Dear Centre Leaders,
Greetings from the INDEPTH Secretariat. We hope you have had a good week.

We have five items for your attention this week:

1.Consultants submit final report on Review of INDEPTH Network Policy Work
The Executive Summary of the Report, prepared by Nyovani Madise and Wolfgang Lutz, is presented below. For the full report, please see the attached PDF.

EXECUTIVE SUMMARY
The INDEPTH Network, with its 49 Health and Demographic Surveillance Systems (HDSS), is unique in its scale and capacity to produce longitudinal data about millions of people in low and middle income countries (LMIC). The potential for HDSS to inform policy decisions and programs is significant, and some HDSS have been successful at generating evidence that ultimately guides policy-making. However, little is known about what conditions must be met by HDSS to achieve success in this regard. The William and Flora Hewlett Foundation commissioned a review to help the INDEPTH Network to determine how the 36 HDSS in sub-Saharan Africa (SSA) translate their findings to maximize impact on policy and practice, and how the Secretariat supports member centers that run HDSS to achieve this goal. The review focused primarily on the translation of research into policy and practice and did not attempt to assess the overall performance of the INDEPTH Network and its Secretariat.

The review defined policy and practitioner impact as occurring at three different levels:
• At the local level where the HDSS centers directly interact with local policy makers and practitioners;
• At the national level through the combined outreach of individual or groups of HDSS centers located in one country possibly with the assistance of the Secretariat; and
• At the international level where impact can be through findings in peer-reviewed journals, provision of internationally comparable data sets, and direct engagement of INDEPTH scientists or Secretariat staff with international organisations and major funding organisations.

The methodology of the review included discussions with the INDEPTH Board of Trustees and Secretariat staff, interviews with staff from seven selected HDSS centers, assessment of six impact case studies provided by the Secretariat and selected HDSS centers, interviews with end-users of research findings, and document reviews.

Key Findings
Translating research into policy and practice is a strategic objective of the INDEPTH Network but progress towards this objective has been weak despite several efforts into this direction in recent years. Over the last ten years, the Secretariat has placed its highest priority on quality control of the data and standardization of data collection methods. Direct policy outreach to national and international decision makers has taken a secondary role. This was a wise choice because the credibility of the data and the resulting analysis are important prerequisites for any kind of policy impact. In 2013, the Network launched the INDEPTH Data Repository and INDEPTHStats, opening up online access to core demographic indicators and some data. This is a good start and, as more harmonized data are placed in the Repository, the scientific community will start to make use of the data on a larger scale.

In its Strategic Plan for the period 2013-16, the Network has committed to “tailoring, packaging and directing research outputs, as appropriate, for different audiences and stakeholders so as to bridge the gap between research findings and policy-making” [1]. The implementation of this objective is yet to be defined but the Network has re-launched its Research to Policy Working Group. With strong and effective leadership, the rejuvenated working group could play a role in supporting the Network to fulfil this objective.

While our review found that the majority of the HDSS are producing high quality peer-reviewed research, translation of the research findings into policy and practice varied. At a deeper level, a key challenge for the INDEPTH Network is to identify and address research and policy questions for which the unique longitudinal and multi-dimensional platform of the HDSS (which is expensive to run) is utilized as an indispensable component. Several of the cases that we assessed (for example interventions to reduce prevalence of certain diseases) could have also been gained from much simpler research designs. This is in part a reflection of the funding bias, which is at the moment predominantly for specific health-related projects. The majority of these projects do not utilize the full potential of the HDSS setting including its extensive demographic components.

This review has identified a number of factors that appear to be linked to how successful HDSS are in translating research into policy. These include:
i) Whether a center is autonomous, locally owned, or owned by institutions in the global north, which in turn determines the primary audience for the research;
ii) The source of funding, with that from research end-users most likely to lead to use of findings for policy and practice;
iii) The researcher-policymaker relationship; and
iv) The presence of staff with skills in policy engagement and communication at the HDSS center.
The role of the Secretariat in translating research into policy and practice has so far focused on supporting member centers with training events for staff involved in data collection, data management, and analysis. While the Secretariat has convened workshops on communication skills for researchers, there was a general view from staff and researchers that more could be done to enhance the profile of the Network and HDSS centers among policy makers and funders.

