Dr Humaira Mahmood, Focal Point, Cochrane Pakistan HSA Chapter
Pakistan produces a great deal of health research, but very little of it reaches the people who make decisions. At the 16th Annual International Public Health Conference, the Cochrane Pakistan HSA Chapter organized a panel discussion on knowledge synthesis and translation to ask why, and what we can do about it. The discussion fell into two parts: producing trustworthy evidence and translating it into policy and practice.
Producing evidence we can trust
It began with an uncomfortable truth. Not all research in Pakistan is of high quality, and this includes research by clinicians. Malpractice exists in many forms, from data fabrication and fraud to paying for an article simply to secure a degree or a promotion. Evidence of this kind does not help patients or policymakers, and it damages the credibility of honest researchers.
The panel agreed that the answer begins with purpose. Original research should be aligned with national problems and priorities, so that it can offer evidence-informed solutions to the questions our health system faces. This needs multidisciplinary and institutional collaboration, because no single department can answer a national problem alone. Funding is a major obstacle, and the panel urged researchers to look beyond traditional sources. Industry and the corporate sector should be approached, and grant writing should become a routine exercise rather than an occasional effort.
Trustworthiness and quality are, above all, the responsibility of supervisors. They should arrange regular training and routine journal clubs, and make sure that students learn how to appraise evidence as well as how to produce it.
Several good examples were highlighted. At NUST, multiple departments collaborate to produce healthcare research. Army Medical College offers a postgraduate research module. The panel also acknowledged the efforts of Maj Gen Sohail Sabir, now Vice Chancellor of the University of Health Sciences, who started Cochrane Pakistan at NUMS. It has since trained a number of master trainers. HSA has also held several capacity-building workshops on knowledge synthesis, being part of Cochrane Pakistan.
Translating evidence into policy and practice
The second part of the discussion turned to knowledge translation. Researchers and policymakers often speak different languages. Researchers write for journals and peers, while policymakers need short, clear, contextual answers within the time they have. Good evidence will not change policy until someone translates it.
The panel therefore stressed the need to prepare a public health workforce that could help policymakers make evidence-informed decisions, adapt guidelines to local conditions and develop patient care guidelines suited to our own context. The practical tools discussed included stakeholder mapping and collaboration from the start of a project, digital media and infographics that make evidence easy to share and understand, and well-written policy briefs. We must also use digital platforms carefully, so that accurate evidence travels faster than misinformation.
Our thanks
I thank Vice Chancellor Dr Shahzad Ali Khan of the Health Services Academy and Maj Gen Sohail Sabir, Vice Chancellor of the University of Health Sciences, for their leadership and support. The session was chaired by Maj Gen Mehmood Sultan, with Dr Shahid Baig and Dr Ramesh Kumar as co-chairs. The panelists were Dr Rukhsana Khan (Fazaia Medical College), Dr Farah Rashid (NSHS), Dr Syed Fawad Mashhadi (AMC), Dr Tahira Sadiq (Bahria University Medical College), Dr Faiza Bashir (NIH), Dr Farrah Pervaiz (RMU), Dr Saira Tariq (HSA), Dr Tayyaba Faisal (CPSP), Dr Ahmad Abdullah (Shifa Tameer-e-Millat University) and Dr Tayyab Qureshi, youth leader of Cochrane Pakistan. Special thanks go to Dr Zakiuddin Ahmed of Health RAB, who joined us from Karachi. Our thanks also go to the facilitators and note-takers whose work made the session possible.
