South African Initiative for Systematic Reviews and Rapid Evidence Syntheses on Health Policies and Systems (SAI)

Background
Health systems decisions should be informed by the best available evidence, and systematic reviews and rapid reviews provide mechanisms through which such evidence can be provided in a timely way. Therefore, SAI hosted by the Health Systems Research Unit (HSRU) of the South African Medical Research Council (SAMRC), and funded by the Alliance for Health Policy and Systems Research (Alliance), aims to:

  1. Develop institutional capacity in low - and middle-income countries for conducting and packaging of systematic reviews on health policies and systems research;
  2. Conduct reviews that are policy-relevant at the national level and could be relevant to the needs of other countries in the region; and
  3. Disseminate the reviews and related products to potential users, particularly decision-makers, and to promote their uptake and use.

Our rapid evidence synthesis service for public health policy makers, practitioners, and civil society

Policy developers and health managers are often required to develop policy and practice guidelines under tight deadlines, and without consideration for evidence. Most rapid reviews are generated in and for high-income settings. Our service aims to address the gap for such a service in lower and middle-income countries. We provide rapidly produced, high-quality, synthesised evidence to ensure that best-available evidence informs policy decisions. Policy makers, practitioners, and civil society are invited to send us requests for synthesised evidence on health systems issues.

We successfully demonstrated the feasibility of a rapid response service, as an innovative response aimed at supporting evidence-informed decision-making. Some questions we have respond to from the Departments of Health of KZN and Western Cape (response time ranged from 7 days to 2 months) were:

  • Utilisation of lay/community health workers in Kwa-Zulu Natal (annotated bibliography)
  • How best to triage all walk-in patients in non-emergency primary healthcare facilities to ensure that those with the most urgent medical needs get the timeliest service? (full rapid review)
  • Enhancing early tuberculosis detection in Kwa-Zulu Natal
  • How should risk assessment and screening for Hypertension, Type 2 Diabetes Mellitus and Dyslipidemia be done for undiagnosed patients who present at primary healthcare facilities? (full rapid review)
  • Understanding out-of-facility primary healthcare models in South Africa (mapping of evidence)
  • MDR-TB drug treatment outcomes in pregnancy (annotated bibliography)
  • Non-emergency transport/ Planned patient transport (literature review)

The products we offer

  • A truncated standard effectiveness systematic review within five months
  • A 15 - working days’ synthesis
  • A five - working days’ synthesis
  • Policy briefs and lay review reports for non-specialist audiences
  • Training and capacity development

A very useful resource regarding rapid evidence syntheses is: Rapid reviews to strengthen health policy and systems: a practical guide, 2017 that can be downloaded from: http://www.who.int/alliance-hpsr/resources/publications/rapid-review-guide/en/.

Systematic reviews that are hosted by SAI are:

Should you wish to receive any more information on any or all of the reviews, or wish to inform us of your particular interest in our reviews, please contact Ms Hlengiwe Moloi: hlengiwe.moloi@mrc.ac.za:

How to find evidence pretty darn quickly
Have you been struggling to find evidence on your health systems related research questions? Then watch our webinar on: Finding reliable and up-to-date evidence to inform health systems and population health decisions: An online webinar on using the PDQ-Evidence database

Download the presentation of the webinar by clicking this link: What is PDQ-Evidence

Presented by: Gabriel Rada ( Associate Professor, Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Co-founder and President of the Epistemonikos Foundation) in conjunction with the ARCADE project of the Karolinska Institutet and the Epistemonikos Foundation in Chile.

Useful resources to health policy and systems research and systematic reviews

The Alliance for Health Policy and Systems Research aims to promote the generation and use of health policy and systems research (HPSR) as a means to improve health and health systems in developing countries.

The South African Cochrane Centre is the only Cochrane Centre in Africa and serves as the reference Centre for individuals in the following African countries: Benin, Botswana, Cameroon, Comoros, Eritrea, Ethiopia, Gambia, Ghana, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Nigeria, Sierra Leone, Somalia, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.

The Centre for Health Policy (CHP)
CHP is one of the few multi-disciplinary health policy units in South Africa and has over 20 years of research experience. The primary focus of our research is to support the development of the South African health system. As an academic research group, CHP actively seeks to draw together theoretical insights and empirical evidence in understanding health system change and in proposing strategies for future health systems development. We conduct both independently-funded research projects as well as commissioned research for the South African government and other South African organisations. We support and engage with a variety of stakeholders to promote appropriate health policy analyses. CHP strives to advance the field of health policy by developing meaningful national and international relationships.

Centre for Evidence-based Health Care (CEBHC)
The CEBHC aims to:

  • conduct and support relevant systematic reviews and primary research related to evidence-informed health care
  • enhance evidence-informed healthcare knowledge, skills and practices through teaching healthcare professionals and other stakeholders
  • promote the use of best evidence in healthcare decision making and the uptake of current best evidence in healthcare policy and practice

Core activities of the CEBHC include research, teaching and knowledge translation, and the CEBHC has a dedicated Biostatistics Unit.

Cochrane Collaboration is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. It is a not-for-profit organisation with collaborators from over 120 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest.

The Norwegian Satellite of the Cochrane Effective Practice and Organisation of Care (EPOC) Review Group [the link stays the same] aims to support the production of Cochrane reviews that address health systems questions relevant to low- and middle-income countries.

GESI
The Global Evidence Synthesis Initiative (GESI) was launched to enhance the capacity of Low- and Middle-Income Countries (LMICs) in synthesizing evidence, and using synthesized evidence to support practice and policy across disciplines including, but not limited to, Agriculture, Economics, Education, Environment and Health. GESI will achieve these aims through supporting Evidence Synthesis Centers based in LMICs.

PDQ (pretty darn quick) - evidence for informed health policy-making. The site provides quick access to the best evidence for informing decisions about health systems.

Health Systems Evidence is the world's most comprehensive, free access point for evidence to support policymakers, stakeholders and researchers interested in how to strengthen or reform health systems or in how to get cost-effective programs, services and drugs to those who need them.

The EPPI-Centre is committed to informing policy and professional practice with sound evidence. It is involved in:

  1. Systematic reviews: This includes developing methods for systematic reviews and research syntheses, conducting reviews, supporting others to undertake reviews, and providing guidance and training in this area. 
  2. Research use: This includes studying the use/non-use of research evidence in personal, practice and political decision-making, supporting those who wish to find and use research to help solve problems, and providing guidance and training in this area. 

Campbell Systematic Reviews is the peer-reviewed monograph series of systematic reviews prepared under the editorial control of the Campbell Collaboration. Campbell Systematic Reviews summarise the international research evidence on the effects of interventions in crime and justice, education, international development, and social welfare.

3ie (International Initiative for Impact Evaluation) funds impact evaluations and systematic reviews that generate high quality evidence on what works in development and why. Evidence on development effectiveness can inform policy and improve the lives of poor people.

National Voices, the health and care charity coalition, is launching a new set of take-away resources which set out the best ways to engage people and make person centred care happen. Called Evidence for Person Centred Care, this rich set of resources is designed to make it easy for commissioners and providers to access, understand and make use of the best evidence for various approaches to involving people in their health and healthcare. Five ‘simple guide’ booklets can be quickly downloaded to use in making value cases for patient and service user involvement.”

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