Recommendations
1) In addition to being responsive to specific donor- driven and mostly exclusively health-related projects, the INDEPTH Network and its funders should invest in the conceptualization of directly policy relevant research questions that optimally utilize the great capabilities of the longitudinal and multi-dimensional HDSS platform. One example for such an effort could be the highly policy relevant study of the interactions between health, education and fertility at the micro and community level. While the scientific literature suggests that these three factors are greatly interconnected (with effects going in all directions) the empirical assessment of these has been hindered by the need for a complex longitudinal and multi-context study design of precisely the sort that HDSS offers. Another example is untangling the causal relationship between reproductive health and women’s economic empowerment. New insights on the nature of these inter-relationships would be of highest policy relevance, from the global level Sustainable Development Goals down to the design of community-level health and social services.

2) A challenge that the Secretariat faces in coordinating and leading network-level work on translating research into policy and practice is the lack of staff at the Secretariat with appropriate skills in policy engagement. While funding is one part of the problem, the Secretariat has been trying unsuccessfully to recruit a senior policy and communications analyst.

Our recommendation is that the Secretariat should intensify efforts to recruit a policy dialogue and communication specialist with knowledge of the international policy arena. While it is desirable that the staff member is based at the Secretariat, another option might be to recruit one or two experienced people from HDSS centers on a part-time basis.

3) The Network does not have a clearly defined strategy for policy engagement, and as a result, most of the activities in this area are ad hoc making it difficult to track impacts. Specifically, the Network has not yet identified the primary stakeholders it wishes to influence nor how to proactively communicate and engage with them. In 2009, the Network developed a Communications and External Relations Strategy which is a useful component of a Policy Engagement Strategy, but it is not clear if this strategy is being implemented or monitored. There has been limited interaction with global high-profile bodies (e.g. World Economic Forum) and while contact has been established with major regional bodies in Africa and Asia (e.g. NEPAD/African Union, Asian Development Bank, African Development Bank), there is potential for INDEPTH to do more to influence these stakeholders.

We recommend that the Network should develop a policy engagement strategy which clearly identifies the potential stakeholders and beneficiaries of INDEPTH’s products, what activities are necessary to ensure that there is impact, and an evaluation plan. In identifying its stakeholders, the Network may want consider mapping stakeholders (e.g. funders, policy actors, media, civil society, academic community and so on) and it should develop action plans to engage with each group. On policy actors, INDEPTH should look beyond WHO and ministries of health.

We further recommend that the Network should review its Communications and External Relations Strategy to align it with the Network’s revised strategic objectives. There should be clarity between the actions that are being led by the Secretariat and those led by center members. Annual action plans would be a useful way of managing and the implementation of the strategy.

At the national level, we see the role of the Secretariat as being strategic but in the background, supporting the HDSS centers. At the international level, the Secretariat should play a lead role in targeted and direct engagement with the international policy and donor community.

4) A distinction between HDSS centers that are more successful in policy engagement and those less engaged is that the former use a proactive approach to policy engagement, with strong links with the stakeholder beneficiaries. HDSS that develop trusted relationships with end-users of research are more likely to be successful in translating research into policy and practice. Where researchers are trusted, the relationship can be bi-directional, with stakeholders sometimes making the first move.

We recommend that HDSS centers that have not yet developed policy engagement strategies should be encouraged to do so, being clear of the audience they wish to influence and developing trusted relationships with stakeholders.

5) With regards to publications from HDSS centers, the “INDEPTH” brand is not highly visible. Although the INDEPTH Data Repository has citation information for more than 3,000 journal publications published by researchers affiliated to HDSS centers, the majority of these do not mention their affiliation to INDEPTH. In contrast, researchers often acknowledge their connection to the Network when applying for grants as there is a perception that this enhances the chances of success.

