EUROHEALTH

More documents

Recommendations

Info

54 Improving health information and health information systems The EVIPNet country team, which worked on the situation analysis described earlier, a representative of the Ministry of Health and the WHO Country Office decided that the first EBP should focus on the payment model for personal physicians (general practitioners or paediatricians) † . The EBP would help guide the Ministry to implement the national health plan. A team was formed to prepare this specific EBP. The group consisted of experts and practitioners, including a family medicine specialist, the director of a health care centre, a community nurse, an expert from the providers’ association, a representative from the HIIS, and the EVIPNet country team. The process involved several iterations before the draft EBP was reviewed by both national and international experts. The preparation of the EBP was then presented and discussed at the health system review policy dialogue on primary care held in December 2015. Lessons learned Slovenia’s experience with both the health systems review and developing a KTP using the EVIPNet methodology have been fundamental to equipping the government with evidence-based and inclusive decision-making processes that are up-to-date, tailored and relevant to the local context. Both the processes of drafting the health system review reports and the EVIPNet-guided EBP and policy dialogues should continue to be employed in the future. The two approaches to EIP are complementary. While both approaches served to summarize and analyze available evidence and information, the EBP to be used for informing primary care reform provides decision makers with three detailed policy options to choose from. The EIP processes used to inform the health system review, on the other hand, resulted, with a few exceptions, in identifying the broader areas of required action. † Personal physicians are primary care providers (particularly general practitioners) in the public health care system, chosen by insured people (or their guardians) as their first port of call for health related services. They also act as gatekeepers to specialist and hospital care. The credibility of any document that synthesises evidence depends on the consistency of the methods used to combine and appraise the evidence, considering locally specific circumstances and the involvement of stakeholders. It is clear that both the health system review and the development of the EVIPNetinformed KTP effectively involved a broad range of stakeholders. For both processes these were valuable opportunities to acquire direct experience and unpublished information (or tacit knowledge) that help strengthen the scientific evidence. With such a large group of interests around the table it is possible to cross check scientific evidence and minimize the monopoly of one single set of interests or agendas. Both processes required time and continuous consultation to address all stakeholders, interests and priorities. Both processes also require continuously clarifying roles and responsibilities among the diverse groups of stakeholders to plan for successful implementation. Finally, an important lesson learned is that a strong convening power, such as that from the Ministry of Health, is necessary. This was particularly evident in the case of the health system review where important backing from the Ministry of Health was in place. As the focus shifts towards implementation of the new national health plan, the Ministry will need to sustain and create additional capacities to ensure the ongoing, systematic and targeted use of evidence in policy-making. This is a primary focus and strength of the EVIPNet methodology. Conclusion The two approaches to EIP clearly responded to different policy-making needs and should be seen along a continuum of EIP. Both approaches set out to “synthesize, exchange and apply knowledge by relevant stakeholders to accelerate the benefits of global and local innovation in strengthening health systems and improving people’s health.” 4 The Slovenian Ministry of Health is clearly committed to engaging EIP processes for health reforms. Without such government support, evidence-based policy-making initiatives would not attract the attention, the expertise, or the involvement of stakeholders that it needs to maintain its integrity and strength. This political support, however, must be matched with ongoing, appropriate local capacity, financial and non-financial resources as well as systematic approaches. References 1 WHO. Ljubljana charter on Reforming Health Care in Europe. Copenhagen: WHO Regional Office for Europe, 1996. Available at: http://www.euro.who. int/__data/assets/pdf_file/0010/113302/E55363. pdf?ua=1 2 MMC RTV SLO. European Commissioner impressed by the preparations for healthcare reform. 