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WP MRO ICP HSR 001 E Eng.Pdf (3.843Mb) ENGLISH ONLY I (wp)~mO/ICP/HSR/OOI-E \ REPORT WORKSHOP ON HEALTH SYSTEMS RESEARCH AS A llANAGEUENT TOOL convened by the REGIONAL OFFICE FOR THE WESTERN PACIFIC Or' THE WORLD HEALTH ORGANIZATION Kuala Lumpur, Malaysia, 8-12 December 1987 • I i WHO! \'/1':,',) LIBRARY !'Vlanllc:.. t- L;':lJJPlDe8 Not for sale Printed and distributed by the Regional Office for the Western Pacific of the World Health Organization Hanila, Philippines May 1988 NOTE The views expressed in this report are those of the participants in the Workshop on Health Systems Research as a l1anagement Tool and do not necessarily reflect the policies of the World Health Organization. This report has been prepared by the Regional Office for the Western Pacific of the World Health Organization for governments of Member States in the Region and for tile participants in the Workshop on Health Systems Research as a Management Tool, which was held in Kuala Lumpur. Malaysia, from 8 to 12 December 1987. , CONTENTS 1. SUMMARY ...................................... ~....................................................................... .. 1 2. PURPOSE ................................................................................................................ 2 2.1 Objectives ................................................................................................ 2 2.2 Expected outcomes • •• • • • • • •• • • • • • • • • • . • • • . • • • . • • • • • • • • • • • • . 2 3. ORGANIZATION 2 3.1 Location and participants • • • • • • • • • • • • • • • • • • • • • • •• . • • • • • • • • 2 3 .. 2 Outline of content .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 3.3 Method of work • • • • • • • • • • • • • • • • • • • • . • • • • • • • • • • • • • • • • • • • • • • . 3 4. OUTCOME ................................................................................................................ 4 4.1 Role of health systems research in management decision-making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 4.2 Institutionalizing health systems research into the managerial process • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 7 4.3 Country plans of action • • • • • •• •• • • • • • • • • • • • • • • • • • • • • • • • • • . 11 4.4 Regional health system research network .•••••••••••••••••• 11 5. EVALUATION 12 6. CONCLUSION .......................................................................................................... 13/14 ANNEX 1 - LIST OF PARTICIPANTS AND SECRETARIAT 15 ANNEX 2 - PROGRAMME ........................................................................................ 21 ANNEX 3- OPENING SPEECH BY Y.B. DATO' K. PAT~~ABAN DEPUTY MINISTER OF HEALTH, MALAYSIA •••••••••••••.••• 25 ANNEX 41- OPENING REMARKS BY DR H. NAKAJIMA, REGIONAL DIRECTOR, , REGIONAL OFFICE FOR THE WESTERN PACIFIC • . • • • • • • • • . • • • 27 ANNEX 5 - HEALTH SYSTEMS RESEARCH (IISR) IN SUPPORT OF MANAGEMENT DECISIONS AT STATE AND PROGRAMME LEVELS 31 ANNEX 6 - INTRODUCTION TO THE PROJECT, "ROLES OF HOSPITALS AT THE FIRST REFERRAL LEVEL FOR HEALTH FOR ALL·· • • • • • • • • • 39 ANNEX 7 - MILESTONES FOR INSTITUTIONALIZING HEALTH SYSTEMS RESEARCH IN THE MANAGEMENT PROCESS •••••••••..••.••••• 51 ANNEX 8 - HEALTH SYSTEMS RESEARCH AS A ~~AGEMENT TOOL IN PAPUA NEW GUINEA • • • • • • • • • • • • • • • • • • • • • • • • . • • • . • • • • • 61 ANNEX 9 - USE OF HEALTH SYSTEMS RESEARCH AS A MANAGEMENT TOOL: MALAYSIAN EXPERIENCE ............... 71 ANNEX 10 - COUNTRY PLANS OF ACTION FOR INSTITUTIONALIZING HEALTH SYSTEMS RESEARCH AS A MANAGE~IENT TOOL 77 1. SUMHARY The Regional Office for the Western Pacific of the World Health Organizdtion (WIlO) in collaboration with the Institute of Public Health, Ministry of Health, llalaysia, organized the intercountry Workshop on Health Systems Research as a Management Tool. The 'mrkshop was a regional activity of the WIIO health systems research and development programme. Twenty-five participants from eight countries, namely, China, Republic of Korea, !lalaysia, Papua New Guinea, Philippines, Singapore, Tonga and Viet Nam, attended the workshop. The adoption of the regional strategy for health for all in 1980 has increased the awareness of many countries that the current health development issues involve a complex mix of social, political, and technological factors. The health-for-all strategies of most countries highlight the need to strengthen management in order to effectively handle these complex issues. One of the ways that management can be strengthened is to integrate within the management process the use of health systems research. A Humber of countries within the region are expt!rimenting with ways to i,.prove the link between