SeriesUse of research to inform public policymaking
Section snippets
Challenges faced by public policymakers
Improving health and reducing health inequalities, whether in general or in the specific domains implicated by the millennium development goals, constitutes a daunting task for public policymakers.3, 4 Three questions need to be answered: (1) what are the best solutions to the most burdensome health problems; (2) what are the best ways to fit these solutions into complex and often overstretched and underresourced health systems; and (3) what are the best ways to bring about the desired changes
Recognising differences in health systems
Public policymakers are likely to ask two questions when faced with the results of a systematic review of health systems research (ie, investigations addressing a second-order or third-order question), especially when no research from their country was included in the review: (1) what can be expected if the same thing is done in our country, and (2) what can be expected if things are done differently? An appreciation of the importance of context often leads investigators to answer that they do
Improving the outlook
Public policymakers, donors, and international agencies can take several steps to raise the likelihood that high quality, locally applicable systematic reviews will inform public policymaking and decisions about funding for more (or different types of) research. Public policymakers can encourage more informed policymaking by asking to see systematic reviews on priority issues, ensuring that these reviews are commissioned when none exist, and placing more value on them in their deliberations and
Conclusion
Politics will always have a role in public policymaking but improving health and reducing health inequalities in low-income and middle-income countries (and indeed in high-income countries) will be made a bit easier if high quality, locally applicable reviews are considered in the policymaking process. If anything, we have underestimated the potential for systematic reviews of health systems research. We have focused on instrumental uses of such work made possible by reviews that answer
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