Universal Health Coverage Requires More Policy-Relevant Research

NEW YORK CITY – Evidence-based decision-making and tapping into local potential are keys to achieving the goals set in the Universal Health Coverage (UHC) declaration, said a panel convened today on the sidelines of the 74th United Nations General Assembly.

The Government of Georgia, whose Permanent Mission to the UN co-sponsored the panel, helped lead key intergovernmental meetings during drafting of the landmark UHC declaration adopted on Monday. Health Systems Global and the Alliance for Health Policy and Systems Research, a collaboration hosted by the World Health Organization, co-hosted the event.

“Without evidence-driven decision making… it will be impossible to obtain the Universal Health Coverage goals,” said Dr. Mariam Jashi, chair of the Education, Science and Culture Committee, Parliament of Georgia.

(left-right) Lola Adedokun, Director of Programs at the Doris Duke Charitable Foundation; Executive Director of NHSRC, Ranjani R. Ved; Director of Health Systems Program at JHSPH, Sara Bennett; Chair of ESC Committee, Parliament of Georgia, Mariam Jashi; Counselor to the Permanent Mission of Georgia to the UN, Tamar Tchelidze; Associate Director of Health Section, Programmes Division at UNICEF, Stefan Swartling Peterson.

The goal in drafting the UHC declaration was “to be prescriptive to the government,” said Tamar Tchelidze, Counselor on Health and Social Issues at the Permanent Mission of Georgia to the UN in New York. Tchelidze emphasized that the drafting team wanted governments to use the statements in the declaration to guide multisectoral engagement within countries, involving stakeholders that were most important to local governments.

Along the same theme, panelists pointed out that addressing shortcomings in policy-relevant research is a responsibility of multilaterals, civil society, and academia, which fund and conduct much of the research that government needs and uses.

Research should aim to inform policy-making more directly, said panelists. And in particular, global health researchers should focus on gathering just enough data to “prove a point,” said Lola Adedokun, Director of the African Health Initiative at the Doris Duke Charitable Foundation.

Adedokun said that the academic mandate to publish can otherwise meander into areas that are not relevant to countries, imposing burdens on data collectors, who are often community health workers that must still carry out routine, primary care duties.

At the same time, local research capacities should be leveraged, said Dr. Stefan Swartling Peterson, associate director of the Health Section, Programme Division at UNICEF.

“Country programs come to UNICEF and ask, ‘We don’t know this, and we don’t know that,’ and I always ask, ‘Who is your local academic partner? And that always throws them off,’ notes Peterson. He says that all stakeholders should build strong partnerships with local academic partners because “safari researchers,” who run short-term research programs, do not “have the same swaying power” as local research institutions do.

He noted that, although the World Health Organization’s plan for UHC does include calls to strengthen human resources for health, discussions focus mostly on the shortage of healthcare workers rather than healthcare researchers.

In communicating research findings to policy makers, the panel highlighted the roles of journalists, civil society, and government champions, who create spaces for knowledge exchange to happen.

“People’s movements are really the key to social accountability,” said Dr. Ranjani R. Ved, executive director of the National Health Systems Resource Centre (NHSRC), a technical agency within India’s Ministry of Health.

Yet at the same time, higher-level “knowledge brokers” are required to help shift the paradigm away from traditional research models that emphasize publication for its own sake, towards more open forum spaces for policy-makers, practitioners, and researchers to discuss lessons learned.

Citing other panelists, Dr. Sara Bennett, director of the Health Systems Program at John’s Hopkins Bloomberg School of Public Health, said that there is a need for countries to institutionalize organizations that “bridge research and policy,” and dedicate funding towards that space.

In response to a query by Health Policy Watch regarding where such investments should be focused, Bennett said, “I’m not quite sure that we have the formula right for how these organizations work yet, but certainly we need to think more about the go-between space [between research and policy]. How do we connect these worlds?”

Image Credits: Health Systems Global.

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