Knowledge Transfer, and Evidence-Informed Health Policy Undersecretary Meeting, Feb. 26, 2009 Ghaiath M.A. Hussein MBBS, M...
Acknowledgement  <ul><li>Many the slides used in this presentation are used with permission from presentations by: </li></...
Outline of the presentation <ul><li>Background </li></ul><ul><li>The ‘Knowledge Cycle’ </li></ul><ul><li>The Knowledge Tra...
خريطة توضح حجم دول العالم من حيث الإنفاق على البحوث والتنمية وأكثر واقل عشر دول إنفاقا على البحوث في العالم  ( بالدولار لك...
خريطة توضح حجم دول العالم من حيث عدد المقالات العلمية المنشورة، وجدول يوضح عدد المقالات العلمية المنشورة لكل مليون من السك...
The ‘Classical’ Knowledge Cycle Researchers Policy makers
What is KT? <ul><li>… a process by which relevant research information is made available and accessible for practice, plan...
What’s  E vidence- B ased  H ealth c are? <ul><li>Evidence-based healthcare (EBH) is the integration of  best   research  ...
Why do we need to be evidence-based? <ul><li>Lack of resources:  we need to be sure this is the best way to spend them - C...
Components of EBM/H Modified from Huneborg, 2000 EBHC Individual  Clinical /Policy Expertise Best  External  Evidence Pati...
Steps of evidence based medicine <ul><li>1) A sk a question </li></ul><ul><li>2) A cquire relevant articles </li></ul><ul>...
<ul><li>What is worse than having no evidence </li></ul><ul><li>is to have bad evidence! </li></ul>
Hierarchy of Evidence Systematic Reviews and Meta-analysis Randomized controlled trials with definitive results RCTs with ...
Evidence Pyramid
Potential contribution of evidence to policy <ul><li>Exposure to a wider range of validated policy options </li></ul><ul><...
Science Decision-Making
You’re 30 metres above the ground in a balloon You must be a researcher Yes. How  did you know? Because what you told me i...
A research institution is a &quot;knowledge&quot; factory Input: information Output:  information Processing Knowledge
The policy and execution  grinding mill Information Policy  and communication Processing Knowledge Analyses of threats and...
Many “Leaks” from research & practice If 80% achieved at each stage then 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 = 0.21 Aw...
Need a ‘new look’? <ul><li>“ In the world of research, completing the study is just the first step…making the research com...
Research <ul><li>Generation of new knowledge </li></ul><ul><li>Synthesis of available information </li></ul><ul><li>Sharin...
<ul><li>Diagnosis, treatment </li></ul><ul><li>Trained health workers </li></ul><ul><li>Clinical diagnostics </li></ul><ul...
<ul><ul><li>Understanding the biological nature of diseases </li></ul></ul><ul><ul><li>Creating products to prevent or tre...
Source:  Institute of Health Economics, Alberta, Canada, 2008. Stakeholders for different types of research
<ul><li>Researchers and Policy-makers: From mutual understanding to mutual work </li></ul>
Matter of Fact! <ul><li>“ There is nothing a government hates more than to be well informed; for it makes the process of a...
Another Set of Facts! <ul><li>A substantial knowledge base exists, albeit under-utilized, to improve the health of populat...
Researchers and Policy makers are two separate communities? <ul><li>“ Researchers search for truth by using a rational mod...
Feature distinguishing ( academic ) research and policy-makers Researchers Policy - makers Overall goal To advance science...
How to Bridge the gaps? Science Decision-Making Knowledge Brokers
 
 
Reza Majdzadeh
What we do now as Research Directorate? Train, Review, curricula Seminars Website Database
Steps Forward <ul><li>Update the research priorities collectively </li></ul><ul><li>Develop a Knowledge Transfer & Evidenc...
Key Messages <ul><li>Policy makers need to be research-oriented </li></ul><ul><li>Researchers should be action-oriented </...
 
 
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Knowledge transfer, and evidence informed health policy-minster's meeting

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A presentation given to the highest executive body in the Federal Ministry of Health in Sudan, which led to the adoption of a new evidence-based policy.

