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Vol. 4, Issue 2. June 2018

Editorial

“Making an impact at the country level"
By Zsuzsanna Jakab, Regional Director, Editor-in-chief

“WHO’s overall leadership in health and its work at the country level depend heavily on its main asset – the staff who work in the COs, and those in regional offices and headquarters who backstop the COs and the WHO representatives (WRs) in a coordinated, cross-divisional manner. Staff at the regional and global levels broker, coordinate and provide the evidence required for outcomes at the country level. Normative work, research and evidence required for policy-making continue to be important for driving policy at the country level, ensuring that human and financial resources are sufficient in countries and are aligned with achieving outcomes rather than outputs."  Continue reading

Panorama people

Interview with the Strategic Relations with Countries team

"The SRC team, based in the WHO Regional Office for Europe in Copenhagen, coordinates the country-specific work of the Regional Office and provides strategic guidance. At the same time, we keep countries up to date on WHO’s work and its global and regional priorities, and so we act as a bridge between countries and the Organization. The team is made up of strategic desk officers who work under the leadership of the Director of Country Support and Communications and the policy direction of the Regional Director, and in line with the Organization’s country strategy, to ensure a coherent, tailored approach to the work of the Regional Office in and with countries." Continue reading

Articles in this issue

Evidence-informed Policy Network (EVIPNet) Europe: knowledge translation success stories

Evidence-informed Policy Network (EVIPNet) Europe was launched in 2012 by the WHO Regional Office for Europe as a capacitybuilding mechanism for knowledge translation (KT). The study presented here focuses on five EVIPNet Europe member countries and their experiences with implementing EVIPNet Europe, and how EVIPNet membership and tools benefited them in their endeavour to improve and institutionalize evidenceinformed health policy- making.This descriptive study used an embedded multiple case study methodology, primarily drawing upon author observations and a document review. Five EVIPNet Europe member countries – Estonia, Hungary, Kazakhstan, Poland and the Republic of Moldova – were selected because each was at a different stage of the EVIPNet Europe implementation and  institutionalization process. The varying experiences of the five countries illuminate how EVIPNet Europe membership increases KT capacity, helps to establish strong links and exchanges between stakeholders across the research-policy divide, and increases the use of high-quality, context-sensitive evidence in health policy-making.

Strengthening implementation mechanisms for national tuberculosis control programme in Turkmenistan to achieve Sustainable Development Goals and End TB Strategy targets at the country level

Turkmenistan was one of the first countries in the world to adopt the SDGs. The country nationalized 148 of the 169 global SDG targets and 197 of the 231 global indicators. In 2017, the United Nations agencies operating in the country supported Turkmenistan in conducting several mainstreaming, acceleration, and policy support strategy (MAPS) missions, and Rapid Integrated Assessment (RIA) of the existing national, regional and sectoral programmes, strategies, action plans and laws for compliance with the SDG targets, including the availability of implementation mechanisms. Overall, 20 documents were available for RIA in Turkmenistan including 16 mid- and longterm national development plans and relevant sectoral strategies, and four legislative acts. The maximum score that can be awarded to a policy document is 27 based on nine RIA criteria. The National Programme for the Prevention and Control of Tuberculosis in Turkmenistan for the years 2016–2020 received a score of 21 (77.8%), which is the highest of all reviewed documents.

Disability and rehabilitation in Tajikistan: Development of a multi-sectoral national program to leave no one behind

In the 21st century, the world faces a new challenge: rapid population ageing accompanied by a rise in chronic conditions and multimorbidities. People live longer and with disabling chronic conditions that impact their functioning and well-being. Rehabilitation and assistive technology are critical for preventing and minimizing functional limitations, including the health, social and economic impacts of health conditions, and for improving well-being. In the aftermath of the 2010 polio outbreak in Tajikistan, improved rehabilitative services for people affected by polio were needed. Subsequently, new approaches to rehabilitation and a reformed system for providing services and assistive devices were established for patient groups such as those with injuries, impairments or disabilities due to noncommunicable diseases. This article describes the involvement of WHO in this process and the work undertaken in Tajikistan during 2013–2017 to support the establishment of a multisectoral national programme on rehabilitation.

