Making research and evaluation more relevant and useful in the real world: favoured solutions and uncomfortable realities

Abstract

There has been a recent upsurge of advocacy from trialists and policy 'modernisers' for far more use of RCTs as the basis for health and wider public policy. This is exemplifi ed by the UK Cabinet Offi ce's report 'Test, Learn, Adapt' (2012). Mainstream policy makers are now being told that they should make policy by experimenting like scientists. Drawing on experience as an applied health services researcher and policy adviser in government, I will attempt to stimulate refl ection on the following questions: how can we explain the timing of this phenomenon; how realistic and helpful is it; and where does it leave the contribution of evaluation in policy? O3 Health system challenges in implementing universal health coverage: Asian perspectives and experiences In line with the global trend towards providing universal health coverage (UHC) as a primary tool in achieving sustainable development in the post-2015, post-MDG era, many low-and middle-income countries in the Asian region are in the midst of developing and implementing various schemes and strategies to achieve UHC. Given the diversity in health system structures, resources and capacities, the implementation of UHC in these countries poses major challenges to health service delivery. Indonesia, the fourth largest country in the world, rolled out its UHC plan, called JKN (National Health Assurance) in early 2014 and faces formidable logistic and administrative challenges with regards to access to medicines, human resources, fi nancing, governance and scaling up health service delivery. Key implementation challenges include those associated with issues of equity, quality and sustainability. The Indonesian experience in rolling out UHC may also be compared to other countries in the region which have implemented UHC with varying degrees of success (e.g. Thailand, Vietnam, Taiwan, India, Malaysia, etc.). In the spirit of 'reverse innovation' , it is also hoped that lessons learnt from UHC implementation in these countries will provide valuable learning lessons for each other, and for the success of UHC more broadly. O4 Health systems: the challenge of adapting and responding to the accelerating health transition in low income countries Don de Savigny