Evidence-informed Policy Network (EVIPNet) Europe Sixth EVIPNet Europe multicountry meeting: Istanbul, Turkey, 3–5 September 2019

1 Evidence-informed Policy Network (EVIPNet) Europe Sixth EVIPNet Europe multicountry meeting Istanbul, Turkey, 3–5 September 2019 Background The Evidence-informed Policy Network (EVIPNet) Europe is an initiative of the WHO Regional Office for Europe. It aims to increase country capacity in developing health policies informed by the best available research evidence, in support of Health 2020, the European policy for health and well-being (1). EVIPNet Europe institutionalizes knowledge translation (KT) – the process of fostering research use in policy-making – through the establishment of national country teams that plan and implement KT activities at the country level. EVIPNet Europe multicountry meetings offer the opportunity to all EVIPNet Europe Member countries to increase their technical capacity in evidence-informed policy-making (EIP) through targeted workshop sessions and discussions of lessons learnt, together with providing a platform for peer exchange and peer support through the Network. This summary describes the sixth multicountry meeting, which had two main foci: conducting rapid syntheses and introducing a cultural contexts of health (CCH) approach to EIP. Bridging culture and health Turkey hosted the sixth annual EVIPNet Europe multicountry meeting, organized by the WHO Regional Office for Europe in collaboration with the WHO Country Office in Turkey. Pavel Ursu, WHO Representative to Turkey, officially opened the meeting by underscoring “the strong affiliation between researchers and policy-makers”, which is the essence of KT. This meeting comprised representatives from 12 countries and served to welcome two new members – Austria and Turkey – to the Network. The meeting facilitated the exchange of experiences, lessons learnt and good practices, including the successful experiences of countries participating in international events. The primary objectives of the meeting were threefold: 1. to build the technical capacity of Network members in conducting rapid syntheses to inform policy-making, integrating a CCH perspective as part of the EIP process, and evaluating their EIP work; 2. to consider the synergies at the interface of CCH and EIP; and 3. to discuss and explore strategies to institutionalize the work of the EIP and EVIPNet Europe teams in each Member country. A growing toolbox for EIP: rapid syntheses Facilitated by Dr Michael Wilson, assistant director of the McMaster Health Forum, a large extent of the workshop was dedicated to theoretical and practical sessions on producing rapid syntheses: reports that consolidate local studies and global evidence on a problem, policy options or implementation considerations, and are performed on a time-scale (three, 10 or 30 business days) that is conducive to meeting policy-makers’ often urgent requests. While emphasizing that such syntheses must always be systematic and transparent in their scope and methodologies, Dr Wilson urged participants to see this new technique “as an accordion that can be expanded or contracted depending on how much time you have”. Over the course of the three-day meeting, country groups endeavoured to actually produce a rapid synthesis on a shared topic of significance, from learning how to continuously refine a © WHO/Mustafa Guzel “Everybody is entitled to health care that is informed by the best available evidence, no matter where you live in the world. The work of EVIPNet Europe of bringing evidence into practice and adapting it to local conditions is therefore a cornerstone of optimism, health care and resource use.” Karsten Juhl Jørgensen, acting director, Nordic Cochrane Centre 2 research question; to searching databases in a reproducible and accountable manner; to appraising systematic reviews for suitability, applicability and rigour using AMSTAR (A MeaSurement Tool to Assess Systematic Reviews); to extracting relevant data; and to synthesizing overall findings in a clear and cohesive fashion. On the final day, country rapporteurs delivered well-received oral presentations that showcased the results of their first rapid syntheses, and received constructive criticism on the entire process from Michael Wilson and Tanja Kuchenmüller, head of EVIPNet Europe and unit leader at the WHO Regional Office for Europe. Overall, participants cited the importance in this process of obtaining reliable local data and access to repositories of systematic reviews, such as HINARI (Hinari Access to Research for Health Programme) and Cochrane. Thinking outside the box: incorporating CCH In an engaging panel discussion with country champions, Nils Fietje, project leader of the CCH project at the WHO Regional Office for Europe, broached the notion that policy-making, like other decision-making processes, is not a black-and-white process but rather one that deals in context-specific shades of grey, incorporating multiple factors that directly and indirectly impact on equity, health and well-being outcomes. Accordingly, central to an improved EIP process should be receptivity to local contexts and people’s needs, values, perceptions and experiences, and, in particular, incorporate the role of narrative (2). Following a persuasive presentation by Dr Felicity Thomas (Senior Research Fellow at the University of Exeter and Co-Director of the WHO Collaborating Centre on Culture and Health) on the manifold ways in which culture, health and research are interconnected, participants were stimulated to consider a culture-centred approach that complements and strengthens existing tools and processes for the systematic use of qualitative evidence. Dr Thomas advised participants to consider the dynamicity of culture, rather than stereotypically reducing culture to “a static set of beliefs and practices”. As health care is a cultural construct, she called attention to the need for cultural humility and recommended that participants consider culture “as an enabler, rather than as a barrier”. The next steps are for participants to aid in formulating a synthesis question for a forthcoming concept note on the cultural contexts of effective KT, which would inform the development of a Health Evidence Network (HEN) report. Additional tools for KT Following a pre-meeting workshop that enabled new members to gain a conceptual understanding of EVIPNet Europe’s goals, methodologies and tools, the official meeting began by showcasing country champions who shared experiences and lessons learnt on three stages of EVIPNet Europe’s work with countries: conducting a situation analysis (Estonia), summarizing evidence in an evidence brief for policy (Moldova) and convening a policy dialogue (Slovenia). Tanja Kuchenmüller led an animated interactive session where she asked country teams to brainstorm the institutionalization of a knowledge translation platform (KTP) in their own countries. Mukdarut Bangpan of the Evidence for Policy and Practice Information and Co-ordinating Centre, a part of the Social Science Research Unit at the University College London Institute of Education, gave an inspiring account of how a well-institutionalized knowledge brokering organization could be formed by a small group of people who wished to “organize, collect and synthesize data in a reliable way”. Last, Adrianna Murphy, assistant professor at the London School of Hygiene and Tropical Medicine, led a workshop in which countries gave feedback regarding a recent, highly adaptable EVIPNet Europe rapid case study evaluation tool to be used following the completion of an evidence brief for policy. “A KTP is, typically, a national- or state-level entity designed to create and nurture links among researchers, policy-makers and other research users; these links draw the research and policy communities closer together to ultimately create cycles of policy- informed evidence and evidence- informed policy.” (3) © WHO/Mustafa Guzel 3 1. Health 2020: a European policy framework and strategy for the 21st century. Copenhagen: World Health Organization Regional Office for Europe; 2013 (http://www.euro.who.int/en/publications/policy-documents/health-2020.-a-european- policy-framework-and-strategy-for-the-21st-century-2013, accessed 17 September 2019). 2. Greenhalgh T. Cultural contexts of health: the use of narrative research in the health sector. Copenhagen: World Health Organization Regional Office for Europe; 2016 (HEN Synthesis Report 49) (http://www.euro.who.int/ __data/assets/pdf_file/0004/317623/HEN-synthesis-report-49.pdf?ua=1, accessed 17 September 2019). 3. Kasonde JM, Campbell S. Creating a knowledge translation platform: nine lessons from the Zambia Forum for Health Research. Health Research Policy Syst. 2012 Dec;10(1):31 (https://link.springer.com/ article/10.1186/1478-4505-10-31, accessed 17 September 2019). Document number: WHO/EURO:2019-3510-43269-60645 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).