Adapting Health Systems: Strengthening Guidance to Local Policy Contexts

A summary of

World Health Organization. (2012). WHO recommendations: Optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting: Annex 8 Contextualizing the guidelines – workbook. World Health Organization. Available at http://www.optimizemnh.org/

How to cite this NCCMT summary:

National Collaborating Centre for Methods and Tools (2016). Adapting Health Systems: Strengthening Guidance to Local Policy Contexts. Hamilton, ON: McMaster University. (Updated 23 February, 2016) Retrieved from http://www.nccmt.ca/resources/search/238.

Categories: Method, Adapt, Consensus building, Policy brief, Policy development, Priority setting, Situational assessment, Stakeholder analysis and engagement

These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.

Relevance for Public Health

This resource is most appropriate for incorporating international evidence at the national or subnational level. Evidence-based guidance can be used to inform health systems policy and improve the delivery of public health and health systems interventions. For example, policymakers in low and middle income countries can use this workbook to guide the development of national policy to support action on promotional interventions for maternal and newborn health.


Public health managers and planners interested in making decisions about local programming and policy priorities may find it useful to use the Applicability and Transferability of Evidence Tool (A&T Tool) at the local/regional level.

Description

When the WHO recommendations "optimizing health worker roles to improve key maternal and newborn health interventions through task shifting" were created, the guidance panel acknowledged that its recommendations would need to be adapted based on local health system arrangements and political system features. The Contextualizing Guidance Workbook provides an eight-step process to adapt guidelines to the local context and circumstances in which recommendations will be prioritized, planned and implemented. The workbook, which is also aligned to the WHO health systems building blocks, incorporates a health policy and systems research perspective. The purpose is to address contextual factors during the policy development process to facilitate decision making.

Implementing the Method/Tool
Steps for Using Method/Tool

The workbook prompts users with key questions and evidence for consideration when transferring findings to the national (or subnational) level. The broad health policy and health systems questions can be posed across different health system arrangements and sociocultural and political systems. Throughout the workbook, evidence prompts are labelled according to the level of evidence (e.g., systematic reviews, systematically collected global data, national data and research evidence) to ensure that the best available and most appropriate global and local evidence are included in the policy decision-making process.


The steps for the evidence-based health systems guidance for policymaking framework are:

  1. Clarify the problem
  2. Frame the options
  3. Identify implementation considerations
  4. Consider the broader health system context
  5. Consider the broader political system context
  6. Refine the statement of the problem, options and implementation considerations in light of health system and political system factors
  7. Anticipate monitoring and evaluation needs
  8. Make national policy recommendations or decisions

The workbook provides a suite of tools (i.e., worksheets) to accompany each step in the process.

Who is involved

While policymakers and policy advisors are primarily responsible for leading the contextualization process, they may seek the views and opinions of public health/health care recipients, health workers and managers in organizations, among others.

Conditions for Use
Not specified
Evaluation and Measurement Characteristics
Evaluation
Has not been evaluated
Validity
Not applicable
Reliability
Not applicable
Methodological Rating
Not applicable
Method/Tool Development
Developer(s)

Elizabeth Alvarez

McMaster Health Forum’s Impact Lab

+1 905.525.9140 ext 22521

ealvarez15@gmail.com

McMaster Health Forum’s Impact Lab

1280 Main St West, CRL-209

Hamilton, ON Canada L8S 4K1

Method of Development

Recommendations were developed from a technical team responsible for defining, searching, appraising and synthesizing the relevant scientific evidence. The 36 recommendations were then discussed and approved by a WHO-led panel.


The workbook builds upon previously published content in the "guidance for evidence-informed policies about health systems" series, in particular article number 2 of 3. This work was at least in part informed by issues raised during meetings of the World Health Organization's (WHO) Task Force on Developing Health Systems Guidance.

Release Date
2012
Contact Person/Source

Elizabeth Alvarez

McMaster Health Forum’s Impact Lab

+1 905.525.9140 ext 22521

ealvarez15@gmail.com

McMaster Health Forum’s Impact Lab

1280 Main St West, CRL-209

Hamilton, ON Canada L8S 4K1

Resources

Title of Primary Resource
WHO recommendations: optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting: Annex 8 Contextualizing the guidelines – workbook.
File Attachment
None
Web-link
Reference

World Health Organization. (2012). WHO recommendations: Optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting: Annex 8 Contextualizing the guidelines – workbook. World Health Organization. Available at http://www.optimizemnh.org/

Type of Material
Method and toolkit
Format
On-line Access
Cost to Access
None.
Language
English, French
Conditions for Use
© World Health Organization 2012

Title of Supplementary Resource
Implementing health systems guidance: A workbook to support the contextualization of recommendations at the national or subnational level
File Attachment
None
Web-link
Reference

Alvarez E, Lavis J. Implementing health systems guidance: A workbook to support the contextualization of recommendations at the national or subnational level. Hamilton, Canada: McMaster Health Forum, April 2016.

Type of Material
Toolkit
Format
On-line Access
Cost to Access
None.
Language
English
Conditions for Use
© 2016 McMaster University

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