Turning health systems research and evidence into country action

The question of how to implement findings from evidence-based research into improved health care policies remains a persistent challenge. But it is essential that we bridge this “know-do” gap in order to strengthen health systems and move toward universal health coverage (UHC).

Finding strategies for translating high-quality research and practical experience into coherent and effective policies is becoming increasingly critical. The global health community must find ways to support policymakers and practitioners in understanding and applying evidence-based recommendations specific to their context.

One approach that is successfully translating evidence into action is called joint learning, and one of the best examples of this approach is the Joint Learning Network for Universal Health Coverage. The Joint Learning Network has 27 country members who are at varying stages of implementing health policy and system reforms to advance universal health coverage. To date, the network has produced more than 130 resources — but these case studies and manuals and toolkits don’t just sit on a shelf collecting dust. The countries are actively using them. For example, Ghana has tapped joint learning to strengthen its provider payment systems, contributing to and utilizing co-produced JLN knowledge products to diagnose key payment challenges, assess reform options, and conduct costing analyses for provider payment. This has stimulated more local evidence generation, including provider mapping, the strategic development of provider networks, and the design and implementation of a new provider payment system to ensure more efficient and effective purchasing of health services by the government.

5 strategies for translating evidence to action with the joint learning approach

1. Start by responding to a need. For research and evidence to be useful, it needs to address a real-life problem. We must ask policymakers and practitioners about the decisions and challenges they routinely face and focus our efforts there. To date, the members of the Joint Learning Network have identified priority topic areas such as how to effectively engage private primary health care providers and how to implement optimal provider payment mechanisms.
2. Focus on the experiences of countries that face similar challenges. For evidence to be translated into action, it needs to be relevant to the specific context it will be used in. As a facilitator for the Joint Learning Network, Results for Development works with countries to review and document their experiences in a structured way and draw lessons that may be applicable to many countries, ultimately helping to develop both country specific and global solutions.
3. Put policymakers and practitioners in the driver’s seat. We firmly believe that people who have led or are leading health-system reforms are best positioned to help others in the same situation and to produce practical ways forward. Our job as facilitators is to foster an environment where policymakers and practitioners are the experts in the room. As experts, they take stock of the available evidence and identify the knowledge gaps for the common challenge they are trying to solve. Then they share their own knowledge with one another and co-create practical solutions. This approach changes the paradigm — government actors become both evidence users and evidence producers. Our experience with the JLN has demonstrated that positioning policymakers and practitioners as the experts promotes strong ownership and increased likelihood they will translate evidence and co-produced knowledge into sustainable change and improvement of their country policy processes.
4. Translate research and evidence into practical tools. Research and evidence can tell you what you ought to do to get a desired result, but figuring out how to get that result is often the more challenging bit. That’s why the Joint Learning Network has focused on developing practical tools and guides that member countries can adapt to their own specific needs and circumstances. For example, members of the network developed the UHC Primary Health Care Self-Assessment Tool based on both the research evidence and practical implementation experience. The assessment tool is a multi-stakeholder survey that helps practitioners and policymakers to rapidly assess whether their health financing approaches are aligned with their primary health care objectives, while identifying key areas for improvement and potential intervention. Ghana, India, Indonesia and Malaysia have piloted the development of the tool and have published their own experiences for other member countries grappling with similar challenges.
5. Stay connected. Translating evidence into action is rarely a one-and-done proposition. It requires feedback loops and continued engagement and support as new and unexpected challenges arise. In fact, members of the Joint Learning Network cite the continuous ability to tap into the expertise of colleagues facing similar challenges around the world as the network’s top benefit.

Knowledge and implementation experience

The Joint Learning Network experience demonstrates collaborative learning is an effective way to build knowledge while resolving implementation challenges. Its fine-tuned country-led model and facilitation techniques enhance knowledge translation, which is key to effective policymaking and reforms. Moreover, these joint learning methods can be adapted and used well into the future by countries across the globe—and across the spectrum in tackling some of global development’s toughest challenges.

Photo © Joint Learning Network