162769 Operations research as a tool to inform public health decision making: Examples from Mozambique

Monday, November 5, 2007: 5:30 PM

Pablo Montoya, MD, MPH , Beira office, Health Alliance International, Chimoio, Mozambique
Wendy Johnson, MD, MPH , Health Alliance International, Seattle, WA
Kenneth Gimbel-Sherr, MPH , Health Alliance International, University of Washington, Maputo, Mozambique
Stephen Gloyd, MD, MPH , Health Alliance International, University of Washington, Seattle, WA
James Pfeiffer, PhD, MPH , School of Public Health, Department of Health Services, Univertsity of Washington, Seattle, WA
        
In Mozambique, a resource-poor environment, improving maternal and child health programs has been an important priority. Policy decisions around the content and expansion of antenatal care services have been directly influenced by the results of operations research (OR) designed to provide critical information for programs using routinely collected data in central Mozambique. This session will explore several examples of how OR can be used to influence policy.

OR demonstrated the feasibility of using rapid tests to expand the congenital syphilis prevention program in rural health facilities without laboratories. Subsequent implementation resulted in a 40% increase in coverage and now over 100,000 pregnant women are tested in160 health facilities per year.

OR was also conducted to test the feasibility of nurses providing intermittent presumptive treatment for malaria (IPT). Researchers focused on the barriers to introduction of IPT and the impact on women's health. Nurses performed well and the proportion of women with parasitemia and severe anemia decreased significantly. IPT is now being implemented in 142 health facilities in the program area and more than 50,000 women received IPT last year.

PMTCT started as a vertical pilot program. A qualitative study demonstrated high acceptability of the intervention and lead to a rapid expansion. The program has been expanded and integrated into ANC in over 50 health facilities and over 40,000 women were tested in 2006.

In each case, the OR influenced policy to develop a comprehensive antenatal care package. Both IPT and PMTCT were scaled-up nationally and the Ministry of health approved the wide-spread use of syphilis rapid tests. As a result of these successful programs, the antenatal care form was revised to include the interventions in the comprehensive national package of routine ANC services. Targeted OR can help inform policy decision-making by demonstrating cost-effective, evidence-based approaches.

Learning Objectives:
1. Recognize the role of OR in affecting policy change. 2. Describe concrete ways in which OR can be used to influence policy. 3. Identify specific opportunities for using OR to scale up sucessful programs.

Keywords: Public Health Advocacy, Research Agenda

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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