Da avaliação de projetos de fortalecimento de capacidades às políticas e práticas em Saúde: um estudo de caso em Moçambique

  • Mie Okamura Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
  • Sónia Dias Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
  • Zulmira Hartz Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Portugal
Palavras-chave: Translação do conhecimento, uso do conhecimento, elaboração de políticas, avaliação

Resumo

Estudos avaliativos são úteis para compreender a implementação e efetividade das estratégias no campo da saúde. Contudo a capacidade de traduzir os resultados desses estudos em mudanças das práticas clínicas e na elaboração de políticas tem sido pequena, comparando com o investimento feito ao longo dos anos. Evidenciando-se assim uma fraca ligação entre o processo de produção de conhecimento, a sua transmissão e utilização na tomada de decisões. 

Este artigo foca a avaliação, como metodologia para facilitar a translação do conhecimento e as suas implicações práticas. Este processo envolveu a interação entre pesquisadores e usuários do conhecimento e a discussão de como transformar o conhecimento em ação, englobando o processo de criação e utilização pelos diversos intervenientes. 

Na perspetiva da translação do conhecimento, a discussão deste artigo centra-se na estrutura de cinco questões proposta por Grinshaw e Lavis em termos do que deve ser transferido, para quem, por quem, como e qual o efeito deste processo. É evidenciado como é um processo coletivo com alto grau de interdependência onde os potenciais usuários podem ou não ter autonomia suficiente para a sua utilização. Além disso, o grau de utilização do conhecimento dependerá de fatores contextuais e do próprio processo como este ocorre. 

Downloads

Não há dados estatísticos.

Referências

1 Oomman, N.B.M.; Rosenzweig, S. 2007. Following the Funding for HIV/AIDS: A Comparative Analysis of the Funding Practices of PEPFAR, the Global Fund and World Bank MAP in Mozambique, Uganda and Zambia. Center for Global Development.

2 Warren, A. E., Wyss, K., Shakarishvili, G., Atun, R. & De Savigny, D. 2013. Global health initiative investments and health systems strengthening: a content analysis of global fund investments. Global Health, 9, 30.

3 Bowser, D., Sparkes, S. P., Mitchell, A., Bossert, T. J., Barnighausen, T., Gedik, G. & Atun, R. 2014. Global Fund investments in human resources for health: innovation and missed opportunities for health systems strengthening. Health Policy Plan, 29, 986-97.

4 Grimshaw et al. 2012. Knowledge translation of research findings. Implementation Science 7:50.

5 Brousselle, A., Contandriopoulos, D., Lemire, M. 2009. Using Logic Analysis to Evaluate Knowledge Transfer Initiatives: The Case of the Research Collective on the Organization of Primary Care Services. Evaluation (Lond), 15, 165-183.

6 World Bank 2011. Using Knowledge Exchange for Capacity Development: What Works in Global Practice?

7 Otoo, S. A., N; Behrens, J; 2009. The Capacity Development Results Framework, World Bank.

8 Canadian Institutes of Health Research. 2012. Guide to Knowledge Translation Planning at CIHR: Integrated and End-of-Grant Approaches.

9 Contandriopoulos, D., Brousselle, A., Kedôté, N.M. 2008. Evaluating Interventions Aimed at Promoting Information Utilization in Organizations and Systems. Health Care Policy, 4, 19.

10 Graham et al. 2006. Lost in knowledge translation. Time for a map? The Journal of Continuing Education in the Health Professions. Volume 26. pp. 13-24.

11 Contandriopoulos, D., Brousselle, A. 2012. Evaluation models and evaluation use. Evaluation. January; 18(1): 61–77.

12 Contandriopoulos, D. et al. 2010. Knowledge Exchange Processes in Organizations and Policy Arenas: A Narrative Systematic Review of the Literature. The Milbank Quarterly, Vol. 88, No. 4, pp. 444–483.

13 Lavis, J.N. et al. 2003. How can research organizations more effectively transfer research knowledge to decision makers? The Milbank Quarterly, Vol 81, Nº2.

14 Kislov, R., Hodgson, D., Boaden, R. 2016. Professionals as knowledge brokers: the limit of authority in health care collaboration. Public Administration. Volume: 94, Issue 2. June. pp 472–489.

15 Currie, G., Burgess, N., Hayton, J.C. 2015. HR Practices and Knowledge Brokering by Hybrid Middle Managers in Hospital Settings: The Influence of Professional Hierarchy. Human Resources Management. Volume 54, Issue 5, September/October pp 793–812.