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  • By best research we mean clinically relevant research ,often from basic science of medicine, but especially from patient-centered clinical research. this new evidence invalidates previously accepted diagnostic tests &amp;treatment and replace them with a more powerful more accurate more efficacious and safer. Clinical expertise it we mean the ability to use our clinical skills and past experience to identify each patients unique health state and diagnosis ,their individual risks and the benefits of potential interventions, their personal values and expectations Patient values: it is the preference, concerns expectations that each pts brings to the clinical encounter which must be integrated into the clinical decisions if they are to serve the patient When these 3 elements are integrated clinicians &amp;pts form a diagnostic &amp;therapeutic alliance which will optimizes clinical outcomes &amp;quality of life.
  • The KTE TUMS model was the attaintment of this research.
  • Knowledge transfer, and evidence informed health policy-minster's meeting

    1. 1. Knowledge Transfer, and Evidence-Informed Health Policy Undersecretary Meeting, Feb. 26, 2009 Ghaiath M.A. Hussein MBBS, MHSc. (Bioethics) Research Directorate Federal Ministry of Health
    2. 2. Acknowledgement <ul><li>Many the slides used in this presentation are used with permission from presentations by: </li></ul><ul><li>Dr. Fadi El-Jardali (AUB) </li></ul><ul><li>Dr. Abdul Ghaffar (RPC Advisor, WHO/EMRO) </li></ul><ul><li>Dr. Noha Dashash (PHC Directorate, Jeddah, KSA) </li></ul>
    3. 3. Outline of the presentation <ul><li>Background </li></ul><ul><li>The ‘Knowledge Cycle’ </li></ul><ul><li>The Knowledge Transfer </li></ul><ul><li>Evidence-Based Healthcare </li></ul><ul><li>Where are we? </li></ul><ul><li>What we need to do? </li></ul><ul><li>Conclusion and Discussion </li></ul>
    4. 4. خريطة توضح حجم دول العالم من حيث الإنفاق على البحوث والتنمية وأكثر واقل عشر دول إنفاقا على البحوث في العالم ( بالدولار لكل مواطن لكل عام ). المصدر : www.worldmapper.org
    5. 5. خريطة توضح حجم دول العالم من حيث عدد المقالات العلمية المنشورة، وجدول يوضح عدد المقالات العلمية المنشورة لكل مليون من السكان لعام 2001 م . المصدر : www.worldmapper.org
    6. 6. The ‘Classical’ Knowledge Cycle Researchers Policy makers
    7. 7. What is KT? <ul><li>… a process by which relevant research information is made available and accessible for practice, planning, and policy-making through interactive engagement with audiences. </li></ul><ul><li>Other terms include: research transfer, knowledge exchange, knowledge translation, knowledge mobilization, research uptake, research/knowledge utilization, and dissemination. Although these terms are similar and are sometimes used interchangeably </li></ul>
    8. 8. What’s E vidence- B ased H ealth c are? <ul><li>Evidence-based healthcare (EBH) is the integration of best research evidence with clinical/policy expertise and patient/population values . </li></ul>
    9. 9. Why do we need to be evidence-based? <ul><li>Lack of resources: we need to be sure this is the best way to spend them - Cost-containmen t </li></ul><ul><li>Quality improvement : Are we providing the best service? </li></ul><ul><li>Accountability (for political leadership and served population) </li></ul>
    10. 10. Components of EBM/H Modified from Huneborg, 2000 EBHC Individual Clinical /Policy Expertise Best External Evidence Patient/Population’s Values & Expectations
    11. 11. Steps of evidence based medicine <ul><li>1) A sk a question </li></ul><ul><li>2) A cquire relevant articles </li></ul><ul><li>3) A ppraise the evidence </li></ul><ul><li>4) A pply the findings </li></ul><ul><li>5) A ssess our performance </li></ul>
    12. 12. <ul><li>What is worse than having no evidence </li></ul><ul><li>is to have bad evidence! </li></ul>
    13. 13. Hierarchy of Evidence Systematic Reviews and Meta-analysis Randomized controlled trials with definitive results RCTs with non-definitive results Cohort studies Case Control studies Cross-sectional surveys Case reports / opinions
    14. 14. Evidence Pyramid
    15. 15. Potential contribution of evidence to policy <ul><li>Exposure to a wider range of validated policy options </li></ul><ul><li>Evaluation of the success and failure of previous policies </li></ul><ul><li>Ability to identify relationships between seemingly </li></ul><ul><li>independent factors (e.g.. Health care reform and health outcomes) </li></ul><ul><li>Capacity to legitimize some policies while casting doubt on others (Hanney et al, 2003) </li></ul><ul><li>Promote evidence based management practices </li></ul>
    16. 16. Science Decision-Making
    17. 17. You’re 30 metres above the ground in a balloon You must be a researcher Yes. How did you know? Because what you told me is absolutely correct but completely useless You must be a policy maker Yes, how did you know? Because you don’t know where you are, you don’t know where you’re going, and now you’re blaming me The problem / 30 Where am I?
    18. 18. A research institution is a &quot;knowledge&quot; factory Input: information Output: information Processing Knowledge
    19. 19. The policy and execution grinding mill Information Policy and communication Processing Knowledge Analyses of threats and benefits Impact Testing Evaluation
