Exploring new ways of approaching familiar ideas: adapting CHEPSAA’s training modules in the Philippines
The development of health policy and systems research (HPSR) as a distinct field has opened a window of opportunity for the Philippines to promote an evidence-informed policy environment. We are pleased to share that CHEPSAA’s pioneering effort in developing training modules for HPSR is helping us mold future leaders in the Philippine health system who are well-aware of the need to ground health policies and programmes with rigorous research.
While there have been significant gains in promoting evidence-based policy-making in the Philippines in the past, the use of HPSR for policy formulation remains tenuous. This may be attributed to some administrative delays in the research process but it may also be due to the lack of a critical mass of researchers capable of integrating research and policy.
To bridge this existing divide between research and policy, the Health Policy Development and Planning Bureau of the Philippine Department of Health (DOH-HPDPB) implemented a research fellowship programme in 2012 with the aim of building the next generation of health sector leaders, researchers, policy-makers and programme managers.
For its fourth cohort of fellows, DOH-HPDPB in partnership with 101 Health Research, a research firm with extensive experience in training and mentoring health professionals on research methods, reoriented its fellowship programme to strengthen its focus on HPSR and build HPSR capacity in the research ecosystem.
To prepare the study groups to conduct research over the next two years, we adapted the CHEPSAA Introduction to Health Policy and Systems Research module, which we found to be appropriate in depth, adequate in scope, and concise yet rigorous to build research skills while establishing a foothold for HPSR within the DOH.
We aim for the fellows to get a good grasp of:
- what constitutes HPSR and its interdisciplinary nature;
- approaches to conducting HPSR in terms of purpose, paradigm and strategies;
- critical appraisal, ethics, rigour and integrity in research;
- preparing protocols and manuscripts; and
- communicating evidence to policy-makers.
|The Martian Game: Working in groups, participants imagine they are meeting a visitor from Mars. Together, they draw a picture to explain to the Martian what a health system is and why it is important to society. As a group, participants think about their different experiences and seek to identify the common key features of a health system as they have experienced it. The participants draw the picture on one large sheet of flip chart paper. View video of Martian Game, as implemented in India [5:00 on video]|
The DOH Health Policy and Systems Research Fellowship programme, a two-year research fellowship, recruited 27 early-career professionals nationwide with backgrounds in health and social sciences. Research fellows were organized to form 5 study groups tackling a specific HPSR focus: Health technology assessment, healthcare financing, health equity, health in all policies (HiAP) and health research impact.
Many of the fellows have gained substantial experience as researchers, consultants and health providers, and were chosen for their potential as future health sector leaders and their commitment to serving the nation. Meanwhile, 101 Health Research convened experts from various HPSR-related fields and institutions, who have done substantial research in their respective areas of study while also having the perspective of programme implementation. Our goal is to capacitate each study group to implement, and subsequently publish, a high-quality and relevant HPSR project over the two-year fellowship programme.
In developing the programme, it was clear to us that the HPSR training effort would not start from square one, because the fellows have had some level of exposure to the health system. Nonetheless, we observed that many of the fellows found it challenging to integrate perspectives from biomedical research, social science research and management research, which is an essential skill in HPSR. The HPSR fellows came from either the biomedical or social science research fields, and we had to design the programme in a way that lets them start from their respective comfort zones and allows them to progress towards more integrative topics.
With the help of our faculty, we were able to facilitate this transition by using familiar topics and other studies dealing with the Philippine context, such as the design of socially acceptable maternal health interventions among Philippine indigenous peoples, examining the health impact of stigma among persons living with HIV, and the realities of catastrophic health expenditure in the country. Additional lectures on health economics, reducing research waste, and issues related to authorship and research misconduct were also included to supplement CHEPSAA’s Introduction to Health Policy and Systems Research.
The fun-filled integration activities included in the training modules, such as the role-playing activities, poster-making, and group discussions, were also helpful as it allowed participants to have a more active role in the learning process.
In conclusion, we found CHEPSAA’s HPSR training modules to be a suitable introductory course for our fellowship programme. Its content and prescribed learning activities allowed us to explore new ways of approaching the problems being faced by the Philippine health care system and build greater appreciation for research in the country’s health policy sector.
For 101 Health Research: Venus Oliva Cloma-Rosales (MD MPH) and Jaifred Christian Lopez (MD MPM) Connect
For the Department of Health: Beverly Lorraine Ho (MD MPH) and Rodley Desmond Daniel Carza (RN MPH)