What is the current status of occupational health and safety (OHS) in southern African? Of an estimated 14 million injuries per year, a mere 93,000 injuries are reported. This brief notes that more data is needed, which should be analysed and reported regularly. In existing compensation systems, there is too much focus on financial governance and not on the production of information to prevent accidents and disease. It recommends that social security/compensation and reporting systems need to be introduced where these do not exist. Active surveillance methods need to be introduced through surveys already carried out by national statistical offices, or by adding occupational health components to future labour force or health and demographic surveys. In addition, targeted research needs to be funded and supported. It will take many years and a lot of resources for southern African countries to develop information systems as sophisticated as those in Western countries.
Monitoring equity and research policy
In this study, researchers evaluated the effect of an intervention to improve the quality of data used to monitor the prevention of mother-to-child transmission (PMTCT) of HIV in South Africa. The study involved 58 antenatal clinics and 20 delivery wards (37 urban, 21 rural and 20 semi-urban) in KwaZulu-Natal province that provided PMTCT services and reported data to the District Health Information System. The data improvement intervention, which was implemented between May 2008 and March 2009, involved training on data collection and feedback for health information personnel and programme managers, monthly data reviews and data audits at health-care facilities. Data on six data elements used to monitor PMTCT services and recorded in the information system were compared with source data from health facility registers before, during and after the intervention. Findings suggested that the level of data completeness increased from 26% before to 64% after the intervention. Similarly, the proportion of data in the information system considered accurate increased from 37% to 65%. Moreover, the correlation between data in the information system and those from facility registers rose from 0.54 to 0.92.
In Tanzania, as in many developing countries, the national Health Management Information System (HMIS) is stuck in a vicious cycle: national health data are used little because they are of poor quality, and their relative lack of use, in turn, makes their quality remain poor. In this study, an action research approach was applied to strengthen the use of information and improve data quality in Zanzibar. The underlying premise was that encouraging use in small incremental steps could help to break the vicious cycle and improve the HMIS. To test the hypothesis at the national and district levels a project to strengthen the HMIS was established in Zanzibar. The project included quarterly data-use workshops during which district staff assessed their own routine data and critiqued their colleagues’ data. The data-use workshops generated inputs that were used by District Health Information Software developers to improve the tool. The HMIS, which initially covered only primary care outpatients and antenatal care, eventually grew to encompass all major health programmes and district and referral hospitals. The workshops directly contributed to improvements in data coverage, data set quality and rationalisation, and local use of target indicators. The authors conclude that data-use workshops with active engagement of data users themselves can improve health information systems overall and enhance staff capacity for information use, presentation and analysis for decision-making.
This article explores how health research can be improved to ensure that its results are translated into action. It is based on the author's experience of health research on HIV/AIDS in South Africa. The article argues that the question of how to translate health research into action should be broken down into four questions: How relevant is the project to health sector development in the short and in the long-term? Are all relevant stakeholders integrally involved in all stages of the research process? Are there skills development or capacity building aspects in the project? What are the strategies for dissemination of the research results?
According to this study, the availability, quality and use of health information, research evidence and knowledge is not adequate in the African Region. This has resulted in two major types of knowledge gaps: gaps in health knowledge, and the so-called ‘know-do gap’. Health knowledge gaps are where essential answers on how to improve the health of the people in the Region are missing. This is an issue related to the acquisition or generation of health information and research evidence. The ‘know-do gap’ is the failure to apply all existing knowledge to improve people’s health. This is related to the issue of sharing and translation of health information, research evidence, or knowledge. Although there are major structural constraints, the study argues that the key to narrowing the knowledge gap and sustaining health and development gains is a long-term commitment to strengthen national capability to ensure the availability of relevant and high quality health information and evidence and its use for policy and decision making. Close links and the co-ordination of fragmented disciplines such as information, health research and knowledge management are argued to be an essential step in this process.
"While significant strides have been made in health research, the incorporation of research evidence into healthcare decision-making has been marginal. The purpose of this paper is to provide an overview of how the utility of health services research can be improved through the use of theory. Integrating theory into health services research can improve research methodology and encourage stronger collaboration with decision-makers. Recognizing the importance of theory calls for new expectations in the practice of health services research. These include: the formation of interdisciplinary research teams; broadening the training for those who will practice health services research; and supportive organizational conditions that promote collaboration between researchers and decision makers. Further, funding bodies can provide a significant role in guiding and supporting the use of theory in the practice of health services research."
Health impact assessment (HIA) has been proposed as one mechanism that can inform decision-making by public policy-makers, yet it has been criticised for a lack of rigour in its use of evidence. The aim of this study was to formulate, develop and test a practical guide to reviewing publicly available evidence for use in HIA. The formulation and development of the guide involved substantial background research, qualitative research with the target audience, substantial consultations with potential users and other stakeholders, a pilot study to explore content, format and usability, and peer review. Finally, the guide was tested in practice by invited volunteers who used it to appraise existing HIA evidence reviews. During development, a wealth of data was generated on how the guide might be applied in practice, on terminology, on ensuring clarity of the text and on additional resources needed. The final guide provides advice on reviewing quantitative and qualitative research in plain language and is suitable for those working in public health but who may not have experience in reviewing evidence. During testing, it enabled users to discriminate between satisfactory and unsatisfactory evidence reviews. By late 2009, 1,700 printed and 2,500 downloaded copies of the guide had been distributed. In conclusion, substantive and iterative consultation, though time-consuming, was pivotal to producing a simple, systematic and accessible guide to reviewing publicly available research evidence for use in HIA.
The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 12th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.
The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 12th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.
The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 14th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.