GOALS OF USE OF RESEARCH Opportunities and choices in SRH Safer passages to adulthood Strengthened health systems Improved health and development

BREATHTAKING CHALLENGES Population of 9 billion in 2050, most pregnancies wanted 600,000 maternal deaths annually 350 million new cases of curable STIs and 22 million infected with HIV Healthy sexuality: violence, mutilation, inability to express and enjoy

TRADITIONAL ROLE OF RESEARCH Testing and development of theory –Rules of design and conduct –Rules of evidence –Discreet audience –Rewards

HEALTH SYSTEMS RESEARCH Process focused on policy and program development, decision making, services –Understandable –Acceptable –Comprehensive –Cost-effective –Capable of being improved

LINEAR MODEL OF POLICY FORMATION Researcher Predictions and Prescriptions Policy Maker Policy Choice Implementation Policy Outcome Social Forces Classes Interest Groups Parties and Voters State-Centered Forces Technocrats Bureaucrats State Interests

Multiple Streams of Negotiated Decision Making Practitioners Policy Makers Flow of Information/Influence Demand for Information Financing Groups Advocacy Groups Research and Analysis National and Local Policy Implementation Process

AUDIENCES IN NEED OF CHAMPION Policy makers Managers Researchers Advocates Public National Regional Local Networks South-South

ROLES OF THEORY AND VALUES THEORY –Stage Theory –Diffusion –Organizational Development –Communication and Social Influence VALUES –Equity of care –Personal choice –Participation –Devolution –Gender relations –Profit-making

TREND TOWARD LEARNING World Bank - knowledge management WHO - evidence based health care DFID - shared knowledge key to development partnerships USAID - evidence on achievement of strategic objectives

APPROACHES TO UTILIZATION Rational: problem solving Strategic: political, tactical Diffusion: enlightenment, interactive Lack insight into process of decision making and manipulatable variables

MORE PRODUCTIVE APPROACH Content and recommendations Actors in policy formation Processes in development and implementation cycles Context within which policy made Diffuse and gradual process

ENHANCING USE Develop research with counterparts Build and foster close relationships Seek interrelations with similar efforts Focus on research quality Disseminate to policy makers by level Mutual formulation of recommendations Sustainability: partners and finance Follow-up

MEASUREMENT OF UTILIZATION Complex: mere citation to range of options of influence within and across systems Quality of research is not a requirement Understanding of policy process Multiple actors, issues and contributions Problem of attribution of causality

CHALLENGES IN LONG RUN Develop human resources capable of producing and using research Improve quality of health information Build capacity to assess new technology Networks for essential health research Relationship between policy makers, researchers and stakeholders