Department of Health Research Methods, Evidence and Impact (HEI), Faculty of Health Sciences, McMaster University, CRL 2nd Floor, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada.
Health Res Policy Syst. 2019 Nov 21;17(1):89. doi: 10.1186/s12961-019-0488-0.
Translating research evidence from global guidance into policy can help strengthen health systems. A workbook was developed to support the contextualization of the WHO's 'Optimizing health worker roles to improve maternal and newborn health' (OptimizeMNH) guidance. This study evaluated the use of the workbook for the development of evidence briefs in two countries - Peru and Uganda. Findings surrounding contextual factors, steps in the process and evaluation of the workbook are presented.
A qualitative embedded case study was used. The case was the process of using the workbook to support the contextualization of global health systems guidance, with local evidence, to develop evidence briefs. Criterion sampling was used to select the countries, participants for interviews and documents included in the study. A template-organizing style and constant comparison were used for data analysis.
A total of 19 participant-observation sessions and 8 interviews were conducted, and 50 documents were reviewed. Contextual factors, including the cadres, or groups, of health workers available in each country, the way the problem and its causes were framed, potential policy options to address the problem, and implementation considerations for these policy options, varied substantially between Peru and Uganda. However, many similarities were found in the process of using the workbook. Overall, the workbook was viewed positively and participants in both countries would use it again for other topics.
Organizations that produce global guidance, such as WHO, need to consider institutionalizing the application of the workbook into their guidance development processes to help users at the national/subnational level create actionable and context-relevant policies. Feedback mechanisms also need to be established so that the evidence briefs and health policies arising from global guidance are tracked and the findings coming out of such guideline contextualization processes can be taken into consideration during future guidance development and research priority-setting.
将全球指南中的研究证据转化为政策可以帮助加强卫生系统。为了支持世卫组织《优化卫生工作者角色以改善孕产妇和新生儿健康》（OptimizeMNH）指南的本地化，开发了一本工作手册。本研究评估了该工作手册在秘鲁和乌干达两国用于制定证据简报的使用情况。本研究报告了围绕情境因素、流程步骤以及工作手册评估的调查结果。
采用定性嵌入式案例研究方法。案例是指使用工作手册支持将全球卫生系统指南与当地证据结合起来，制定证据简报的过程。采用标准抽样选择国家、参与访谈的人员以及纳入研究的文件。采用模板组织和不断比较的方法进行数据分析。
共进行了 19 次参与式观察会议和 8 次访谈，并审查了 50 份文件。情境因素，包括两国各有哪些卫生工作者队伍/群体、问题及其原因的表述方式、解决问题的潜在政策选择以及这些政策选择的实施考虑因素，在秘鲁和乌干达之间存在很大差异。然而，在使用工作手册的过程中发现了许多相似之处。总体而言，工作手册得到了积极评价，两国的参与者都将再次使用它来处理其他主题。
制定全球指南的组织，如世卫组织，需要考虑将工作手册的应用纳入其指南制定流程中，以帮助国家/次国家层面的用户制定可操作和与情境相关的政策。还需要建立反馈机制，以便跟踪全球指南产生的证据简报和卫生政策，并在未来的指南制定和研究重点设定过程中考虑到从这种指南本地化过程中得出的发现。