Since research findings from HDSS centers published in peer-reviewed journals are a key outlet that has the potential to influence the international state of the art, we recommend that efforts should be made to increase the visibility of INDEPTH in the publication and dissemination of such findings. It may be a promising idea to occasionally publish (in the form of reprints or summaries of findings) a bundle of such scientifically influential studies and distribute them under the INDEPTH logo.

We also recommend that the Secretariat should identify “cross-cutting products” that it can spearhead in dissemination for policy translation. Repeatedly, the “cause of death” work was mentioned as one such example that the Secretariat should focus on.

6) Recently, the Network has launched the INDEPTH DATA Repository and INDEPTHStats which have the potential to increase utilization of the data by the wider research community.

We recommend that efforts should continue to make more surveys and more standardized variables available so that over time this could become one of the standard references for international comparative studies. Investments in software to reduce the time between data collection and analysis could reap huge rewards. We recognize that dealing with longitudinal data is more challenging than for example, the widely used IPUMS and DHS databases, but ultimately it must be the goal to make as much INDEPTH data as possible available to the international research community in order for it to become a significant resource for international policymaking.

7) Funding for research usually ends with data collection or publication of findings in journals without any funding for impact activities. Also, because of the lag time between the end of a project and realization of impact, there is often no money left for policy engagement activities.

Our recommendation to the Network is to ensure that project costings include budget lines for policy engagement and impact-related activities. Periodically, the Secretariat could apply for follow-on funding to “mine” INDEPTH’s research for policy engagement and societal impact. Examples of such opportunities include the Wellcome Trust International Public Engagement grants and grants for systematic reviews.

2.INDEPTH Annual General Meeting (AGM) 2014
The AGM will take place from October 29 – 31, 2014 at Africana Hotel in Kampala, Uganda. Registration for the AGM is now open and can only be done online. All centre leaders are required to attend. For self-sponsored participants, the accommodation cost per night is $100.

For registration click: http://www.indepth-network.org/agmform.php

3. Master of Science in Epidemiology – Wits School of Public Health
The Wits School of Public Health offers a Master of Science (MSc) degree in Epidemiology in four fields of study namely: Epidemiology and Biostatistics, Population-based Field Epidemiology, Infectious Disease Epidemiology and Research Data Management. The degree focuses on the principles and practice of epidemiology, biostatistics and data management.

The deadline for application is July 31, 2014. Please see attached for details.

4. INDEPTH Small Grants Programme
Don’t miss this opportunity to apply for small grants from INDEPTH. The overall goal of this INDEPTH Small Grants programme is to support research and research capacity strengthening among INDEPTH member centres in low- and middle-income countries. We fund collaborative projects among three or more INDEPTH member centres.

Please see attached for details.

5. Advanced methods and applications in Ecology, Evolution and Control of Infectious Diseases with a focus on Neotropical Infections
This will be from the 17th – 21st November 2014 at the Autonomous University of Yucatan, Merida, Mexico. It is provided by the Centre for the study of Biodiversity in the Amazon (CEBA).

The courses will cover recent advances within the field of the ecology, evolution and control of infectious diseases, with a specific focus on innovative research on multi-host and/or multi-pathogen dynamics in order to cope with LabEx CEBA’s main field of interest. In addition to these courses, which will be followed by tutorials using the R statistical platform, evening lectures will provide insights into the more recent developments in modelling of ecology, evolution and control of infectious diseases. Prospective course and practicum teachers and lecturers include internationally-well known experts within the different sub-fields of research (all courses and tutorials will be given in English). 

Full information: http://www.labex-ceba.fr/en/thematic-school-2014/

Note:
We apologise sincerely for our inability to bring you the short profiles of scientists who have been funded by INDEPTH to pursue MSc in Population-based Field Epidemiology at the University of the Witwatersrand in Johannesburg and Masters in Public Health at the Brac University in Bangladesh, today .