Panel 1: Cases description

Title	Prevailing contextual factors	Why and how the KTP get involved	Events during and after dialogues
Case 1: Improving governance for health district development in Cameroon	Structures Anti corruption commission National programme for governance Ministries in charge of public health, territorial administration and decentralization Legacies Growth and employment strategic paper embodying principles and requirements for good governance to achieve MDGs Constitution inscribing decentralization of public health role to municipal authorities Policy networks Cameroon branch of Transparency International Association of municipalities Civil servants Bureaucrats in charge of health, territorial administration and finance Elected officials Mayors expected to gain prestige as chairs of the management boards of the district hospitals Donor bureaucrats German cooperation (GIZ) World Bank Researchers EVIPNet Cameroon Values Good governance Health system strengthening Local social control Research evidence Negative impacts of poor governance and petty corruption on district performance Report World Bank Doing Business World Bank report on petty corruption in public services Transparency International Corruption Index Commitment Health MDGs African Union peer review mechanism	Mid-term evaluation of the 2001-2015 health sector strategy identified poor governance as a leading cause of poor performance towards the achievement of health MDGs The “Doing Business” reports from the World Bank and the “corruption perception index” reports from Transparency International shed light on poor governance indicators The priority setting exercise of the Alliance for Health Policy and Systems Research grant N°ID49 (AHPSR ID49) to support in-country evidence policy initiatives (www.who.int/alliance-ahpsr/grants) and the European Union FP7 grant N°222881 to support the use of research evidence for policy in African health systems (SURE 222881) (www.who.int/evidence/sure) top-ranked improving governance for health district development	The Government and the World Bank included governance indicators pertaining to the operations of district management boards and community satisfaction during the experimentation of the performance based financing programme in selected districts Seminars were organized to strengthen leadership and management skills amongst district management teams. The German technical cooperation (GIZ) embarked during the period 2011-2013 on a nationwide project to revamp community-based dialogue structures (e.g., local health area committees, district hospital management boards) A nationwide campaign against petty corruption in health facilities was jointly launched in 2012-2013 by the ministry of public health and the national anti corruption commission Consultations engaged in 2013 to revise the framework laws orienting the health sector and hospital management and the regulatory framework for the operations of district and district hospital boards were still pending in December 2016
		EVIPNet Cameroon prepared two evidence briefs and organized one stakeholder dialogue. The brief to foster stakeholder involvement was disseminated to a selected audience in 2010 while the second pertaining to good governance for health district development was pre-circulated to inform the dialogue convened in March 2011 by the ministry of public health. Both briefs were made publicly available on a website
Case 2: Scaling up malaria control interventions in Cameroon	Structures Roll Back Malaria Committee Malaria control programme Malaria treatment guideline committee Ministry of public health Legacies Health sector strategic paper aligning its objectives to health MDGs and fostering community participation Malaria control programme as a learning organization valuing evidence based decision-making since 2002 Policy networks Cameroon Coalition Against Malaria including Parliamentarians network and Cameroon Media Against Malaria Private groups Union of private pharmacists Traditional healers Private not-for-profit healthcare organizations Civil servants Health bureaucrats Donor bureaucrats UN agencies French cooperation (AFD) Researchers EVIPNet Cameroon University Yaoundé 1 Institute for Statistics Values Equity and universal access to health Community participation Research evidence Effective interventions Implementation strategies Report MDG Countdown report Commitment Health MDGs Abuja Declaration of the African Union on Malaria	The program manager was involved in the first EVIPNet workshop in Addis Ababa (February 2008) to build capacity for writing evidence briefs and organizing stakeholder dialogues on scaling up access to artemisinin-based combination therapy (ACT) to treat uncomplicated malaria The inception priority setting exercise of the AHPSR ID49 grant top-ranked scaling up of malaria control interventions	A coalition of CSOs and NGOs was granted resources by the Global Fund to fight AIDS, Malaria and Tuberculosis for “scaling up malaria control for impact in Cameroon” set to promote universal access to proven effective anti-malarial interventions along with further involvement of community based associations (CBAs) to enhance performance and social accountability Preexisting policy network gained prominence with a research-to-policy platform. Control strategies were adapted to varied epidemiological profiles nationwide and funds mobilized to rollout the periodic chemoprophylaxis for children under 5-year of age in the northern regions with related guideline developed during the last quarter of 2014 and the interventions launched in 2016 Poor quality of surveillance data signaled during dialogues were addressed in the 2010-2014 strategic plan to fight against malaria with remarkable allocation of resources for monitoring and evaluation and operational research (Ongolo-Zogo 2015) Knowledge gaps underscored by the evidence briefs inspired new research on the quality of anti-malarial medicines, the role of drug shops and the actual use of rapid diagnostic tests (Mbacham 2014)
		Cameroon Coalition against Malaria (CCAM) (www.cameroon-coalition-malaria.org), a NGO linked to Malaria Consortium was identified as a champion. EVIPNet-Cameroon and CCAM co-produced an evidence brief and co-hosted a stakeholder dialogue in October 2010 with all the stakeholder groups represented at the Cameroon Roll Back Malaria committee in attendance
