PLoS Medicine articles highlight need for better processes to ensure research evidence informs health systems guidance, policies

March 13, 2012 - McMaster University’s John Lavis played a key role in a series of articles being published in PLoS Medicine that examine the need for and process of translating research evidence into guidance to inform policies that ultimately improve the delivery of healthcare nationally and globally.

Lavis is the lead author on the second of the three articles, and a contributing author on the other two that PLoS Medicine is publishing over a two-week period. The articles address how research evidence should be translated into guidance to inform policies on health systems, and improve the delivery of effective clinical and public health interventions. Particular attention is given to the issues raised during meetings of a task force on developing health systems guidance which was set up following a request from the World Health Organization.

The article authored by Lavis notes that policies about health systems can have profound impacts on citizens, patients, health professionals and managers. It explores the challenge of linking guidance development and policy development at global and national levels, and examines the range of factors that can influence policy development.

Health systems guidance consists of systematically developed statements created at the global or national level to assist with decisions about appropriate options for addressing a health system problem in a range of settings, as well as to assist with implementation and with monitoring and evaluation.

The findings of the paper by Lavis include:

  • Contextual factors are extremely important in shaping decisions about health systems, and policymakers need to work through all the pros and cons of different options before adopting specific health systems guidance;
  • Rigorous health systems analyses and political systems analyses are needed at the global and national level to support guideline and policy development; and
  • A panel charged with developing health systems guidance at the global level could best add value by ensuring that its output can be used for policy development at the global and national level, and for guidance development at the national level.

The final point would mean a big change for organizations like the World Health Organization. Instead of producing one-size-fits-all guidance, the organization would produce ‘workbooks’ that assist those working in countries like Canada and provinces like Ontario to work through what needs to be done in their particular setting.

The first paper in the three-part series examines how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance. The third article explores the challenge of assessing how much confidence to place in evidence on health systems interventions.

The first article can be accessed online here. The third article will be published on March 20.

Lavis is a renowned expert on evidence-informed policymaking. He is director of the McMaster Health Forum, associate director of the Centre for Health Economics and Policy Analysis, and a professor in the Department of Clinical Epidemiology and Biostatistics at McMaster University. He is also co-director of the WHO Collaborating Centre for Evidence-Informed Policy, and president of the Pan American Health Organization Advisory Committee on Health Research.

PLoS Medicine is a peer-reviewed open access journal published by the Public Library of Science.