An Advocacy-Research Partnership: A Successful Knowledge-Translation Platform? McAuliffe, E, DePinho, H., Clark, P, Sawyer, A, Shehu, D, Masanja, H, Kamwendo, F, Sidat, M, & Bradley, S. eilish.mcauliffe@tcd.ie

Knowledge translation knowledge translation (KT) methodologies are an integral part of the health policymaking process. KT methodologies or platforms are mechanisms designed to use evidence to improve the safety and effectiveness of health policies and policy implementation interventions. Not just disseminating evidence but encouraging the use of evidence eilish.mcauliffe@tcd.ie

Inadequate long-term human resource planning and domestic production of health workers, coupled with ageing populations in developed countries, will continue to fuel recruitment from resource-poor countries unless there is a significant commitment to address this global inequity.” EU HRH Strategy 2005 eilish.mcauliffe@tcd.ie

Rationale for Project focus midlevel providers are already providing a significant share of maternal health services including the bulk of emergency obstetrical surgery (EmOC), in at least three countries in Africa: Malawi, Mozambique, and Tanzania. But they receive little attention. clearly defined tasks and standards of care for the provision of maternal health and in particular emergency obstetric care that can be used to assess midlevel providers interventions to reduce maternal and newborn deaths depend on the presence of a functioning health system that enables health worker performance. existing data indicate that of all the MDGs, MDG 5, reducing maternal mortality ratios, is the one least likely to be achieved by 2015 Requires change in all building blocks in WHO Health Systems framework: Governance and Leadership, Health Workforce, Financing, Information, Supplies and Infrastructure, Service Delivery. eilish.mcauliffe@tcd.ie

Supported by Irish Aid and Ministry of Foreign Affairs Denmark eilish.mcauliffe@tcd.ie

Project aims four-year, multi-country research project in Malawi, Tanzania and Mozambique to expand the evidence base in support of the effective use of mid-level providers (MLPs) in maternal and newborn health and promote greater political leadership and critical policy action on their use. The focus on the delivery of the Emergency Obstetric Care signal functions seen as a strategic entry point to assessing the use and effectiveness of MLPs more broadly. eilish.mcauliffe@tcd.ie

Partners Ministries of Health HR Directorates Reproductive Health programmes Global Advocacy – Realizing Rights (Mary Robinson) Research partners Ifakara, Tanzania College of Medicine, Malawi. EM University, Mozambique AMDD, Columbia University CGH, Trinity College Regional & Local Advocacy – Regional Prevention of Maternal Mortality Network eilish.mcauliffe@tcd.ie

Advocacy activities - examples Before During After Global Discussions with key actors in Maternal Health e.g. White Ribbon Alliance, Donors etc. Conference presentations making case for research through evidence to date (from previous research) Roundtables with critical actors Policy briefs issued Strategic conference presentations Advocacy with country presidents and vice-presidents National & Local Discussion with MoH stakeholders Workshops for professional networks Interviews with professional associations, training bodies and district health mgt staff Dissemination to ministry staff Workshops with professional networks eilish.mcauliffe@tcd.ie

Challenges What is advocacy? Who should be doing it? Timing and integration of research and advocacy elements Communication challenges (Bradley et al. poster) Complexity overwhelming at times Managing and targeting outputs eilish.mcauliffe@tcd.ie

Lessons Preparing intended audience for research outputs is a valuable activity that increases the utility of research findings. Having a champion makes it more likely that message will be heard. Preparation time to plan specific strengths and contributions of each partner would help to manage expectations and reduce tensions. Complex multi-stranded project - a phased approach with responsibility for specific phases being assigned to individual partners. Integration of the advocacy elements of the project into these phases would also have ensured that the data analysis and advocacy were better aligned. A more strategic, streamlined approach to planning the outputs from the project. eilish.mcauliffe@tcd.ie

Some evidence that visibility and use of MLPs has increased EU projects recently funded STEM – Support train and empower managers. Improving HRM and supervision of MLPs providing obstetric care in Tanzania and Mozambique (CGH) PERFORM- strengthening HRM in Tanzania (Liverpool School of Tropical Medicine) Training programme for Clinical Officers in Malawi (RCSI) eilish.mcauliffe@tcd.ie

With Thanks HSSE Team: Centre for Global Health, Trinity College, University of Dublin AMDD, Mailman School of Public Health, Columbia University, USA Centre for Reproductive Health, College of Medicine, Malawi Ifakara Health Institute, Tanzania Dept. of Community Health, Eduardo Mondlane University, Mozambique Realizing Rights: Ethical Globalization Initiative, USA Regional Prevention of Maternal Mortality Network, Ghana Funders: IrishAid & Ministry of Foreign Affairs, Denmark eilish.mcauliffe@tcd.ie