Setting up a rapid evidence synthesis service in the Western Cape, South Africa

Session: 

Oral session: Knowledge translation and communicating evidence (4)

Date: 

Monday 17 September 2018 - 11:00 to 11:20

Location: 

Carrick 1

All authors in correct order:

Moloi H1, Odendaal W2, Goudge J3, Goliath C4, Daniels K5
1 Health Systems Research Unit, South African Medical Research Council, South Africa, South Africa
2 Health Systems Research Unit, South African Medical Research Council, South Africa; Health Systems Research Unit, South African Medical Research Council, South Africa, South Africa
3 Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, South Africa
4 Western Cape Department of Health, Cape Metropol District, Cape Town, South Africa, South Africa
5 Health Systems Research Unit, South African Medical Research Council, South Africa; Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, South Africa, South Africa
Presenting author and contact person

Presenting author:

Willem Odendaal

Contact person:

Hlengiwe Moloi
Willem Odendaal
Abstract text
Background: Health systems decision makers - policy makers and managers - need evidence quickly, to assist in their decision making. A well-functioning rapid evidence synthesis service can meet this need. Yet, while some high-income countries have sophisticated knowledge clearing centres, such services are rare in many low- and middle-income country settings.

Objectives: To describe the establishment of a rapid evidence synthesis service for health policy and systems questions in South Africa.

Methods: We initiated our services by skilling ourselves in rapid evidence synthesis approaches, as well as piloting the service with select health systems managers. We engaged these managers from the start of the project, by inviting them to our training, so that they too could fully understand the service. Our focus in eliciting topics for review, has been on urgent priority implementation questions at district level, rather than on larger national health systems policies.

Results: Establishing the service has turned out to be even more complex than we expected. Although we understood that the intention was to produce products rapidly, our commitment to producing a rigorous and 'perfect' product, delayed the timing of our first outputs considerably. This caused some anxiety about whether we had failed in our responsiveness to our knowledge user. We were also concerned that we had not engaged sufficiently in the negotiation process around the question, and thus were unsure as to whether the final product would be useful. Based on these lessons, when responding to subsequent requests, we have decided that the most senior members of our team will engage in active negotiation of the question, setting clear perimeters around what we can answer and what we cannot. We have also begun to see our engagement as a conversation, in which we start with a rapidly produced policy brief, annotated bibliography, or evidence map. This then becomes the basis from which we negotiate our continued engagement, with the intention of producing a rapidly conducted, truncated review as an end product.

Conclusions: Establishing a rapid evidence synthesis service has taught us to balance the need for responsiveness with the need for methodological perfection.

Patient or healthcare consumer involvement: We engaged health systems implementation managers as consumers.

Relevance to patients and consumers: 

We directly engage with policy makers to understand what urgent health systems’ decisions they have to make, and how we can support their decision making through producing rapid evidence syntheses. We spend time assisting them to clarify their questions and turning them into reviewable questions. We maintain continuous communication throughout the process to ensure that the syntheses will assist in their decision making. We have extended Cochrane’s definition of health care consumers by including policy makers and health systems implementation managers, as consumers.