LEARN Lao PDR - Strengthening research capacity for influencing policy development through SPHIP

Strengthening research capacity for influencing policy development in LAO PDR, through SPHIP

The Lao Equity through policy Analysis and Research Networks program (LEARN) in Lao PDR, is one of the eight countries participating in and supported by the EU funded Supporting Public Health Institutes Program (SPHIP) with technical assistance from the EU Support Team (EUST). Although the LEARN program will finalize in July 2020, as part of the last edition of the EU Newsletter, this article provides some highlights of LEARN’s implementation period. 

In Lao PDR, the aim of SPHIP is to support the development of national public health institutes (NHPIs) through enhancing the expertise, knowledge and resources. This is accomplished through enabling NPHIs to provide national authorities and other stakeholders with evidence-based research to support health policy-making and to monitor and evaluate the effectiveness of these policies and programs.

Through LEARN, SPHIP focuses on strengthening the capacities of Lao Tropical and Public Health Institute (Lao TPHI) and the University of Health Sciences (UHS). Through a multi-year project (2015-2020), LEARN is promoting the importance of Lao public health research, and its role in assisting the Government of Lao PDR (GoL) to meet its targets for Universal Health Coverage (UHC) and to achieve other health-related Sustainable Development Goals (SDGs).

LEARN’s overall goal is to contribute to improved population health and achieving universal health care in Lao PDR through better-informed health policies and monitoring and evaluation of their implementation. The two specific objectives of LEARN consist of:  supporting Lao public health institutes to strengthen their capacity to provide national health authorities and other stakeholders with evidence, and secondly, to support Lao TPHI and UHS to provide evidence from high quality health research to the GoL, with a focus on two priority areas, reproductive health and nutrition. 

The LEARN program is managed by Medical Committee Netherlands Vietnam (MCNV). MCNV has over 50 years of experience supporting the strengthening of health systems in both Vietnam and Lao PDR. MCNV plays the essential role of managing the grant and ensuring that standards required by the EU and EUMF are met.

To achieve Lao TPHI and UHS’ need for adequate human resources and improving the researchers’ ability to work, LEARN supported physical infrastructure, such as study facilities, upgrading internet connections, and enabling better access to online resources in Laos, international academic journals and research databases. LEARN conducted an Organizational Capacity Assessment, which resulted in technical assistance for Lao TPHI’s Strategic plan to reflect GoL Strategic Planning government cycle (2021-2025) as well as conducting short courses for staff of the institutions and researchers on topics such as qualitative research methods, data collection and analysis, research ethics, presentation skills, and producing policy briefs.

LEARN trained the next generation of researchers, supporting them in aligning their research so that it is relevant to the public health priorities of Lao PDR, resulting in better quality evidence to inform policy-makers and to monitor policy implementation. To support learning of high quality research, LEARN established technical support from the Hanoi University of Public Health (HUPH), Vietnam for the MPH program. In addition a line of technical support was formed with the Vrije University (VU), the Netherlands. 

To ensure the research conducted within Lao PDR addressed public health issues relevant to the context of the country, LEARN supported the development of National Health Research Agenda (NRHA). This process was spearheaded by Lao TPHI and published. The NHRA was built on an assessment of the existing health policy and implementation gaps distilled through in-depth interviews with stakeholders and involving health service providers at district, provincial and national levels. The prioritized health themes were presented and by using the Delphi technique, a panel of Lao public health experts did the ranking. The final list of health research priorities were recorded in the NRHA and approved by the Ministry of Health (MoH). The completion of the official document and launch of the NHRA occurred during the National Health Research Forum in October 2018.

For the development and implementation of Laos’ first international Master in Public Health (MPH) Program, LEARN activated the collaboration between UHS with the Hanoi University of Public Health. The program involves twenty Lao MPH students. The students received technical assistance from supervisors of UHS and HUPH. For quality and sustainability the Lao MPH curriculum undergoes quality checks/inspections through exchanging experiences, student and course assessments, which is completed in collaboration with HUPH. UHS intensively accompanied the twenty Lao MPH students undertaking their coursework in Hanoi and Vientiane, conducting their research in Lao PDR and ensuring their research topics all align with the NHRA. By February this year, the last ten of the twenty MPH defended their thesis and are expected to fulfill their final requirements of the MPH program by May 2020.

In addition to the MPH program, the LEARN project supports five PhD students and four senior Lao researchers who are conducting post-doctoral studies. Under the collaboration with Amsterdam, through the VU’s Global Public Health Program, the PhDs are undertaking their coursework at the VU in the Netherlands and receive technical assistance for their research, manuscripts and dissertation from supervisors at the VU. The PhD students are involved in an exchange program with both Lao and Dutch MPH students to improve their own ability to support the MPH students. Furthermore, the post-doctoral candidates receiving technical support for their research from supervisors of the VU.

Besides the above mentioned researchers, LEARN provides grants to five Open Call researchers.  All the researchers and students research is linked to the NHRA. Their research is approved by the Lao National Ethics Review Committee, who received specific training to ensure the approved research is conducted to the highest ethical standards and guarantee the safety of research participants. This trainings resulted in the establishment of documented procedures for the review and approval of research undertaken in Lao PDR.

The research in LEARN is not a standalone component, the researchers contribute to improved health outcomes in Lao PDR by providing quality research evidence to policy makers. To lead this process, the research results needed to be translated into policy briefs and actions. LEARN, through EUMF, supported the development of a Knowledge Translation Strategy (KTS) involving LEARN stakeholders and staff of the institutions. KTS facilitates and supports the process for ongoing and future research, to contribute to a better population health system in the Lao PDR, through improved policies. Lao TPHI established a dedicated division to facilitate knowledge translation informing health policies and practices through strong and objective evidence, to support improvement of communication between researchers and policy makers. Therefore, LEARN supported the maintenance of a research portal which stores results from research undertaken in the health sector and Ministry of Health, making those results more accessible for different audiences.

Individual researchers disseminated their research results in policy briefs in the areas of antenatal care, adolescent sexual reproductive health and nutrition for presentation to decision makers of different departments and high level meetings. In this ongoing process, results were disseminated during technical working groups, and taken into account for the review of national guidelines. LEARN supports researchers in the consultation process with stakeholders and implementers, to develop clustered policy briefs with evidence based information for policy makers. These clustered policy briefs give a stronger message to policy makers rather than many individual policy briefs.

In addition, individual researchers disseminated their research findings during several international conferences and during policy dialogue at the annual National Health Research Forum and Adolescent Research Day in collaboration with UNFPA. They also presented at the annual International Conference on Public Health among the Greater Mekong Sub-Regional countries; a platform to link Lao research with international research and engaging in dialogue with other researchers, policy makers and implementers.  

Some of the researchers centered their research on adolescents and sexual reproductive health. They invited the Lao Youth Union (LYU) to participate in collecting and disseminating research findings on health literacy and teenage pregnancy in Laos. A ‘Research café’ became the venue for ministries, health and education services, research institutes and international and national organisations to share the researchers’ findings and discuss activities to increase knowledge on both topics. Through a joint decision a video contest was conducted to get the perspective of adolescents on health literacy and teenage pregnancy. Through this joint information gathering, the LYU incorporated some of the results in their five year strategic plan developed in 2019.

To conclude the above presented highlights, in the time still available until the closing of the program, LEARN is working towards a special edition of the Global Health Action Journal, publishing a compilation of articles of involved students and researchers. The special publication will be launched in the final LEARN Knowledge Translation event, and serve as another format to engage policy makers, stakeholders and implementers in dialogue to provide strong evidence to influence the development of policies, which can be implemented and benefit all  people in Lao PDR.