Policy options for strengthening evidence-informed health policy-making in Iran: overall SASHA project findings

Background The institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider challenges and address them through effective, harmonized and contextualized strategies. This study aims to develop a road map for enhancing EIHP in Iran based on steps of planning. Methods This study consisted of three phases: (1) identifying barriers to EIHP, (2) recognizing interventions and (3) measuring the use of evidence in Iran's health policy-making. A set of activities was established for conducting these, including foresight, systematic review and policy dialogue, to identify the current and potential barriers for the first phase. For the second phase, an evidence synthesis was performed through a scoping review, by searching the websites of benchmark institutions which had good examples of EIHP practices in order to extract and identify interventions, and through eight policy dialogues and two broad opinion polls to contextualize the list of interventions. Simultaneously, two qualitative-quantitative studies were conducted to design and use a tool for assessing EIHP in the third phase. Results We identified 97 barriers to EIHP and categorized them into three groups, including 35 barriers on the “generation of evidence” (push side), 41 on the “use of evidence” (pull side) and 21 on the “interaction between these two” (exchange side). The list of 41 interventions identified through evidence synthesis and eight policy dialogues was reduced to 32 interventions after two expert opinion polling rounds. These interventions were classified into four main strategies for strengthening (1) the education and training system (6 interventions), (2) the incentives programmes (7 interventions), (3) the structure of policy support organizations (4 interventions) and (4) the enabling processes to support EIHP (15 interventions). Conclusion The policy options developed in the study provide a comprehensive framework to chart a path for strengthening the country’s EIHP considering both global practices and the context of Iran. It is recommended that operational plans be prepared for road map interventions, and the necessary resources provided for their implementation. The implementation of the road map will require attention to the principles of good governance, with a focus on transparency and accountability.

Estimation Of The Value Of Goods And Services Produced By Protected Areas: Case Of The Ndock Sare Community Forest In Senegal

The community forests of Senegal, and particularly those of the Groundnut Basin, play an important role in the lives of rural populations. They are significant sources of supply of various products and services. But despite their economic and ecological importance, community forests have never been the subject of an economic evaluation. This is likely to obscure the decision-making auspices of sustainable management of community forests. This study, based on vegetation surveys and socio-economic surveys, assessed the value of ecosystem goods and services. The results of the analysis showed that the forest has 21 species distributed among 08 families and that this diversity varies from one area to another. With this specific diversity, the basal area is evaluated at 2.64 m2/ha and the cover of 6081.17 m²/ha for a density of 327 individuals per hectare. The forest has a carbon storage capacity evaluated at 15.32 tons. The goods and services of the forest were estimated at 3,391,757 F CFA/year. This value is divided between direct uses estimated at 1,236,575 F CFA/year, indirect uses of 168,495 F CFA/year and an existence value of 1,986,687 F CFA/year. The study also showed that the exploitation of the forest is the most viable management option, as strict conservation imposes a social cost of 370,058 CFA francs per year on the population. In the context of decentralization, these results can serve as a basis for policy dialogue and decision-making processes on the sustainable management of forest resources

How to attract and retain health workers in rural areas of a fragile state: Findings from a labour market survey in Guinea

Most countries face challenges attracting and retaining health staff in remote areas but this is especially acute in fragile and shock-prone contexts, like Guinea, where imbalances in staffing are high and financial and governance arrangements to address rural shortfalls are weak. The objective of this study was to understand how health staff could be better motivated to work and remain in rural, under-served areas in Guinea. In order to inform the policy dialogue on strengthening human resources for health, we conducted three nationally representative cross-sectional surveys, adapted from tools used in other fragile contexts. This article focuses on the health worker survey. We found that the locational job preferences of health workers in Guinea are particularly influenced by opportunities for training, working conditions, and housing. Most staff are satisfied with their work and with supervision, however, financial aspects and working conditions are considered least satisfactory, and worrying findings include the high proportion of staff favouring emigration, their high tolerance of informal user payments, as well as their limited exposure to rural areas during training. Based on our findings, we highlight measures which could improve rural recruitment and retention in Guinea and similar settings. These include offering upgrading and specialization in return for rural service; providing greater exposure to rural areas during training; increasing recruitment from rural areas; experimenting with fixed term contracts in rural areas; and improving working conditions in rural posts. The development of incentive packages should be accompanied by action to tackle wider issues, such as reforms to training and staff management.

