Social science research & health policy nexus in Sri Lanka

Transcription

1 Social science research & health policy nexus in Sri Lanka Ravi P. Rannan-Eliya Institute for Health Policy Dialogue on Social Science Research-Policy Nexus August 12, 2010

2 Issues Current linkages and impact of social science research Global trends Challenges to improve impact Challenges to improve research contribution 1

3 Personal note Undergraduate training Medicine Social and political science Graduate level training Public health Economics UK and USA during 1990s 2

4 Sri Lanka health policy - observations Research and knowledge do have a major influence on policy and action Partial insulation of medical bureaucracy from the general politicization Centrality of medical knowledge and medical professionalism Maintenance of openness to global research Lesser role of social sciences vs. biomedical knowledge 3

5 Increasing importance of social sciences in health the incomplete welfare state Successful provision of basic medical services > more complex policy challenges Health financing Management challenges of running complex systems Behavioral changes linked to lifestyle diseases Management of social expectations The unfinished agenda of Sri Lanka s social democracy Providing for wider range of health and social services 4

6 Global trends (1) Increased involvement of social sciences in health field Emergence of policy fields as specialized domains, e.g., health policy, global health, health economics Trend towards multidisciplinary training and research centres in developed countries Parallel changes in mechanisms for research funding and academic organization Establishment of graduate level public health schools separate from medical faculties Emergence of research universities LSE, LSHTM in UK 5

7 Global trends (2) WHO 2007 review of capacity for health policy research in developing countries Increasing complexity of health policy research and emergence as its own speciality Shift from cottage industry to modern organized research: multidisciplinary research capacity with ability to manage complex research projects - Emergence of global hot spots specialized centres combining multi-disciplinary skills and close links to policymakers 6

8 Sri Lanka: current problems in nexus Negative impact of politicisation on use of evidence Ignoring of evidence Demotivation of bureaucracy Limited capacity of health sector managers to absorb research evidence Biomedical training bias Lack of appropriate mechanisms in administration to commission, assess, filter and use research Weak links between academia/research and policy field 7

9 Sri Lanka: current problems in research production Lack of change in training and academic structures in health policy domains Persistence of traditional medical framework. E.g., Depts of community medicine, but no public health schools Lack of clear career pathways for potential researchers, esp. if physicians Absence of institutions capable of managing complex health policy research using multiple disciplines Motivation for establishment of IHP Inability of much of public sector academia/research to take advantage of emerging funding trends Lack of orientation towards competitive research funding, and administrative shortcomings Lack of orientation towards international collaboration Lack of national strategy to build external linkages 8

10 Experience of lack of awareness Equitap EU INCO-DEV and successors (> 1 billion/yr) Largest source of open, competitive global research funding No NSF strategy to facilitate access by Sri Lankan researchers 9

11 National policy challenges - Issues Healthcare financing and health economics Context of increasing incomes, aging, rising democratic expectations, modernizing social policies in context of market economy Significant challenges ahead with how to expand public financing and address new health trends such as NCDs The unfinished agenda of Sri Lankan social democracy Managing policy advice from development agencies with limited knowledge of where we are and what lies ahead Need for development of Sri Lankan self-understanding and capacity to develop solutions 10

12 National challenges research system Evolving the research system and infrastructure to keep up with global and regional trends Academic organization Research organization and funding National research policies for health How to encourage young researchers to return Providing a clear career pathway Liberalizing the research process beyond traditional institutions Building linkages with global institutions 11

13 Thank you 12