 6. AlliAnCe finAnCiAl MAnAgeMent report 2011


ANNEX 6. AlliAnCe finAnCiAl MAnAgeMent report 2011

FINANCIAL MANAGEMENT SUMMARY REPORT 2011

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T he Alliance for Health Policy and Systems Research is an international collaboration, based within WHO, Geneva, aiming to promote the

generation and use of health policy and systems research as a means to improve the health systems of developing countries.

Specifi cally, the Alliance aims to:

• Stimulate the generation and synthesis of policy-relevant health systems knowledge, encompassing evidence, tools and methods;

• Promote the dissemination and use of health policy and systems knowledge to improve the performance of health systems;

• Facilitate the development of capacity for the generation, dissemination and use of health policy and systems research knowledge among researchers, policy-makers and other stakeholders.

World Health OrganizationAvenue Appia 20CH-1211 Genève 27

[email protected]://www.who.int/alliance-hpsr WHO/Alliance HPSR/12.1

annual report 2011 - who.int · the designations employed and the presentation of the material in...

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