Article type
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Abstract
Background: Evidence about the effectiveness of health care interventions is necessary for informed health care decision-making. Both policy and practice should be based on the best available evidence. However, despite available evidence, gaps exist between evidence, policy and practice.
Objectives: In an effort to strengthen evidence-based policy in the Western Cape Province, the South African Cochrane Centre in collaboration with the University of Cape Town and the Provincial Department of Health (DoH), South Africa, launched STEPP. The project aims to bridge the gaps between research evidence, policy and real world practice.
Methods: STEPP reports compare specific policies formulated by the Provincial DoH with the best available evidence on benefits, harms, costs and feasibility of recommended interventions. The process begins by reviewing an existing policy guideline and defining targeted research questions. Next, comprehensive searches are conducted for synthesized evidence on benefits and harms, preferably based on Cochrane systematic reviews. Policymakers, clinicians and consumers are consulted for expert opinion, local cost data and feasibility. The end product is a critical summary of the evidence in light of current policy. STEPP reports are distributed to relevant policymakers, consumers and clinicians.
Results: One assessment has been completed and two are ongoing. The assessment on the effects of various emergency contraceptive regimens showed that current policy is not based on best available evidence and makes recommendations for amendments. The report was positively received by policymakers, clinicians and consumers. One policymaker responded, "... it is very useful. I recommend that the Policy be revised to comply with best evidence available." A reproductive health clinician said, "... it is very useful to utilise a resource like this for Policy development. It is important that Policy documents contain best possible advice based on sound and scientific principles. I recommend that Policy be amended as the STEPP assessment recommends."
Two ongoing assessments are evaluating the effects of nutrition interventions on HIV/AIDS and effects of cotrimoxazole prophylaxis on morbidity and mortality in HIV/AIDS.
Conclusions: This innovative project holds promise as a mechanism for promoting evidence-based health policy. Feedback from stakeholders suggests that it is a STEPP in the right direction!
Objectives: In an effort to strengthen evidence-based policy in the Western Cape Province, the South African Cochrane Centre in collaboration with the University of Cape Town and the Provincial Department of Health (DoH), South Africa, launched STEPP. The project aims to bridge the gaps between research evidence, policy and real world practice.
Methods: STEPP reports compare specific policies formulated by the Provincial DoH with the best available evidence on benefits, harms, costs and feasibility of recommended interventions. The process begins by reviewing an existing policy guideline and defining targeted research questions. Next, comprehensive searches are conducted for synthesized evidence on benefits and harms, preferably based on Cochrane systematic reviews. Policymakers, clinicians and consumers are consulted for expert opinion, local cost data and feasibility. The end product is a critical summary of the evidence in light of current policy. STEPP reports are distributed to relevant policymakers, consumers and clinicians.
Results: One assessment has been completed and two are ongoing. The assessment on the effects of various emergency contraceptive regimens showed that current policy is not based on best available evidence and makes recommendations for amendments. The report was positively received by policymakers, clinicians and consumers. One policymaker responded, "... it is very useful. I recommend that the Policy be revised to comply with best evidence available." A reproductive health clinician said, "... it is very useful to utilise a resource like this for Policy development. It is important that Policy documents contain best possible advice based on sound and scientific principles. I recommend that Policy be amended as the STEPP assessment recommends."
Two ongoing assessments are evaluating the effects of nutrition interventions on HIV/AIDS and effects of cotrimoxazole prophylaxis on morbidity and mortality in HIV/AIDS.
Conclusions: This innovative project holds promise as a mechanism for promoting evidence-based health policy. Feedback from stakeholders suggests that it is a STEPP in the right direction!
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