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Connecting Research And Policy To Strengthen Health Systems

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By Alain Beaudet

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It was a pleasure to take part in the recent Global Symposium on Health Systems Research in Vancouver. It was equally heartening to see how researchers and policy makers in global health are becoming more and more interconnected -- which is vital to its continued success and growth. These connections between research and policy are essential to strengthen health systems in an evidence-based fashion.

The Government of Canada has made health system improvement a priority -- with research playing a vital role in producing the evidence and innovations that are needed to ensure that our health-care systems remain effective and sustainable.

Canadian Institutes of Health Research (CIHR) investments in health systems research and, more broadly, in global health, have been steadily increasing over the past few years, in a context of overall budgetary stagnation and fiscal restraint. In the field of global health alone, our investments have doubled over the past ten years, growing from approximately $15 million to $30 million per year.

This is due in part to our strategic investments in research on emerging threats, such as the Ebola and Zika outbreaks, but also to major partnered investments in research on mother and child health in Africa, as well as on the prevention and control of non-communicable diseases in low- and middle-income countries broadly.

Last year, I was part of an important mission to Africa with the President of International Development Research Centre (IDRC), Dr. Jean Lebel. I drew two important conclusions from this mission.

The first is the need to continue building research capacity in low- and middle-income countries to help develop a cadre of solid investigators in health systems research, as well as in health economics.

The second -- and this is crucial -- is the need to continue supporting implementation research and delivery science.

One of our major strategic initiatives in Africa, supported jointly with IDRC and Global Affairs Canada, is a program called Innovating for Maternal and Child Health in Africa -- or IMCHA for short.

This program, which supports 19 implementation research teams, aims to develop effective policies, programs, and strategies to improve health and strengthen health systems in the countries of sub-Saharan Africa.

For example, in Tanzania, which has made it a priority to improve obstetrical and neonatal care in its health facilities, Canadian and African researchers are working together with clinicians, midwives, and nurses to provide training in emergency obstetrical care so that expecting mothers have access to skilled care and emergency services. Importantly, the project is also investigating how these interventions can be scaled-up nationwide.

Bringing interventions, programs, and policies to scale remains the ultimate challenge in health systems research, a challenge that the Global Alliance for Chronic Diseases (GACD) has chosen to tackle head on.

The GACD is the first collaboration of major research funding agencies to specifically address chronic, non-communicable diseases in low- and middle-income countries (and in vulnerable populations in high income countries), where these diseases are currently responsible for over 80 per cent of deaths.

What is unique about the GACD is the fact that it is committed to focusing on implementation research and delivery science. In addition, our focus on implementation science means that we are looking at what interventions are scalable in a sustainable and equitable way.

To ensure the scaling of these interventions, the GACD has recently signed a Memorandum of Understanding with the World Bank Group. The intent of this World Bank-GACD collaboration is to integrate implementation research into reforms aimed at achieving universal access to interventions for non-communicable diseases.

The initial focus of the partnership will be on the prevention and control of hypertension in a number of focus countries, as a sentinel for the rising burden of non-communicable diseases.

The organizations will be working together over the coming year to operationalize this vision on a moderate scale and to fully assess the potential of the model to enhance health system performance and equity.

IMCHA and the GACD are just two success stories that demonstrate how Canada can play a significant role in strengthening health systems and improving the well-being of people around the world.

Of course, while conferences like the Global Symposium on Health Systems Research provide us with an opportunity to celebrate our collective successes, we know that there is much more work to do.

It is critical that we continue to work together to elevate the importance of health systems research -- not only to improve health, but also to improve the economic and social well-being of nations around the world.

Here at home, we have a federal government that is increasingly looking to researchers to provide the evidence-based policies we need to improve our own healthcare system -- which has many challenges of its own. It is critical that researchers be responsive to this call and the needs expressed by policy makers.

Alain Beaudet, MD, PhD is President of the Canadian Institutes of Health Research

This blog is part of the series: "Resilient and Responsive Health Systems for a Changing World" by the Canadian Society for International Health and Health Systems Global, to share the central issues explored at the 4th Global Symposium on Health Systems Research in Vancouver, 14-18 November 2016.

The views expressed are those of the authors and do not necessarily reflect the views of CCIC or its members.

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