Listening to partners: Caribbean Centre for Health Systems Research and Development (CCHSRD)

Presentation: the Caribbean Centre for Health Systems Research and Development (CCHSRD) is a Research Centre at The University of the West Indies, St. Augustine, Trinidad and Tobago (T&T). The Centre was established in 2018 to pursue a program of work in Health Policy and Systems Research (HPSR), to address pressing policy and system issues faced by decision-makers in the Caribbean region. We engage in several activities within four core functions: Research Execution, Knowledge Translation, Health Human Resource Training and Development, and Citizen Engagement. For this newsletter, we spoke with Kershelle Barker, Junior Fellow, Evidence Synthesis at CCHSRD.

Hub LAC: Tell us a little bit about the Caribbean Centre for Health Systems Research and Development and its research focuses on evidence-informed policy-making.

K.B: With a mission to generate and facilitate the use of research evidence to strengthen health systems and policymaking processes, much of our work focuses on building individual and institutional capacity in evidence-informed policymaking (EIP). To this end, CCHSRD has conducted Needs Assessments with the Ministries of Health; Labour; Planning and Development; Social Development and Family Services; and Sport and Community Development in T&T, to understand their policymaking processes, their use of evidence, and their EIP training needs. Subsequently, we hosted priority setting exercises and EIP capacity building workshops, and provided coaching and mentoring to selected staff as part of two major projects – the WHO Building Institutional Capacity for HPSR and Delivery Science (Knowledge to Policy Centre Mentorship Program) and the Partnership for Evidence and Equity in Responsive Social Systems (PEERSS) project.

Additionally, CCHSRD successfully launched its Evidence to Policy Fellowship Training Programme in 2020, to promote evidence-informed policymaking and practice by building the capacity of policymakers (to use evidence) and researchers (to support the policymaking process).

The Centre has produced / co-produced several knowledge translation products to inform multisectoral policy or programmatic action. These include six (6) Evidence Briefs for Policy and four (4) Rapid Response Briefs on priorities in health (human resources, sexual and reproductive health services, mental health, and service delivery); and other social sectors (labour, education, social welfare, and community development). We have also hosted a stakeholder dissemination meeting and two stakeholder dialogues, and are engaged in follow-up/advocacy activities to encourage uptake of the evidence.

Hub LAC: What specific regional efforts has the CCHSRD undertaken to enhance decision-making in the Caribbean context? Could you provide a few brief examples to illustrate?

K.B: The second cohort of CCHSRD’s Evidence to Policy Fellowship Training Programme was open to decision-makers in the Caribbean. One fellow from Guyana successfully completed the programme, and an Evidence Brief for Policy aimed at improving access, quality and equity in health service delivery in Guyana was produced. This Brief contained local evidence on the problem, as well as proposed policy elements to address the problem, informed by the best available evidence. Though the fellowship programme has since ended, we intend to further engage with stakeholders in Guyana, to provide training and capacity-building in EIP skills and processes.

In 2022, CCHSRD collaborated with the Latin American and Caribbean (LAC) Evidence Hub to host a virtual learning workshop. The objectives were to identify local and regional EIP needs; connect key stakeholders from three Caribbean countries (T&T, Barbados and Jamaica); and generate knowledge about EIP in the LAC region. This workshop provided valuable insights about common barriers and facilitators to EIP in the Caribbean, and the factors needed to build a strong evidence ecosystem.

Also, CCHSRD is home to the Caribbean Community of Practice for Health Policy and Systems Research (CoP4HPSR), which is a network of 135 researchers, health professionals, policymakers, and other stakeholders from 14 countries, who are committed to building HPSR capacity in the Caribbean region. Through information-sharing and frequent discourse on HPSR topics, we aim to continue strengthening decision-makers and researchers’ understanding of the crucial role of evidence in policymaking/decision-making in the Caribbean.

In your opinion, what significant contributions can a regional collaborative Hub make to address the knowledge translation needs in an evidence-informed policy-making ecosystem in our LAC region?

K.B: A regional collaborative Hub is important in fostering a shared understanding of and commitment to utilising evidence in decision-making in LAC. Common challenges we face on a regular basis, which hamper this effort, include a disconnect between research outputs and policymakers’ needs; and a lack of contextualised data and evidence to inform policies, programmes or interventions in-country.