Refugee and Migrant Health – Improving access to health care for people in-between

Since 2015, Serbia has been a central waypoint along the western Balkans migration route. After the closure of the humanitarian corridor in March 2016, thousands remained trapped in Serbia reluctant to seek asylum, as this would undermine their chances of finding protection in one of the EU Member States. The WHO Country Office for Serbia needed to address the challenges involved in providing health services to persons with an often unregulated legal status and in the context of limited financial and human resources of the national health system. Further difficulties included unmet hygienic, sanitary and health needs of persons voluntarily staying outside state shelters, and the cultural and language barriers preventing provision of health care. In line with the Strategy and action plan for refugee and migrant health laid down in the WHO European Region and resolution EUR/RC66/R6 of the WHO Regional Committee for Europe, the intervention by the WHO Country Office for Serbia was focused on a coordination role supporting the establishment of a national coordination mechanism for health services which included all state actors as well as NGOs.

Accelerating the response to noncommunicable diseases in Belarus: the role of focusing events and policy entrepreneurs in enabling policy transfer

In response to the global burden of noncommunicable diseases (NCDs), a set of international policy recommendations has been developed. However, implementing these recommendations at national and local levels has been difficult owing to wide contextual variations among countries. Adding to this difficulty is the scarcity of empirical evidence on the process of NCD policy transfer, especially regarding low- and middle-income countries. This study analysed recent changes in NCD-related policies in Belarus using a multiplestreams framework to gain a better understanding of NCD policy transfer. The findings emphasize the importance of focusing events and actors in this process. In Belarus, focusing events were the presentation and dissemination of the results of the STEPwise approach to surveillance (STEPS) survey and the actors were identified as WHO and national specialists on primary health care. The case of Belarus provides insight into how international policy recommendations can be transferred and adapted to national contexts, especially in countries with competing political priorities. The multiple-streams framework was useful for analysing NCD policy development in Belarus and might thus be of interest to specialists involved in developing and analysing national policies aimed at curbing the rise in NCDs.

Walking the talk: implementing HSPA in Hungary

Following the adoption of the Tallinn Charter in June 2008 (1), the WHO Regional Office for Europe and the Government of Hungary, in their biennial collaborative agreements (BCAs), agreed to prioritize the institutionalization of health system performance assessment (HSPA) in Hungary in order to promote transparency and accountability for performance and to improve analytical capacity to assess the attainment of policy objectives and the impact of health system reforms. One of the underlying assumptions of the technical work was that institutionalizing performance assessment can provide health policy-makers with systematic and comprehensive information about the performance of various parts of the health system. The following case study summarizes the process, the results and some of the challenges of the implementation of HSPA in Hungary, which might be helpful for those countries and experts who are looking for insights into and examples of a sustainable institutionalization and production process in this area.

The WHO Regional Office for Europe Small Countries Initiative – an introduction

Established in 2013, the WHO Small Countries Initiative is a platform where Member States in the WHO European Region with a population of less than one million can share their experiences with implementing Health 2020 and the 2030 Agenda for Sustainable Development. The Initiative seeks to (i) document ways of aligning national health policies with Health 2020 and the 2030 Agenda for Sustainable Development; (ii) develop joint capacity-building events around the key themes of Health 2020 to promote health and reduce health inequities; (iii) create an environment that supports the Health 2020 strategy by engaging the media as an implementation partner and (iv) create a platform for sharing experiences and learning about, Health 2020 implementation. It is an example of WHO Europe’s cost-effective support of Member States by means of a diversified portfolio focusing on support for alignment of national policies; topic-specific technical assistance and offering opportunities for networking.

Call for papers

March 2019 special issue – Deadline for submissions 31-09-2018

Public Health Panorama calls for the submission of papers for a special issue on health information and evidence in the WHO European Region, including innovations in big data, reporting on the Sustainable Development Goals (SDGs), health information systems strengthening, and digital health applications such as eHealth and mHealth. The special issue will be published in March 2019 and will focus on innovative policy and practice from across the European Region.
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