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Supporting Evidence: A WHO/EMRO Perspective

This article explores the WHO's mandate for research and the generation and governance of supporting evidence for public health policies. It also discusses research dissemination and the way forward in the Eastern Mediterranean Region.

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Supporting Evidence: A WHO/EMRO Perspective

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  1. Supporting Evidence: A WHO/EMRO Perspective Public Health Arab Conference Casablanca, Morocco, 4 April, 2019

  2. Headlines • EMRO overview • WHO’s mandate for research • WHO research support bodies • Evidence generation & governance • Supporting evidence for policy • Research dissemination • Way forward

  3. HR in the EMR WHO/EMR Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates, Yemen Palestine is member of the Regional Committee of the EMR

  4. Vision 2023 in EMRRegional Strategic Priorities • Expanding universal health coverage • Addressing health emergencies • Promoting healthier populations • Making transformative changes in WHO

  5. Vision 2023 in EMRKey Initiatives for 2019 1 • Forming an Alliance for Health for All by All with key partners and stakeholders in the Region • Accelerating functional reviews to strengthen WHO’s country offices and the Centre for Environmental Health Action (CEHA) • Establishing a leadership and health diplomacy development programme • Addressing SDGs by revitalizing the community-based initiatives programme including healthy cities, healthy villages, healthy markets and health- promoting schools

  6. Vision 2023 in EMRKey Initiatives for 2019 2 • Launching regional essential health service and inter-sectoral packages to support the achievement of universal health coverage • Promoting the Patient Safety Friendly Hospital Initiative in the Region • Launching a health innovation programme and advancing the use of information technology by introducing the latest tools and innovations

  7. Vision 2023 in EMRKey Initiatives for 2019 3 • Scaling up contributions by the WHO Collaborating Centres in the Region • Expanding rosters of human, institutional and financial resources in the Region, including experts, partners, research and academic institutions and donor agencies • Building capacity among future public health experts by promoting and streamlining the WHO internship and junior professional officer programmes

  8. WHO/EMRO • Senior Administration (RD, DPM, directors) • Departments • Administration & Finance (DAF) • Health Systems Development (HSD) • Non-communicable Diseases & Mental Health (NMH) • Health Protection & Promotion (DHP) • Communicable Diseases Control (DCD) • WHO Health Emergencies (WHE) • Information, Evidence & Research (IER)

  9. Information, Evidence and Research (IER) • RegionalDirector • Director of Programme • Management • Information, Evidence and Research (IER) • Editorial, • Publishing and • Web Support • Knowledge • Sharing and • Production • Arabic Programme • and French • Translation • Health Information • and Statistics • Research, Development • and Innovation

  10. Supporting evidence

  11. WHO’s Mandate • WHO is mandated by its constitution to support and and promote health research (1948) • The World Health Report: “Research for Universal Health Coverage” (2013) emphasized WHO’s role in advancing research that addresses the dominant health needs of its Member States, supporting: • national health research systems • setting norms and standards for the proper conduct of research and • accelerating translation of research findings into health policy and practice

  12. WHO Resolutions Executive Board EB124/12 Add.2 (2009) Bamako Global Ministerial Forum on Research for Health [pdf 90.78kb World Health Assembly • WHA63/21 (2010) Resolution: WHO’s role and responsibilities in health research • WHA63/22 (2010) WHO’s role and responsibilities in health research: Draft WHO strategy on research for health Regional • EM/RC48/R.8 (2001) Renewed health research for development in the Eastern Mediterranean Region • EM/RC55/R7 (2008) Bridging the gap between health researchers and policy-makers in the Eastern Mediterranean Region • EM/RC58/R3 (2011) Strategic directions for scaling up research for health in the Eastern Mediterranean Region • EM/RC64/R.1 (2017) Importance of research evidence in health policy-making

  13. WHO’s Strategy on RFH: Areas Research for health covers the full spectrum of research, which spans the following five generic areas of activity: • Measuring the magnitude and distribution of the health problem • Understanding the diverse causes or the determinants of the problem, whether they are due to biological, behavioural, social or environmental factors • Developingsolutions or interventions that will help to prevent or mitigate the problem • Implementing or delivering solutions through policies and programmes • Evaluatingthe impact of these solutions on the level and distribution of the problem

  14. WHO’s Strategy on RFH: Pillars • Priorities (meeting health needs) • EMRO: biennial regional health prioritization exercises, based on national needs • Capacity (strengthening health research systems) • EMRO: capacity building activities • Standards(good research practice) • EMRO: research standards and oversight • Translation (evidence to practice) • EMRO’s initiatives; WHO-CCs (K2P, etc.)