Having a regional body dedicated to filling this gap and generating knowledge translation products and services tailored to the LAC region would result in policymakers/decision-makers being provided with timely, relevant evidence to inform actions that are more likely to: (i) be feasible and make better use of already limited resources; (ii) counteract potential context-specific barriers to implementation; and thus (iii) achieve positive impact, such as improving health and other population outcomes.

Collaboration at the regional level can also help increase decision-makers’ buy-in to the research/evidence-to-policy process, and strengthen relationships between countries, to pool resources and efforts in order to address regional health and social priorities.

Listening to partners: Women in Global Health

Presentation

Starting its journey in 2015 as a Non-Profit Organization, Women in Global Health (WGH) now represents a global movement of action and leadership for gender equity in health. Currently, the organization has 47 chapters in

43 countries, over 5000 members and 100,000 people in some way involved in its activities across more than 100 countries, establishing a broad network of allies in favor of strengthening gender equal leadership in global health. For this newsletter, we spoke with Janessa Oliveira, PhD in Public Health, who currently coordinates the Brazilian chapter of Women in Global Health.

Hub LAC: WGH has actions both in advocacy and as a platform for different initiatives and partnerships. In this sense, could you give us a concrete overview of the initiatives that you develop?

J.O: WGH has been active for eight years through various initiatives to promote gender equality in the health sector. Our advocacy and stakeholder coordination front, dedicated to collaborating with influential organizations in the field proved to be a crucial part of our work. In fact, regional and national chapters are encouraged to seek alliances and contacts to implement actions that generate noticeable change at the local level. Moreover, the organization promotes events for showcasing successful experiences in other countries, so that other chapters can be inspired to lead their own initiatives. A final aspect we consider critical to our work is participation in global events, as a way of encouraging the

representation of women in these spaces, and being actively engaged in debates towards tackling gender inequalities in the health sector.

Hub LAC: What are the main pieces of evidence that support your understanding of the nature and magnitude of challenges to gender equality in health?

J.O: As it stands, we rely chiefly on secondary data provided mainly by the CNES – National Registry of Health Establishments, and we are working on establishing local alliances to gather information and glean a better understanding of the demographic profile of health professionals in Brazil. With regard to investigating pay inequality, we are in contact with professional councils to obtain robust data. Finally, concerning the various forms of violence that can affect the healthcare workforce, the Brazilian chapter is pursuing data gathering via professional councils and by running its own survey. We do realize this is a sensitive topic, so in order to maximize participation in this survey, we have been forming alliances to disseminate the questionnaire across the country and ensure a more representative sample.

Hub LAC: WGH now has an extensive global network, spanning across five continents. How are these initiatives engendered, considering the particularities of each region or even between countries?

J.O: WGH’s leadership accords a lot of value to creating regional and global collaboration mechanisms between the chapters. To this end, several regional Hubs were put in place, where chapters can come together to align priorities, organize joint activities, among other things. There are also monthly global meetings where chapters engage, share their updates and discuss a range of current issues in the field of global health advocacy.

In order to promote the exchange of experiences and ideas, WGH Global also organizes events and activities with the aim of showing how various themes manifest in different regions. An example of this type of activity were the four regional townhalls (assembly-type meetings) on the subject of Sexual Exploitation, Abuse and Harassment (SEAH) in the health sector, to which representatives of governments, NGOs and activists were invited to discuss proposed issues on the topic.

During these events (which were held for the regions of Eastern and Southern Africa, Asia, Latin America and the Caribbean, Francophone Africa), interesting initiatives were presented, expanding the exchange of ideas and experiences between representatives of these sectors in different countries. The Brazilian chapter was one of the co-sponsors of the event for the Americas and Caribbean region. See here the results of the events.

Another initiative we’d like to mention, which is more in line with the new WGH proposal, launched at the end of last year, focuses on Universal Health Coverage. We’ve secured funding for projects along these lines and our first initiative will be to work with podcasts. We believe that podcasts are an excellent tool for disseminating quality content in remote areas where internet coverage is limited, as is the case in the Amazon region. We want to disseminate content that promotes female leadership and improves the quality of healthcare in these areas.