21 March 2016. Available at: https://www.rtvslo.si/ zdravje/novice/evropski-komisar-navdusen-nadpripravami-na-zdravstveno-reformo/388793 3 Kolar Celar M. Speech by the Minister of Health at the presentation of the analysis of the health care system in Slovenia, Brdo pri Kranju, Slovenia on, 8 January 2016. Available at: http://www.mz.gov.si/ fileadmin/mz.gov.si/pageuploads/Analiza/8_1_2016/ Uvodni_nagovor_Milojka_Kolar_Celarc.pdf 4 WHO. EVIPNet Europe Strategic Plan. Copenhagen: WHO Regional Office for Europe, 2015. Available at: http://www.euro.who.int/__data/assets/pdf_ file/0009/291636/EVIPNet-Europe-strategic-plan- 2013-17-en.pdf 5 WHO. Slovenia holds workshop to optimize evidence-based health policy-making. Copenhagen: WHO Regional Office for Europe, 2015. Available at: http://www.euro.who.int/en/countries/slovenia/ news/news/2015/02/slovenia-holds-workshop-tooptimize-evidence-based-health-policy-making 6 Petrič D, Žerdin M. Public network of primary care providers in the Republic of Slovenia – General and familiy medicine clinics and paediatric clinics at the primary care level. Ljubljana: Ministry of Health, 2013. Available at: http://www.mz.gov.si/fileadmin/mz.gov. si/pageuploads/mreza_na_primarni__sekundarni_ in_terciarni_ravni/Mreza_za_ZS_13-11-2013- lektorirano.pdf 7 WHO. EVIPNet Europe starter kit. Copenhagen: WHO Regional Office for Europe; in press. 8 Ongolo-Zogo P, Lavis JN, Tomson G, Sewankambo NK. Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study. BMC health services research 2014;14(1):1. Eurohealth — Vol.22 | No.2 | 2016
Improving health information and health information systems 55 THE EUROPEAN OBSERVATORY ON HEALTH SYSTEMS AND POLICIES: KNOWLEDGE BROKERING FOR HEALTH SYSTEMS STRENGTHENING By: Suszy Lessof, Josep Figueras and Willy Palm Summary: The European Observatory on Health Systems and Policies (Observatory) is a partnership hosted by the WHO Regional Office for Europe. It emerged from the preparatory work for the Ljubljana Charter and in response to the focus on people centred, quality health systems shaped by values and evidence. Over the last 20 years it has generated and communicated evidence explicitly to inform policy makers, developing a range of innovative approaches to knowledge brokering. The key lessons for bringing evidence into the processes of health systems strengthening revolve around the understanding that knowledge brokering is a dynamic process with three phases: identifying what the evidence need is; pulling together the right evidence; and unpacking and sharing that evidence so that policy makers can use it. Keywords: Observatory, Health Systems, Health Policy, Knowledge Brokering Suszy Lessof, Josep Figueras and Willy Palm are all based at the European Observatory on Health Systems and Policies’, Brussels hub Belgium. Email: szy@obs.euro. who.int The legacy of Ljubljana The Ljubljana Charter, adopted 20 years ago, was a remarkable achievement. It was rooted in the belief that health cannot be separated from the wider society or economy and articulated a set of principles for health system reform, which understood that people’s experiences of health systems are central to improving them. It went on to inform the Tallinn Charter and the WHO Regional Office for Europe commitment on walking the talk on people centeredness. The Observatory follows from the commitment that all the big decisions on health system development should be “based on evidence where available”. 1 Its founding Partners recognized the lack of health systems evidence and, perhaps more importantly, the significant gap between what academic researchers were producing and what decision makers needed to shape policy. They designed the Observatory to bridge that gap, and to support evidencebased policy making through the rigorous analysis of the dynamics of health care systems. Eurohealth — Vol.22 | No.2 | 2016
Page 1 and 2:
Quarterly of the European Observato
Page 3 and 4:
Quarterly of the European Observato
Page 5 and 6: Editorial 3 community care, day car
Page 7 and 8: INTRODUCTION 5 of budgetary pressur
Page 9 and 10: Transforming health services 7 7 WH
Page 11 and 12: Transforming health services 9 Figu
Page 13 and 14: Transforming health services 11 DEV
Page 15 and 16: Transforming health services 13 Box
Page 17 and 18: Transforming health services 15 3 J
Page 19 and 20: Transforming health services 17 Tab
Page 21 and 22: Moving towards universal health cov
Page 29 and 30: Enhancing the health workforce 27 i
Page 31 and 32: Enhancing the health workforce 29 h
Page 33 and 34: Enhancing the health workforce 31 B
Page 35 and 36: Enhancing the health workforce 33 b
Page 37 and 38: Enhancing the health workforce 35 t
Page 39 and 40: Enhancing the health workforce 37 a
Page 41 and 42: Enhancing the health workforce 39 T
Page 43 and 44: 1 Enhancing the health workforce 41
Page 45 and 46: Ensuring eeuitable access to cost-e
Page 51 and 52: Improving health information and he
Page 55: Improving health information and he
Page 64: REGIONAL COMMITTEE FOR EUROPE 65th
show all

EUROHEALTH

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?