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The SUPPORT Collaboration: Supporting Policy Relevant Reviews and Trials

Final Report Summary - SUPPORT (The SUPPORT Collaboration: Supporting Policy Relevant Reviews and Trials)

One reason for slow progress with the maternal and child health millennium development goals is a lack of awareness among policymakers and others of effective interventions within maternal and child health. SUPPORT is addressing this by producing policymaker summaries of research evidence from systematic reviews. These summaries are divided into three areas: maternal health, child health and, health systems.

Having systematically searched a range of databases for relevant reviews, three support teams have now summarised these reviews. We have completed 101 maternal health summaries, 58 child health summaries and 60 health systems summaries. A database containing the support summaries is available at http://www.iecs.org.ar/support(s’ouvre dans une nouvelle fenêtre). In addition to summarising the results of the review, the summaries also give information on the applicability of the results to other settings, equity issues and information on economic issues. These are all questions faced by policymakers and these summaries, therefore, offer more value than the systematic review alone. Moreover, the summaries have been user-tested with policymakers in Norway, South Africa and Argentina and the information in them, and the way this information is presented, comes directly from discussions with policymakers. SUPPORT has also developed ways of delivering these summaries and other resources to researchers and analysts who support policymakers. In particular, SUPPORT has developed a series of 19 articles (called 'Support tools for policymakers', or STP), which describe the processes that ensure relevant research is identified, appraised and used appropriately to inform health policymaking. These articles are to be published in the biomed open access journal 'Harms' and will be translated into Spanish through SUPPORT and into Portuguese, French and Chinese through our links with the WHO EVIPNET project (please see http://www.who.int/rpc/evipnet/en/(s’ouvre dans une nouvelle fenêtre) online), which is involved in one of our projects. Active implementation and evaluation of policy and programs is being supported by our modification of a resource developed in one of our earlier EC Fifth Framework Programme (FP5) project called NORTHSTAR (please see http://www.rebeqi.org/?pageID=34&ItemID=35(s’ouvre dans une nouvelle fenêtre) online). NORTHSTAR is a tool that will help evaluators of interventions to improve the quality of healthcare and is targeted at quality improvement researchers and healthcare professionals and managers responsible for developing, delivering and evaluating continuing education and quality improvement programmes. The modified version is available for download from the SUPPORT website.

The majority of research evidence is not relevant to LMIC and more LMIC-focused research, especially trials, is urgently needed. The first step in running a high quality trial is to produce a good research protocol. Many of SUPPORT's partners were involved in producing a trial protocol tool in an earlier FP5 project (PRACTIHC, please see http://www.practihc.org/(s’ouvre dans une nouvelle fenêtre) toolindex.htm online). But writing a protocol, and obtaining funding, is only the start. The trial has to be conducted and managed well and a tool to support this process is one of SUPPORT deliverables: the trial management tool. This tool packages a wide range of practical information about managing trials in LMICs into a single software tool. The tool is available for download from the SUPPORT website. One particular area where SUPPORT is adding immense value to the trial management tool is by providing practical examples that give advice and tips based on the huge experience of running trials available within the consortium. These examples are sometimes text but we also provide audio and video clips of SUPPORT members and others represents a significant move forward of the state of the art, especially because of the audio and video delivery of practical information from world leading figures in trial management.

One of the important barriers to increasing the production of high quality research in LMIC, particularly in maternal and child health, is the difficulty in accessing funds for such research both within the country and internationally. Support has reviewed barriers and mechanisms to improving access to funding for researchers in LMIC who wish to undertake high quality pragmatic RCTs on priority maternal and child health service and public health questions. The consortium has collected interview and survey data from 23 researchers in 7 countries on the barriers and facilitators to obtaining funding for trials in their countries. As with the trial management tool, this information has now been packaged into a single software tool, the trial funding tool, which is available for download from the SUPPORT website.

The large number of summaries of what is known about effective interventions in maternal and child care and health services will support policymakers and others in their choice of, and support for, a range of interventions and delivery mechanisms. The trial management tool will support the conduct and management of pragmatic randomised controlled trials, which will help trialists to resolve practical issues regarding the day-to-day management of a trial. The project has built capacity by running a series of workshops and other knowledge transfer activities for policymakers and funders and for trialists and authors of systematic reviews. Through these results and outcomes, SUPPORT will we believe, continue to improve healthcare delivery and health systems in LMIC by increasing the proportion of care that can be regarded as best practice and the extent to which health care policies are based on rigorous evidence of intervention effectiveness. SUPPORT's aims and outputs will support and promote European values such as solidarity while also directly supporting European Union development policies such as reduction of poverty, sustainability, good governance and long-term economic growth.