management and health systems research. This workshop brought together these country experiences in order to strengthen the participants' ability to promote and use health ·systems research in management decision-making. As a result of this workshop, it was expected that: (1) the participants would have a clearer understanding of how health systems research can be used to solve health development problems in their country; (2) the participants would know ho\/ to initiate and maintain health systems research projects in support of management decision-making, and (3) a plan would be made to start a health systems research network that would support the new initiatives in each country. As a result of the workshop, it was possible to prepare a precise description of how health systems research can support the managerial process. The workshop participants also developed a generic scheme for institutionalizing health systems research in the management decision-making of health organizations. Using the generic model, each country was then able to prepare a specific plan of action for what was needed to initiate and maintain health systems research as a management tool in their respective countries. - 2 - 2. PURPOSE 2.1 Objectives The workshop was designed to strengthen the participants' ability to promote and use health systems research in management decision-making. Specifically the workshop enabled the participants to: (1) review country experiences in using health systems research as a part of the management process; (2) determine how health systems research can contribute to improve management of the health system; and (3) outline a strategy for developing a management system within which health systems research is an integral part. 2.2 Expected outcomes At the end of the workshop, it was expected that country specific plans would be prepared. These plans would show how: (1) health systems research could be used to solve health· development problems in their country; (2) health systems research projects could be initiated and maintained in support of management decision-making; and (3) a health systems research network could support the country health systems research activities. 3. ORGANIZATION 3.1 Location and participants The workshop was held at the MinS Court Hotel in Kuala Lumpur, Malaysia, from 8 to 12 December 1987. The workshop was very efficiently administered by staff from the Institute of Public Health, Hinistry of Health, Malaysia. It was conducted by six facilitators from WHO and the Ministry of Health, Malaysia. There were twenty-five participants from eight countries of the Region, namely, China, Republic of Korea, Malaysia, Papua New Guinea, Philippines, Singapore, Tonga and Viet Nam. In addition, there were observers from Kuwait and Malaysia. A list of participants, facilitators, organizers and observers is found in Annex 1. - 3 - 3.2 Outline of content The objective of the WHO regional health systems research programme is the development of national capabilities to plan and implement health systems research activities. The strategy that is being promoted to achieve this objective is to integrate he.alth systems research activities within the managerial process of the health system. This means that health managers are encouraged (1) to conduct health systems research as a part of their routine work, and (2) to support projects that are initiated by health system managers. riost countries of tile Region recognize that the appropriate solutions to their healtt. development problems can be derived from conducting well-directed, problem-oriented research. Consequently, countries are searching for the most effective way to develop research capabilities in management and or~anize research activities. The workshop was an opportunity for country participants to share experiences on how health systems research strategies can become an important management tool. The workshop experiences were structured around two themes: (1) clarifying management's understanding of what health systems research as a tool can do for management decision-making; and (2) how this tool can be institutionalized in a country's management process. The specific workshop sessions were organized around the above two themes and consisted of the following topics: (1) reviewing of health development issues facing health managers in the Region; (2) classifying these issues on the basis of a management decision-making hierarchy; (3) preparing a generic scheme for integrating health systems research into the managerial process; and (4) outlining country and regional support to initiate and maintain the institutional link between health systems research and II13nagement .. The detailed
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