DR ANGELA MUSHAVI NATIONAL PMTCT AND PEDIATRIC HIV CARE AND TREATMENT COORDINATOR, ZIM 19/07/2011 IAS 2011: ITALY, ROME Operations Research from a Policy maker’s Perspective

Do policy makers need evidence? And if they do, how can this evidence be generated? This is where the results from operations research become very important And so if results from clinical and scientific research are available, a policy maker may now want to know how to best operationalize the findings And, what the real life challenges with nationwide implementation are?

Important issues policy makers want addressed by OR Is it doable? What are the cost implications? How can we use costing to inform budget allocations? How much does a particular intervention cost? And is it cost effective to implement it? These are critical questions to address and information generated from such OR can then be used to lobby for resources e.g. With the Ministry of Finance and other stakeholders

Acceptability of some interventions It is a fact that there is need to address ethical issues in research. It is also equally important that when policy makers accept findings from research, they have looked at the implications of wide scale implementation as it relates to the individual Example is the child health card. There is no question as regards the utility of having HIV exposure status reflected on the child health card; but is it acceptable to the users? This is where OR/IR becomes really useful in trying to answer the question of ‘is it acceptable?’ Otherwise a child health card could be mass produced and at the end not be used at all by most people

How do policy makers use results from operations research? Change of treatment guidelines: this indeed is a real policy issue as a change in guidelines may involve need for more resources that have to be sanctioned by policy makers; need for changes to EML/STGs Change in policy e.g. task sharing; especially if outcomes demonstrate better outcomes for programs, or deal with pressing issues for governments e.g. The critical gaps in human resources for health

Do policy makers themselves ever need to use results from OR/IR? Perhaps policy makers themselves may identify that there are challenges with scaling up HIV prevention, treatment, or PMTCT, or EID They can then institute a process to look at why targets are not being met: e.g. Universal access targets, MDGs And engage in a process of consultation with partners and funders to design research that can answer how best to deliver intervention so a country can meet its targets Based on the results of the research, a change in policy can be initiated backed up with evidence

Summary Therefore OR/IR is critical to point the way to policy makers regarding how best to scale up (best practices), how acceptable interventions for HIV prevention, care and treatment are to the consumers of those services, to understand costs and lobby for resources; and to use evidence generated with regulatory authorities in matters pertaining to issues such as task sharing; amongst others