| A development
framework for promoting evidence-based policy action: drawing on experiences
in Sri Lanka
Most developing countries have embarked on one form or another
of health sector reform as a result of the global trend for health
and health care reform that has emerged during the past decade.
One consequence is that the issue of health sector performance is
moving higher on the agenda of many developing countries, and particularly
that of the corporate performance of health sector staff. Along
with this movement has come increased attention to strengthening
evidence-based management decision-making. To date, studies on measuring
health sector performance, have had little impact on developing
country health systems and have been limited to explorations primarily
at an operational level. However, there is a growing recognition
that there is a need to strengthen the policy function of ministries
and their ability to monitor policy impact.
Sri Lanka is one country that has identified the need to strengthen
policy at national level. Many developing countries, like Sri Lanka,
are familiar with input, process and output dimensions of operational
performance. However, most are not ready to engage in routine performance
assessment that can strengthen policy processes at national level.
This paper explores (1) the implication and the use of indicators
to support evidence based policy decision-making, and (2) the complexity
of doing so in Ministries of Health that are undergoing some form
of health sector reform.
The paper emphasizes that new forms of organizational support are
required for performance management at policy level. A conceptual
framework for managing the collection and use of performance evidence
is developed, including proposals for the introduction of outcome
indicators into that process. The paper concludes with recommendations
on initiatives required to develop appropriate organizational and
technical capacity to engage with performance management at policy
level and for further research towards creating ministries of health
as learning organizations that can change and adapt with informed
decisions.
(based on article's abstract)
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