16 Tasseli, S. 2015. Social Networks and Inter-professional Knowledge Transfer: The Case of Healthcare Professionals. Organization Studies. Volume: 36 issue 7. pp 841-872.

17 Spyridonidis, D., Currie, G. 2016. The Translational Role of Hybrid Nurse Middle Managers in Implementing Clinical Guidelines: Effect of, and upon, Professional and Managerial Hierarchies. British Journal of Management. Volume 27, Issue 4, October pp 760–777.

18 Contandriopoulos, A., Champagne, F., Denis, J. & Pineault, R. 2002. A Avaliação na Área da Saúde: Conceitos e Métodos. In: FIOCRUZ (ed.) Avaliação em Saúde – Dos Modelos conceituais à Prática na Análise da Implantação de Programas. Rio de Janeiro: Fiocruz.

19 Champagne, F., Contandriopoulos, A., Brousselle, A., Hartz, Z. & Denis, J. 2011. A Avaliação no Campo da Saúde: Conceitos e Métodos. In: FIOCRUZ (ed.) Avaliação conceitos e métodos. Rio de Janeiro: Fiocruz.

20 Donnelly, C.A. 2013. Evaluation as a Mechanism for Integrated Knowledge Translation. PhD thesis submitted to the Graduate Program in the Faculty of Education. Ontário.

21 UNDP 2014a. hdr14_statisticaltables. UNDP.

22 Rey, L., Tremblay, M. & Brousselle, A. 2013. Managing Tensions Between Evaluation and Research: Illustrative Cases of Developmental Evaluation in the Context of Research. American Journal of Evaluation, 35, 45-60.

23 Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., Petticrew, M. & Medical Research Council, G. 2008. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ, 337, a1655.

24 Ogilvie, D., Cummings, S., Petticrew, M., White, M., Jones, A. & Wheeler, K. 2011. Assessing the Evaluability of Complex Public Health Interventions: Five Questions for Researchers, Funders, and Policymakers. The Milbank Quarterly, 89, 19.

25 Drobac, P. C., et al. 2013. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership. BMC Health Serv Res, 13 Suppl 2, S5.

26 UNDP 2014. Strengthening National Capacity to Fight Aids, TB and Malaria in Zambia.

27 UNDP 2014. Strengthening Skills, Tools and Systems for Better Services: Emerging Lessons from Global Fund Programme Implementation in Zimbabwe.

28 Semrau, M., et al. 2015. Strengthening mental health systems in low- and middle-income countries: the Emerald programme. BMC Med, 13, 79.

29 Okihiro, M., Sehgal, V., Wilkinson, T., Voloch, K.A., Enos, R. & O’Brien, J. 2014. Addressing health disparities by building organizational capacity in the community: a case study of the Wai’anae Coast Comprehensive Health Center. Hawaii J Med Public Health, 73, 34-9.

30 Mpofu, M., Semo, B. W., Grignon, J., Lebelonyane, R., Ludick, S., Matshediso, E., Sento, B. & Ledikwe, J. H. 2014. Strengthening monitoring and evaluation (M&E) and building sustainable health information systems in resource limited countries: lessons learned from an M&E task-shifting initiative in Botswana. BMC Public Health, 14, 1032.

31 Zhao, R., Chen, R., Zhang, B., Ma, Y., Qin, X. & Hu, Z. 2015. The Chinese version of monitoring and evaluation system strengthening tool for human immunodeficiency virus (HIV) capacity building: Development and evaluation. Biosci Trends, 9, 259-65.

32 Kauye, F., Chiwandira, C., Wright, J., Common, S., Phiri, M., Mafuta, C., Maliwichi-Senganimalunje, L. & Udedi, M. 2011. Increasing the capacity of health surveillance assistants in community mental health care in a developing country, Malawi. Malawi Med J, 23, 85-8.

33 Giugliani, C., et all. 2014. Community health workers programme in Luanda, Angola: an evaluation of the implementation process. Hum Resour Health, 12, 68.

34 Sahay, S., Kumar, M., Srikrishnan, A. K., Ramanathan, V. & Mehendale, S. 2014. Experiences in recruiting volunteers through community based initiatives in phase-1 vaccine trials in India. HumVaccin Immunother, 10, 485-91.

