Is nursing research informing health policy in the EMR. Dr Sawsan Majali Member Advisory Committee for Health Research WHO- EMR

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1 Is nursing research informing health policy in the EMR Dr Sawsan Majali Member Advisory Committee for Health Research WHO- EMR

2 2 Before these recent developments of the Arab spring, most countries in the region had not prioritized research, science and innovation as key to their development. The political changes happening now provide a great opportunity to renew interest in research, science and innovation for the Arab countries.

3 3 Policymakers in the developed world understand that research, science and technology are vital components of economic growth and prosperity. But, in the Arab world, translating this realization into policies and actions backed by resource commitments has been a major challenge.

4 4 In 2004, 2007, analysis of National Health Research System was carried out in 20 on the EMR countries.

5 5 Findings of NHRS analysis: All countries have a designated structure in their ministries of health which has the overall responsibility for the governance of national health research. All the countries have national health priorities Absence of comprehensive national health research priority-setting efforts except in Tunisia

6 6 Research for Health Provides the knowledge required to understand the concerns, as well as the effectiveness and efficiency, of the health services and the future needs of the health sector in general.

7 7 Research for health encompasses: measuring the magnitude and distribution of the health problem; understanding the diverse causes or the determinants (factors could be biological, behavioral, social or environmental) of the problem; developing solutions or interventions that will help to prevent or mitigate the problem; implementing or delivering solutions through policies and programs; evaluating the impact of these solutions on the level and distribution of the problem.

8 8 Persistent challenges facing research for health in the region insufficient resources (financial and institutional); lack of conducive and supportive research environments; low political commitment to research as an important contributor to economic and health development; insufficient networking and partnerships among the various sectors to conduct and utilize research for health;

9 9 fragmented and weak management, collaboration and coordination of research for health, within and between countries; poor identification of priorities in line with the changing health scene in the Region (social, demographic, political and economic); insufficient preparedness (based on research-evidence) to respond to immediate emergencies and needs.

10 Strategic Directions for scaling up research for Health in EMR September 2011 EM/RC58/6

11 11 Goals Goal 1. Organization: promote and strengthen the research culture across the Region and strengthen the management and coordination of research activities. Goal 2. Empowerment: build, strengthen and nurture capacity and resources for improved conduct and use of health research in order to strengthen national health research systems.

12 12 Goal 3. Research priorities: support the setting of research priorities and work towards alignment of resources with health needs, including in emergencies. Goal 4. Norms and standards: create and advocate an environment of good research practice, adhering to ethical principles, and enable the greater sharing of research evidence, tools and materials. Goal 5. Knowledge translation: improve the access of governments and decision-makers to the research evidence necessary to inform health policy and practice.

13 13 Nursing is at the heart of patient care and is therefore crucial to changing the way health care is delivered so that patients receive better care at a cost we can afford (Dr. Risa Lavizzo-Moursy, Robert Wood Johnson Foundation, 2010).

14 14 Nursing Leadership From Bedside to Boardroom: A Gallup National Survey of 1500 Opinion Leaders (2011). The opinion leaders viewed government (75%) and health insurance executives (56%) as the groups most likely to exert a great deal of influence on health reform, compared with 14% for nurses. Government respondents were significantly different than all other respondents; 23%of these respondents said nurses have a great deal of influence in healthcare reform, compared with 14% of other individuals.

15 15 Challenges facing nursing in Arab countries Disparity between supply and demand: Shortage of nursing and midwifery, high workload, poor working environment, low job satisfaction, inadequate remuneration all affect the quality of care. Weak participation of Nursing leaders in health and nursing policy making and planning Weak or absent National nursing regulations Poorly implemented National strategic plans for nursing and midwifery Variable quality of education of nursing and allied health personnel Heightened public demand and expectation for better health services

16 16 Fast pace of advanced research and technology Patient safety issues Rising health care costs and limited financial resources Poor access to and coverage of health care services Countries in conflict and emergencies Nurse migration and retention Poor collaboration between nursing education and nursing services Shifting patient demographics

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18 18 Objective

19 19 Actions for Member States

20 20 What s happening in Nursing research in the EMR? Some research is being carried out related to nursing HR There is no evidence indicating that health system policies are being supported by nursing research Research is mainly carried out for academic purposes rather than guided by a national research strategy Countries active in Nursing research and publication: Jordan, Lebanon, Egypt, Saudi Arabia

21 21 Nursing Research in EMR related to health care systems Patient safety Nurse satisfaction Retention Hospital accreditation Migration Violence in the work place Underserved areas Primary healthcare Medication errors

22 22 Challenges facing nursing research in Arab Countries Shortage of qualified researchers at masters and doctoral level No clear national or regional strategy for nursing research Minimal funding is available to support nursing research Nursing researchers working in isolation from other health disciplines

23 23 Focus of role of doctoral prepared nurses is on education and management No regional nursing research database available (Jordan working on national database) Poor commitment by academic and clinical administration to apply findings of nursing research Lack of infrastructure in university and academic teaching hospitals to support research in nursing Poor dissemination of research findings (conference presentations, publication in international journals) Little interest in EBNP by practicing nurses

24 24 The big Question? How can nursing be engaged in research to improve the health of the people and the performance of the health system?

25 25 Recommendations Develop a regional strategy for Nursing research Identify nursing s role in national and regional research for health strategy Encourage a multidisciplinary approach to research Identify funding resources to support research (public and private sector) Designate a percentage of health research budgets to support nursing research Revitalize role of WHO collaborating centers in EMR to support research

26 26 Capacity building of researchers Developing a mentoring system for young researchers Disseminating research findings through creative use of IT and media Develop research working groups and learning communities (academic and practicing nurses) Encourage multisite (national and regional) studies Encouraging undergraduate students in participating in research projects (nursing and multidisciplinary) and conferences

27 27 Building research networks Integrating Evidence Based Nursing Practice in the nursing curriculum (utilization of research outcomes) Focus on conducting high quality cost effective studies that can contribute to the scientific base for nursing practice. Emphasizing Evidence Based Nursing Practice in clinical settings Encouraging nursing (graduate & faculty) research to focus on clinical issues and health priorities and measuring impact of nursing interventions Developing a database for nursing research as part of a national and regional health research database.

28 28 We need to remember that: Conducting research is one of the major obligations of nursing and of any profession (Johnson, 2006). Nurses need to venture beyond the roles of knowledge gatherers and consumers to become knowledge generators (Spear, 2006).

29 29 Two of the key messages of IOM report The Future of Nursing: Leading Change, Advancing Health (2010): Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States Effective workforce planning and policy making require better data collection and an improved information infrastructure.

30 30 To be effective in reconceptualized roles, nurses must see policy as something they can shape rather than something that happens to them. Nurses should have a voice in health policy decision making and be engaged in implementation efforts related to health care reform. Nurses also should serve actively on advisory committees, commissions, and boards where policy decisions are made to advance health systems to improve patient care.

31 31 Departing thought: Knowing is not enough; we must apply. Willing is not enough; we must do. Goethe