Supporting evidence-informed decisions about healthcare systems in low and middle-income countries: the Norwegian EPOC satellite

Tags: Oral
Munabi-Babigumira S, Johansen M, David Oxman A

Background: "If you are poor, you actually need more evidence, before you invest, rather than if you are rich" (Dr. H. Mshinda, Ifakara Centre, Tanzania). The health system challenges that currently exist in Low and Middle Income countries mean that health managers often require evidence on the effectiveness of interventions to inform their decisions. However, this evidence is often not available or when available, not applicable to their settings.

Objectives: To provide editorial support to authors developing Cochrane reviews on the effective practice and organisation of care relevant to Low and Middle Income countries

Methods: The Norwegian satellite of the Effective Practice and Organisation of Care (EPOC) Group was established in November 2006. This satellite is based at the Norwegian Knowledge Centre for Health Serves in Oslo. An editorial meeting to share tasks and hand over LMIC relevant reviews was held between staff of EPOC Oslo and Ottawa. Examples from ongoing Cochrane reviews that are relevant to LMICs were presented. Brainstorming sessions were held to provide information on other initiatives already working to provide evidence for LMICs.

Results: Three reviews and one update of a review that focus on health financing strategies, human resources for health and interventions that target health workers for provision of quality health care are currently underway. Collaborations with organisations like the Norwegian Agency for Development Cooperation (Norad), the Alliance for Health Policy and Systems Research (AHPSR), the World Health Organization and the South Asian Cochrane Network have been established. In collaboration with AHPSR, staff from four centres in Chile, Uganda, Bangladesh and China will be supported in their effort to develop reviews that answer priority health system questions.

Conclusions: A focussed effort by The Norwegian satellite of the EPOC group will support the preparing, updating and making accessible reviews of health systems research and health policies that are relevant and important to inform decisions about how to provide effective, efficient and equitable health services in LMICs.