Johns Hopkins School of Public Health, 615 North Wolfe St., Baltimore, MD, USA.
Health Res Policy Syst. 2012 Mar 5;10:7. doi: 10.1186/1478-4505-10-7.
To review and assess (i) the factors that facilitate the development of sustainable health policy analysis institutes in low and middle income countries and (ii) the nature of external support for capacity development provided to such institutes.
Comparative case studies of six health policy analysis institutes (3 from Asia and 3 from Africa) were conducted. In each region an NGO institute, an institute linked to government and a university based institute were included. Data collection comprised document review, semi-structured interviews with stakeholders and discussion of preliminary findings with institute staff.
The findings are organized around four key themes: (i) Financial resources: three of the institutes had received substantial external grants at start-up, however two of these institutes subsequently collapsed. At all but one institute, reliance upon short term, donor funding, created high administrative costs and unpredictability. (ii) Human resources: the retention of skilled human resources was perceived to be key to institute success but was problematic at all but one institute. In particular staff often moved to better paid positions elsewhere once having acquired necessary skills and experience, leaving remaining senior staff with heavy workloads. (iii) Governance and management: board structures and roles varied according to the nature of institute ownership. Boards made important contributions to organizational capacity through promoting continuity, independence and fund raising. Routine management systems were typically perceived to be strong. (iv) Networks: linkages to policy makers helped promote policy influences. External networks with other research organizations, particularly where these were longer term institutional collaborations helped promote capacity.
The development of strong in-country analytical and research capacity to guide health policy development is critical, yet many health policy analysis institutes remain very fragile. A combination of more strategic planning, active recruitment and retention strategies, and longer term, flexible funding, for example through endowments, needs to be promoted. Specific recommendations to funders and institutes are provided.
回顾和评估（i）促进中低收入国家可持续卫生政策分析机构发展的因素，以及（ii）向此类机构提供能力发展的外部支持的性质。
对六个卫生政策分析机构（三个来自亚洲，三个来自非洲）进行了比较案例研究。在每个地区，都包括一个非政府组织机构、一个与政府有关联的机构和一个基于大学的机构。数据收集包括文件审查、对利益相关者的半结构化访谈以及与机构工作人员讨论初步发现。
研究结果围绕四个关键主题组织：（i）财务资源：三个机构在启动时都获得了大量外部赠款，但其中两个机构随后倒闭。除了一个机构之外，所有机构都依赖短期、捐助者的资金，这导致了高昂的行政成本和不可预测性。（ii）人力资源：保留熟练的人力资源被认为是机构成功的关键，但除了一个机构之外，所有机构都存在问题。特别是，一旦员工获得了必要的技能和经验，他们往往会转移到其他薪酬更高的职位，而留下的高级员工则面临繁重的工作量。（iii）治理和管理：董事会结构和角色根据机构所有权的性质而有所不同。董事会通过促进连续性、独立性和筹款来为组织能力做出重要贡献。常规管理系统通常被认为是强大的。（iv）网络：与政策制定者的联系有助于促进政策影响力。与其他研究组织的外部网络，特别是那些长期的机构合作关系，有助于促进能力。
发展强大的国内分析和研究能力以指导卫生政策制定至关重要，但许多卫生政策分析机构仍然非常脆弱。需要促进更具战略性的规划、积极的招聘和留用策略，以及更长期、灵活的资金，例如通过捐赠基金。为资助者和机构提供了具体建议。
