Innovative strategies to enhance capacity to apply health policy and systems research evidence in policy-making, Mexico
Supporting evidence-informed health policy making in Mexico: Targeted training & tools to address contrasting state-level contexts
Mexico is a middle-income country undergoing rapid epidemiological transition and a continuous process of health sector change. State health authorities face the challenge of administering growing federal and state resources allocated to Seguro Popular, the insurance initiative targeting universalization of social protection for health by 2010. Today more than 40% of the rural and 20% of the urban population outside the social security coverage have gained access to Seguro Popular. Furthermore, sector integration through contracting across the various public institutions will happen mostly at the state level and within the federal-level public hospital and specialty medical providers. State ministries of health are thus quickly gaining important responsibilities for the financing and purchasing of services, while also facing the brunt of this epidemiological transition.
This project, focused at state-level, builds on products developed during the two-year INDESES consortium, led by National Institute for Public Health (INSP) in conjunction with three state-level academic institutions – ECOSUR, Chiapas; Universidad de Guadalajara, Jalisco; Universidad de Baja California – and funded by the Mexican Science and Technology Council “Research for the Development of State Health Systems”. The INDESES consortium targeted middle and senior level policymakers within federal agencies and within three contrasting states: Baja California, Jalisco and Chiapas. Among others, it developed and extensively applied the following relevant activities: a research use training module, adapted from the Canadian Health Services Research Foundation’s (CHSRF) first module of the Executive Training for Research Application (EXTRA) program, to promote the use of evidence in healthcare organizations, and an adapted version of the self-assessment tool developed by CHSRF to help generate discussion around research use capacities and strategies.
Also, the National Institute of Public Health (INSP) is implementing a research brokering strategy at state level, the Centers for Health System Development (CEDESS) in the State of Mexico, Oaxaca and Veracruz. In the first stage, the CEDESS – established as a program within a nongovernmental organization – is acquainted with various research and training platforms available at INSP. CEDESS then identifies areas of opportunity for research utilization and undertakes specific research and training projects.
Objective
This project aims to improve the organizational and state-level use of evidence by training and supporting policy making and planning agencies in using research, thus contributing to the enhancement of state-level health system quality, effectiveness and efficiency. Four specific objectives will be pursued:
- Supporting policy-making and program implementation in high priority areas through targeted research use capacity building and coaching.
- Building research use guidelines, research summaries and other coaching tools appropriate to the high priority needs identified.
- Developing a diploma-level curriculum and other teaching materials to be offered for the potential scaling up of the program.
- Evaluating the impact of the program at the organizational and state levels.
Each of these four objectives will be pursued through three specific streams of activities coordinated at national and local levels, with the fourth objective, evaluation, crossing all streams. The products within these streams will be tailored to the needs of each specific state. Special attention will be given to poorer regions of Mexico: Chiapas, Veracruz, Oaxaca, and the State of Mexico that includes important lower socioeconomic communities. Note that the latter three are also part of the CEDESS project. To solidify activities already undertaken, another state included in the INDESES program –Baja California – will also be integrated.
The three streams are coaching and targeted capacity building; building of research-use guidelines, research summaries and other coaching toos appropriate to the identified high priority needs; and developing a diploma-level curriculum and other teaching materials for the potential scaling up of the project. An external evaluator will assess the project’s impact on participating organization’s capacity to use research.
Project description
Programme: Innovative strategies to enhance capacity to apply health policy and systems research evidence in policy-making
Research title: Supporting evidence-informed health policy making in Mexico: Targeted training & tools to address contrasting state-level contexts
Thematic Research Area: Capacity development
Grantee Country: Mexico
Grantee Institution: National Institute for Public Health (INSP)
Program Coordinator/Principle Investigator:Miguel Ángel González-Block
Start date: January 2009
Status of grant: Ongoing