35 Sanou, A. S., Awoyale, F. A. & Diallo, A. 2014. An interventional model to develop health professionals in West Africa. Pan Afr Med J, 18, 152.

36 Bell, J. S. & Marais, D. 2015. Participatory training in monitoring and evaluation for maternal and newborn health programmes. Glob J Health Sci, 7, 192-202.

37 Davari, A., Rashidi, A. & Baartmans, J. A. 2015. Nutrition Leadership Development: Capacity-Building Initiatives in Iran and the Middle-East Region Since 2009. Front Public Health, 3, 184.

38 Bennett, S., Paina, L., Ssengooba, F., Waswa, D. & M’imunya, J. M. 2013. The impact of Fogarty International Center research training programs on public health policy and program development in Kenya and Uganda. BMC Public Health, 13, 770.

39 Haafkens, J., Blomstedt, Y., Eriksson, M., Becher, H., Ramroth, H. & Kinsman, J. 2014. Training needs for research in health inequities among health and demographic researchers from eight African and Asian countries. BMC Public Health, 14, 1254.

40 Ogundahunsi, O.A., Vahedi, M., Kamau, E. M., Aslanyan, G., Terry, R.F., Zicker, F. & Launois, P. 2015. Strengthening research capacity--TDR’s evolving experience in low- and middle-income countries. PLoS Negl Trop Dis, 9, e3380.

41 Dean, H. D., Myles, R.L., Spears-Jones, C., Bishop-Cline, A. & Fenton, K.A. 2014. A strategic approach to public health workforce development and capacity building. Am J Prev Med, 47, S288-96.

42 Rosenthal, M. S. et all. 2014. Building community capacity: sustaining the effects of multiple, two-year community-based participatory research projects. Prog Community Health Partnersh, 8, 365-74.

43 Aluttis, C., Den Broucke, S.V., Chiotan, C., Costongs, C., Michelsen, K. & Brand, H. 2014. Public health and health promotion capacity at national and regional level: a review of conceptual frameworks. J Public Health Res, 3, 199.

44 Pfeiffer, J. et all. 2010. Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique - a case study. J Int AIDS Soc, 13, 3.

45 Sherr, K. et all. 2013. Strengthening integrated primary health care in Sofala, Mozambique. BMC Health Serv Res, 13 Suppl 2, S4.

46 Schwarcz, S.K.R., G.W.; Horvath, H. 2015. Training for Better Management: Avante Zambézia, PEPFAR and Improving the Quality of Administrative Services Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”. International Journal of Health Policy and Management, 4, 773-775.

47 WHO 2010. Human resources for health and aid effectiveness in Mozambique.

48 WHO 2011. Efficiency and effectiveness of aid flows towards health workforce development: exploratory study based on 4 case study.

49 Sherr, K. et all. 2012. Brain drain and health workforce distortions in Mozambique. PLoS One, 7, e35840.

50 Sherr, K. et all. 2009. The Role of Nonphysician Clinicians in the Rapid Expansion of HIV Care in Mozambique. Acquir Immune Defic Syndr, 52, 4.

51 Ferrinho, P.S.M.; Goma, F; Dussalt, G.; 2012. Task-shifting: experiences and opinions of health workers in Mozambique and Zambia. Human Resources for Health, 10.

52 Dgedge, M., Mendoza, A., Necochea, E., Bossemayer, D., Rajabo, M. & Fullerton, J. 2014. Assessment of the nursing skill mix in Mozambique using a task analysis methodology. Human Resources for Health, 12.

53 Cailhol, J. et all. 2013. Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities. Global Health, 9, 52.

54 REPÚBLICA DE MOÇAMBIQUE, C. D. M. 2010. Plano Estratégico Nacional de Resposta ao HIV e SIDA 2010 – 2014. In: CNCS (ed.). Maputo.

55 Willcox, M.L. et all. 2015. Human resources for primary health care in sub-Saharan Africa: progress or stagnation? Hum Resour Health, 13, 76.

56 Francisco, A. 2010. Sociedade Civil em Moçambique Expectativas e Desafios, Maputo, Insituto de Estudos Sociais e Económicos - IESE.

57 Drobac, P.C. et all. 2013. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership. BMC Health Serv Res, 13 Suppl 2, S5.

58 Dwan, K.M., McInnes, P.C. 2013. Increasing the influence of one’s research on policy. Australian Health Review. 37, pp 194–198.
Publicado
2018-06-22