Bosnia and Herzegovina’s Family Policy Challenges in Meeting the European Union’s Standards and Recommendations

Family policy in Bosnia and Herzegovina’s entities (Federation of Bosnia and Herzegovina and the Republic Srpska) is incoherent, with its different elements being scattered across different ministries and levels of government. The system is found to be inapt to respond to the needs of families, thus enhancing gender inequalities in the labour market and within families. As a country aspiring to join the European Union, Bosnia and Herzegovina, together with other countries of the Western Balkans region, participates in regular policy dialogue with the European Union institutions. The latest European Commission assessment of the country’s Economic Reform Programme identifies low employment of women as one of the key challenges and implicitly calls for the country to develop an employment-oriented family policy. By analysing the system of family policy and its recent policy developments, the article assesses the country’s capacity to respond to the recommendation and create conditions for greater participation of women in the labour market. The question is whether the European Union’s conditionality and recommendations have the potential to transform the current family policy arrangements in the entities. Key words: work-family policy, female employment, gender inequalities, maternity leave, parental leave, early childhood education and care services, Bosnia and Herzegovina.

Global Education Monitoring Report - Non-state actors in education: Who chooses? Who loses?

Non-state actors’ role extends beyond provision of schooling to interventions at various education levels and influence spheres. Alongside its review of progress towards SDG 4, including emerging evidence on the COVID-19 pandemic’s impact, the 2021/2 Global Education Monitoring Report urges governments to see all institutions, students and teachers as part of a single system. Standards, information, incentives and accountability should help governments protect, respect and fulfil the right to education of all, without turning their eyes away from privilege or exploitation. Publicly funded education does not have to be publicly provided but disparity in education processes, student outcomes and teacher working conditions must be addressed. Efficiency and innovation, rather than being commercial secrets, should be diffused and practised by all. To that end, transparency and integrity in the public education policy process need to be maintained to block vested interests. The report’s rallying call – Who chooses? Who loses? – invites policymakers to question relationships with non-state actors in terms of fundamental choices: between equity and freedom of choice; between encouraging initiative and setting standards; between groups of varying means and needs; between immediate commitments under SDG 4 and those to be progressively realized (e.g. post-secondary education); and between education and other social sectors. Supporting the fifth Global Education Monitoring Report are two online tools: PEER, a policy dialogue resource describing non-state activity and regulations in the world’s education systems; and VIEW, a new website consolidating sources and providing new completion rate estimates over time.

Assessing the usefulness of policy brief and policy dialogue as knowledge translation tools towards contextualizing the accountability framework for routine immunization at a subnational level in Nigeria

Background Evidence suggests that implementing an accountability mechanism such as the accountability framework for routine immunization in Nigeria (AFRIN) will improve routine immunization (RI) performance. The fact that the AFRIN, which was developed in 2012, still had not been operationalized at the subnational level (Ebonyi State) by 2018 may in part account for the poor RI coverage (33%) in 2017. Knowledge translation (KT) is defined as the methods for closing the gaps from knowledge to practice. Policy briefs (useful in communicating research findings to policy-makers) and policy dialogues (that enable stakeholders to understand research evidence and create context-resonant implementation plans) are two KT tools. This study evaluated their usefulness in enabling policy-makers to contextualize AFRIN in Ebonyi State, Nigeria. Methods The study design was cross-sectional descriptive with mixed-methods data collection. A policy brief developed from AFRIN guided deliberations in a 1-day multi-stakeholder policy dialogue by 30 policy actors. The usefulness of the KT tools in contextualizing policy recommendations in the AFRIN was assessed using validated questionnaires developed at McMaster University, Canada. Results At the end of the policy dialogue, the policy options in the policy brief were accepted but their implementation strategies were altered to suit the local context. The respondents’ mean ratings (MNR) of the overall usefulness of the policy brief and the policy dialogue in contextualizing the implementation strategies were 6.39 and 6.67, respectively, on a seven-point Likert scale (very useful). The MNR of the different dimensions of the policy brief and policy dialogue ranged from 6.17 to 6.60 and from 6.10 to 6.83, respectively (i.e. moderately helpful to very helpful). Conclusion The participants perceived the KT tools (policy brief and policy dialogue) as being very useful in contextualizing policy recommendations in a national policy document into state context-resonant implementable recommendations. We recommend the use of these KT tools in operationalizing AFRIN at the subnational level in Nigeria.

