This post is authored by Shu Chen, MSc-GH Candidate, Duke Global Health Institute. This summer, Shu interned at the World Health Organization (WHO) through the Global Health Fellows Program.
I cannot believe that two-month internship at the World Health Organization (WHO) is going to end soon. This is truly a wonderful and unforgettable experience for me as a future global health researcher. I met a group of talented interns who have the same passion for global health and are willing to dedicate their entire lives to bridging the gaps between developing and developed world in public health. I was also lucky to work with my amazing supervisor Islene Araujo de Carvalho, who leads me to the evidence-based policy-making world by showing me how it works in the field.
The department I was interning in is Age and Life Course and our focus is to create an ageing-friendly world where every elder can enjoy a healthy ageing life. I primarily worked on the Knowledge Translation on Ageing and Health (KT) project, of which the aim is to facilitate the development of evidence-based policy responses to ageing globally. China is one of the two piloted countries of KT project given its rapid ageing situation and the availability of data from the WHO Study on Global Ageing and Adult Health (a nationally representative sample comprised of eight provinces on older people’s health).
Initiated in November, 2013, the KT China project aims to facilitate evidence-informed policies and priorities for elderly health and establish a multi-sector collaboration mechanism for elderly health efforts to improve health status of the elderly in China. Led by China National Health and Family Planning Commission (NHFPC) and WHO Country Office in China, the project consists of four major steps to close the gap between research and policy-making on ageing: 1) identify priority problems on ageing in China; 2) synthesize and package evidence on interventions; 3) engage local policy-makers and experts for a national policy dialogue and policy briefs and 4) implement policy-directed interventions. The China project was on the second stage and most of my work was to help coordinate the project partners and prepare for the policy briefs.
The department I was interning in is Age and Life Course and our focus is to create an ageing-friendly world where every elder can enjoy a healthy ageing life. I primarily worked on the Knowledge Translation on Ageing and Health (KT) project, of which the aim is to facilitate the development of evidence-based policy responses to ageing globally. China is one of the two piloted countries of KT project given its rapid ageing situation and the availability of data from the WHO Study on Global Ageing and Adult Health (a nationally representative sample comprised of eight provinces on older people’s health).
Initiated in November, 2013, the KT China project aims to facilitate evidence-informed policies and priorities for elderly health and establish a multi-sector collaboration mechanism for elderly health efforts to improve health status of the elderly in China. Led by China National Health and Family Planning Commission (NHFPC) and WHO Country Office in China, the project consists of four major steps to close the gap between research and policy-making on ageing: 1) identify priority problems on ageing in China; 2) synthesize and package evidence on interventions; 3) engage local policy-makers and experts for a national policy dialogue and policy briefs and 4) implement policy-directed interventions. The China project was on the second stage and most of my work was to help coordinate the project partners and prepare for the policy briefs.
Evidence-based policy-making is definitely a new idea in China and the traditional way of policy-making depends on experts’ opinions instead of research evidence. As a loyal supporter of the evidence-based policy-making, I am excited to witness the change and be given the opportunity to foster its happening. While I was working on synthesizing the evidence, however, I did have a few concerns towards the evidence: 1) Most of the high-quality evidence, typically randomized control trails, are from high income countries rather than developing countries where the interventions are going to be implemented in; 2) Some systematic reviews find that the evidences available, for example in long-term care, are pretty weak and limited. Bad-quality evidences will surely mislead policy-makers and result in unimaginable consequences to the society. There is a need for well-designed high-quality researches whose results can boost the policy development, especially in developing countries where the research capacity is a huge issue. How to help build the research capacity should be another import area to work on. Further, personally I think as a policy-maker he or she should be able to distinguish good evidences from under-qualified ones. Having a research background is more than necessary for policy-makers, which, however, is often not the case in countries where evidence-based policy-making is novel.
It involves system thinking in fostering evidence-based policy-making in developing countries. Neither building evidence pool nor research capacity alone can create an enabling environment for its development. Seven elements, as the WHO framework has highlighted, are essential to formulate and influence evidence-based policy-making. These elements include: “1) Context looks at whether ageing is included in current policy agendas and if the health system values the use of research to inform policy-making; 2) Linkage and Exchange Efforts examine the relationships needed to enable the use of evidence; 3) Knowledge Creation looks at the opportunities and existing capacity to conduct relevant research in the local context; 4) Push Efforts assesses whether the information is pushed to different user groups in appropriate formats; 5) Pull Efforts are the efforts of policy-makers to seek and use research on ageing and health; 6) Facilitating Pull Efforts relates to systems that enable access to relevant research in ageing and health: for example, technical infrastructure, ‘one-stop websites’ and unrestricted access to online resources and journals providing research evidence on ageing and health; 7) Evaluation Efforts assess whether health systems allocate resources and funding to monitor implementation and evaluate the impact of evidence informed decision making in ageing and health.” (Cited from the WHO Ageing and Life Course internal working paper)
It does take time and efforts to achieve such an enabling environment for evidence-based policy making and hopefully I can be part of it to make it happen in China.
It involves system thinking in fostering evidence-based policy-making in developing countries. Neither building evidence pool nor research capacity alone can create an enabling environment for its development. Seven elements, as the WHO framework has highlighted, are essential to formulate and influence evidence-based policy-making. These elements include: “1) Context looks at whether ageing is included in current policy agendas and if the health system values the use of research to inform policy-making; 2) Linkage and Exchange Efforts examine the relationships needed to enable the use of evidence; 3) Knowledge Creation looks at the opportunities and existing capacity to conduct relevant research in the local context; 4) Push Efforts assesses whether the information is pushed to different user groups in appropriate formats; 5) Pull Efforts are the efforts of policy-makers to seek and use research on ageing and health; 6) Facilitating Pull Efforts relates to systems that enable access to relevant research in ageing and health: for example, technical infrastructure, ‘one-stop websites’ and unrestricted access to online resources and journals providing research evidence on ageing and health; 7) Evaluation Efforts assess whether health systems allocate resources and funding to monitor implementation and evaluate the impact of evidence informed decision making in ageing and health.” (Cited from the WHO Ageing and Life Course internal working paper)
It does take time and efforts to achieve such an enabling environment for evidence-based policy making and hopefully I can be part of it to make it happen in China.
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