    20. 20. Many “Leaks” from research & practice If 80% achieved at each stage then 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 = 0.21 Aware Accept Target Doable Recall Agree Done Valid Research
    21. 21. Need a ‘new look’? <ul><li>“ In the world of research, completing the study is just the first step…making the research come alive and using it to build capacity for future science and scientists and to tell stories that capture policy-maker’s attention and ultimately lead to policy changes, are what it is all about” </li></ul><ul><li>(O’Brien-Pallas, 2003) </li></ul>
    22. 22. Research <ul><li>Generation of new knowledge </li></ul><ul><li>Synthesis of available information </li></ul><ul><li>Sharing good practices </li></ul><ul><li>Translation of knowledge (for improved policy and management decisions) </li></ul>
    23. 23. <ul><li>Diagnosis, treatment </li></ul><ul><li>Trained health workers </li></ul><ul><li>Clinical diagnostics </li></ul><ul><li>Treatment/medicines </li></ul><ul><li>Hospital services </li></ul><ul><li>Information </li></ul><ul><li>Health promotion, disease prevention </li></ul><ul><li>Information </li></ul><ul><li>Products </li></ul><ul><li>Services </li></ul>Access to <ul><li>Health products and services </li></ul><ul><li>Information </li></ul><ul><li>Conditions to gain/maintain good health </li></ul>environment work social conditions economic conditions
    24. 24. <ul><ul><li>Understanding the biological nature of diseases </li></ul></ul><ul><ul><li>Creating products to prevent or treat disease states </li></ul></ul>Understanding how to test, scale-up and follow through on the introduction of interventions to optimise their benefits Impact The spectrum of research for development Biomedical research Health policy and systems research Social sciences and behavioural research Operational research Basic research: physical and biological sciences, including chemistry, pharmacology, toxicology, genetics, etc. Research on policy formulation, relationship to evidence, prioritization, etc. Research and development for medicines, vaccines, diagnostics, appliances, etc. Research on health systems management, functions, efficiency, effectiveness, system factors affecting access, scale-up, monitoring and evaluation, etc. Research on social and behavioral factors influencing health and their relation to equity, access, lifestyle and health-seeking behaviours, etc. Research on factors affecting functioning of programmes, effectiveness of targeting, impact on behaviour, disease burdens and public health, etc.
    25. 25. Source: Institute of Health Economics, Alberta, Canada, 2008. Stakeholders for different types of research
    26. 26. <ul><li>Researchers and Policy-makers: From mutual understanding to mutual work </li></ul>
    27. 27. Matter of Fact! <ul><li>“ There is nothing a government hates more than to be well informed; for it makes the process of arriving at decisions much more complicated and difficult” </li></ul><ul><li>John Maynard Keynes </li></ul>
    28. 28. Another Set of Facts! <ul><li>A substantial knowledge base exists, albeit under-utilized, to improve the health of populations </li></ul><ul><li>Research is biased in favour of biomedical sciences and public health interventions with significant (disease-based) implications </li></ul><ul><li>Researchers and policy-makers are two different groups with different backgrounds, different incentives and with different roles and responsibilities </li></ul>
    29. 29. Researchers and Policy makers are two separate communities? <ul><li>“ Researchers search for truth by using a rational model…policy makers search for a compromise, by using an intuitive model” </li></ul><ul><li>Choi et al (2005) </li></ul>
    30. 30. Feature distinguishing ( academic ) research and policy-makers Researchers Policy - makers Overall goal To advance science To improve the performance of health systems Specific objectives Tenure track positions Publications To gain popular and political support Output Detailed reports, based on science Press release s Desired outcome Respect of peers Perception more important than what happens in reality Time factor Some studies can take years Demand results in the short term Accountable to Peers and editors of medical journals Cabinet and c onstituents
    31. 31. How to Bridge the gaps? Science Decision-Making Knowledge Brokers
    32. 34. Reza Majdzadeh
    33. 35. What we do now as Research Directorate? Train, Review, curricula Seminars Website Database
    34. 36. Steps Forward <ul><li>Update the research priorities collectively </li></ul><ul><li>Develop a Knowledge Transfer & Evidence Synthesis Unit </li></ul><ul><li>Establish a Decision Support Unit </li></ul><ul><li>Develop and activate the Policy Forum </li></ul><ul><li>Policy makers need to be able to: </li></ul><ul><li>Identify situations where research can help </li></ul><ul><li>Articulate research questions for topics of policy relevant research; and </li></ul><ul><li>Access evidence and incorporate them in decision making </li></ul>
    35. 37. Key Messages <ul><li>Policy makers need to be research-oriented </li></ul><ul><li>Researchers should be action-oriented </li></ul><ul><li>Each partner need to understand and cope with other partners </li></ul><ul><li>Always remember that our common and ultimate goal as researchers & policy makers if the health of our people! </li></ul>

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