  15. WHO Research-Support Bodies • Research units (HQ, Regional Offices: e.g. RPD) • Advisory Committees for Health Research(ACHR) • Kobe Center for Health Research, Japan • International Agency for Research on Cancer (IARC), Lyon • Alliance for Health Policy & Systems Research (AHPSR), Geneva • Special Programme for Research and Training in Tropical Diseases (TDR), Geneva / RFP • Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, RFP • WHO-CC and technical programmes (e.g. influenza, TFI)

  16. TDR: building the science of solutions • Supporting research that improves disease control and ensures effective implementation of new and proven interventions. • Increasing the capacity to do this research at different levels and in different systems in disease-affected countries. • Using the power of global engagement to facilitate and accelerate a global response.

  17. SUPPORTING 6 TDR REGIONAL TRAINING CENTRES • Coordinating training courses across multiple countries • Forming a network that includes satellite centres • Fostering learning and collaboration within their respective regions and also among each other • Developing a massive open online course (MOOC) on implementation research and a basic course on the principles of this type of research Astana Medical University, Astana, Kazakhstan Institut Pasteur de Tunis, Tunisia Research Institute of Tropical Medicine (RITM), The Philippines Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia School of Public Health University of Ghana Gadjah Mada University Yogyakarta, Indonesia

  18. SEVEN UNIVERSITIES PARTICIPATING IN TDRPOSTGRADUATE TRAINING SCHEME • Increasing the numbers of scientists in low- and middle-income countries trained in implementation research and supporting the development of this field of study • Increasing the capacity of universities in these countries to provide this curriculum, manage training grant schemes and mentor students • Expanding the reach of this type of education and training in a systematic process American University of Beirut – Faculty of Health Sciences, Lebanon Universidad de Antioquia, Medellin, Colombia BRAC University, Dhaka, Bangladesh GadjahMada University, Yogyakarta, Indonesia University of Zambia,Lusaka University of Ghana, Accra University of Witwatersrand,Johannesburg, South Africa

  19. STRUCTURED OPERATIONALRESEARCH & TRAINING INitIATIVE • SUPPORTING COUNTRIES TO: • Conduct operational research according to their own priorities • Use existing or new data to improve delivery and outcomes • HANDS-ON TRAINING FOR NATIONALCONTROL PROGRAMMES AND CLINICIANS: • Three 1-week training modules over one year • Ongoing mentorship by operational research experts • Work is published in peer reviewed journals • Recommendations taken up bynational authorities A global partnership

  20. SORT IT Courses (2009 – 2018) Total: 64 courses with 684 participants from 90 countries Asia Europe South Pacific Africa South America

  21. Human Reproduction Programme (HRP) HRP contributes to global work to help people lead healthy reproductive lives by supporting and conducting research in partnership with countries to provide the evidence needed to achieve universal access to effective care and to enable people to protect and promote their own health. HRP currently runs projects in the following thematic areas: • Abortion • Adolescents • Cervical cancer • Contraception and family planning • IBP Initiative • Infertility • Maternal and perinatal health • mHealth / Digital health • Reproductive Health Library (RHL) • Reproductive tract infections, STIs, multipurpose technologies, HIV and linkages • Violence against women • Zika virus

  22. Health research prioritization

  23. HR Priorities in EMR Overview • Every 2 years, EMRO builds consensus on a set of regional health research priorities(last was 2018) • This process supports planning for: • Calls for Proposals, e.g. Research in Priority Areas of Public Health (RPPH) grants; Tropical Disease Research - Small Grant Scheme (TDR-SGS) • Research supported by WHO’s technical programmes • Research within EMR member states

  24. HR Priorities in EMR Participants (2018) • Representatives of different technical departments within EMRO, Cairo: • DCD (2 representatives) • NMH (3 representatives) • DHP (2 representatives) • HSD (2 representatives) • IER (4 representatives) • WHE (4 representatives) • Center of Environmental Health Actions (CEHA), Amman (1 representative) • TDR/HQ, Geneva (1 representative)