Education and labour migration in Solomon Islands: Policy interaction between the education system and the labour market

<p>Education is considered, in every sense, as one of the fundamental factors of development. No country can achieve sustainable development and economic growth without a systematic education system. Education raises people’s productivity and competency to build a strong economy and society. Many different development theories have influence and inform education systems in many countries in different ways. Solomon Islands’ education system has shifted from traditional knowledge to Western oriented style of learning influenced by different development ideas, modernisation, capitalism and globalisation. Traditional knowledge existed for many generations before the introduction of Western education system. The transition period encountered more policy setbacks, rejection of traditional knowledge and incoherent policy models. These transformations happened in the political spheres, social ideas and economic system, influenced by the modern education system. Today, Solomon Islands’ economy and population are largely diverse across the country. The recognition of alternative opportunities available through diverse economies model by Gibson-Graham will help national policymakers to see different education priorities and development needs. Even with the rapid change in the state’s modern machineries, political system and institutions, more responsibility and cooperation is required to tackle the relation between education, migration and development. Education must empower people of ages and market levels to realise their full potentials by becoming an effective instrument to provide an answer for linking education, migration and development. The policy dialogue and discussion must open despite many agreements and disagreements.</p>

Education and labour migration in Solomon Islands: Policy interaction between the education system and the labour market

<p>Education is considered, in every sense, as one of the fundamental factors of development. No country can achieve sustainable development and economic growth without a systematic education system. Education raises people’s productivity and competency to build a strong economy and society. Many different development theories have influence and inform education systems in many countries in different ways. Solomon Islands’ education system has shifted from traditional knowledge to Western oriented style of learning influenced by different development ideas, modernisation, capitalism and globalisation. Traditional knowledge existed for many generations before the introduction of Western education system. The transition period encountered more policy setbacks, rejection of traditional knowledge and incoherent policy models. These transformations happened in the political spheres, social ideas and economic system, influenced by the modern education system. Today, Solomon Islands’ economy and population are largely diverse across the country. The recognition of alternative opportunities available through diverse economies model by Gibson-Graham will help national policymakers to see different education priorities and development needs. Even with the rapid change in the state’s modern machineries, political system and institutions, more responsibility and cooperation is required to tackle the relation between education, migration and development. Education must empower people of ages and market levels to realise their full potentials by becoming an effective instrument to provide an answer for linking education, migration and development. The policy dialogue and discussion must open despite many agreements and disagreements.</p>

5. Leave It to the People

This chapter treats democracy as a way of approaching problems through involving a variety of interests and actors along with citizens in interactive problem solving within the basic institutional structure of liberal capitalist democracy. It is manifested in for example public consultation, alternative dispute resolution, policy dialogue, lay citizen deliberation, and public inquiries. The turn from government to more decentralized and networked governance can be seen as a kind of democratic pragmatism, though networks do not always enhance democracy. This problem solving must be a flexible process that involves many voices and cooperation across a plurality of perspectives. The degree of participation with which pragmatists are happy often corresponds to existing liberal democracies and enables congruence between the demands of rationality in social problem solving and democratic values, though efforts exist to deepen both the democratic and problem-solving capacity of participation.