  25. HR Priorities in EMR Process • Asking departments / technical units / areas of work to come up with long list of questions (4 weeks) • All questions were tabulated by department / area of work / national feedback (as applicable) • Presenting and explaining importance and feasibility of different long lists of research questions • Discussing (Q & A) such long lists • Voting on each question on basis of: importance and feasibility to produce a shorter list of priorities • Sharing exercise outcomes for feedback (one week) • Report finalization and dissemination (2-3 weeks)

  26. HR Priorities in EMR Communicable Disease Research Priorities

  27. HR Priorities in EMR Non-communicable Disease Research Priorities

  28. HR Priorities in EMR Maternal & Child Health Research Priorities

  29. HR Priorities in EMR Environmental Health & Food Safety Research Priorities

  30. HR Priorities in EMR Health System Research Priorities

  31. HR Priorities in EMR Information Research Priorities

  32. HR Priorities in EMR Health Emergencies Research Priorities

  33. Health Research governance

  34. Research Governance • EM-Advisory Committee for Health Research (EM-ACHR) • EM-Research Ethics Committee (EM-RERC), in coordination with Global Health Ethics unit (HQ) • Closely working with UNESCO in support of developing / fostering National Ethics / Bioethics Committees (NEC), Institutional Review Boards (IRB)

  35. Expanded ACHR Meeting, Cairo, February 2015

  36. EM-Research Ethics Review Committee Proposals recommended for WHO funding pass through 2 tiers of ethical review, i.e. • National / institutional ethical review • EM-Research Ethics Review Committee, which includes 50 % external, including UNESCO (co-chaired by: Prof Mohamed Saleh Ben Ammar & Prof Gamal Serour) and 50 % in-house members • Has its checklists for PIs / reviewers, with special sections for research on: minors, pregnant women, emergencies

  37. Capacity Building Activities In collaboration with national / lead academic (e.g. AUB-FHS, AKU, HIPH, KSU) and research (e.g. IPT, IPM) institutions, WHO conducts regional / national capacity building activities in: • Scientific writing and publishing • Good health research practice (GHRP) • Implementation research methods • Research and publication ethics • Knowledge translation(policy briefs development; guideline adaptation, etc.)

  38. HR in the EMR Tropical Disease Implementation Research Workshop, Tunis, June 2015

  39. HR in the EMR iPIER workshop, Cairo, March 2015

  40. IR Workshop, AGU, Bahrain, Feb 2017

  41. WHO-CC Meeting, Muscat, Jan 2019

  42. WHO-CC Meeting, Muscat, Jan 2019

  43. WHO-CC Meeting, Muscat, Jan 2019

  44. Evidence for policy & practice

  45. Evidence for Policy & Practice • EMRO’s initiatives: • Expert consultations (2016, 2018, 2019) • RC resolution (2017) • Policy-makers and supporters survey (2019) • RC technical paper (proposed for 2019) • Experience of different EMRO’s areas of work • In collaboration with different stakeholders including: • Alliance for Health Policy & Systems Research (AHPSR) • WHO-CC (K2P): AUB Faculty of Health Sciences • Evidence for Policy Network (EVIPnet)

  46. HLM on Generation & Use of Evidence for Health-Policy Making, Beirut, Feb, 2019

  47. RC Resolution EM/RC64/R.1 (2017) Recognizing importance of research evidence in health policy-making,URGES Member States to …. Take necessary action towards conducting public health research that is directed towards the requirements of health services and that addresses people’s health needs; and build national capacity to use evidence from health research in national policy-making for health REQUESTS the Regional Director to … Establish regional mechanisms to support the bridging of gaps between relevant research institutions and policy-makers and the translation of research evidence into health policy statements ….”

  48. Alliance for Health Policy & Systems Research Mission:promote the generation and use of health policy and systems research as a means to strengthen the health systems in low- and middle-income countries Objectives: • Providing a unique forum for the health policy & systems research community • Supporting institutional capacity for the conduct and uptake of health policy and systems research • Stimulating the generation of knowledge and innovations to nurture learning and resilience in health systems • Increasing the demand for and use of knowledge for strengthening health systems

  49. Facilitate use of knowledge for health systems strengthening Embedding Rapid Reviews in Health Systems Decision-Making (ERA) • Four ERA platforms embedded in LMIC Ministries of Health will respond to policymakers’ requests for rapid HPSR syntheses • India, Malaysia, Zimbabwe, Georgia Improving Programme Implementation through Embedded Research (with PAHO, EMRO) • Research to identify implementation barriers in health programs and how to overcome them • 32 projects in Eastern Mediterranean and Americas regions

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