Case 3: Task shifting to optimize the roles of health workers for maternal and child health in Uganda	Structures Health policy unit Health Policy Advisory Committee Ministries in charge of health and public services Health and social services committee of the Parliament Cabinet Legacies National development plans and health sector strategic paper emphasizing principles and requirements for good governance and evidence-based decision-making and participatory processes Regulations and rules of health professional training and licensing Norms and standards of practices Recruitment policies in civil services Private groups Uganda medical association Uganda nurses and midwives council Uganda national health consumers organization Private not-for-profit healthcare organizations Traditional birth attendants Civil servants Bureaucrats in charge of health Elected officials Parliamentarians health and social services committee Donor bureaucrats UN agencies International NGOs Researchers REACH-PI Uganda Makerere University Values Quality and safety of care Equity and universal access to health Safer motherhood Research evidence Feasibility and effectiveness of task shifting High unemployment rates of trained health professionals Lack of motivation because of low salaries Report MDG Countdown report Health workforce shortage Commitment Health MDGs Regional commitment to curb workforce shortage CARMMA: Campaign to accelerate the reduction of maternal mortality in Africa	The surge of the HIV-AIDS epidemics prompted a global push for task shifting from specialized and overworked health professionals to lower cadres so as to mitigate the unintended consequences of the shrinking specialized workforce caring for people living with HIV/AIDS Evaluation and research studies demonstrating the ability of community health workers to run preventive activities such as voluntary counseling and testing for HIV, several donors and nongovernmental organizations pushed for international meetings, including one in Uganda in 2008, convened by the African Regional Office of the World Health Organization to brainstorm on how to support countries moving towards national policies on task shifting Echoing this global and regional push, the priority setting meeting in Uganda at the inception of the SURE 222881 top-ranked task shifting for maternal and child health	Conflicting positions arose on the framing of task shifting and means for conducive working conditions and appropriate roles of health workers to improve maternal and child health Health professional bodies were opposed to a written policy on task shifting when hundreds of well trained professionals were unemployed and poorly remunerated The reframed issue was tabled to the senior management in the ministry of health. The decision was made to maintain the status quo i.e. no written policy on task shifting despite the endorsement of the regional call for regulations by the Government Parliamentarians took note of the magnitude of the workforce shortage particularly in rural areas and the underlying factors Some participants argued that a formal regulation on task shifting will legitimate poor quality of care and expose women and children to unsafe care Some suspected the Government was trying to evade responsibility of not staffing appropriately state-owned facilities Two research projects triggered on aspects of task shifting (e.g.; delegation of some surgical tasks such as C-sections to medical officers in district hospitals; strategies for integrated community case management of childhood illnesses by village health teams) Private not-for profit healthcare organizations and international NGOs have continued to practice task shifting as evidenced in a scoping study that confirmed the enduring conflicts regarding a written policy on task shifting (Baine 2014)
		The evidence brief was prepared with technical assistance from the global EVIPNet support group and in collaboration with an ad hoc task force comprising senior officials from the ministry of health such as members of the health policy advisory committee (Nabudere 2011) Two stakeholder dialogues were co-hosted in May 2010 by the Uganda National Health Research Organization and REACH-PI Uganda with parliamentarians, health bureaucrats, representatives from UN agencies and CSOs, and researchers in attendance
Case 4: Improving access to skilled birth attendance in Uganda	Structures Health policy unit Health Policy Advisory Committee Ministries in charge of health and public services Health and social services committee in Parliament Cabinet Legacies National development plans and health sector strategic paper emphasizing principles and requirements for good governance and evidence-based decision-making and participatory processes Regulations and rules of health professional training and licensing Norms and standards of practices Recruitment policies in civil services Private groups Uganda medical association Uganda nurses and midwives council Uganda national health consumers organization (UNHCO) Private not-for-profit healthcare organizations Traditional birth attendants Civil servants Bureaucrats in health, education and public services Elected officials Association of women members of Parliament Donor bureaucrats UN agencies World Bank Researchers REACH-PI Uganda Makerere University Mbarara University Values Quality and safety of care Equity and universal access to health Safer motherhood Rights-based approach pushed by UNHCO Research evidence Feasibility and effectiveness of task shifting High unemployment rates amongst trained health professionals Lack of motivation because of low salaries Report MDG Countdown report Health workforce shortage Commitment Health MDGs Regional commitment to curb workforce shortage African Union campaign to accelerate the reduction of maternal mortality in Africa (CARMMA) adopted in 2007	This issue was raised during the consultations to identify priority health system bottlenecks related to achieving health MDGs as part of the year-2 planning of the SURE 222881 grant for several reasons: Slow progress in the implementation of the « roadmap » of the African Union CARMMA Reports exhibiting slow progress towards targets for MDGs Reports underscoring the failure of strategies such as training programs for traditional birth attendants and the inability to provide the essential services in all health centres II “Renewed promise” initiative spearheaded by overseas development agencies to maintain a high profile for skilled birth attendance, Advocacy campaigns and petition to save Ugandan mothers by the UNHCO (www.unhco.or.ug)	Deliberations converged towards creating attractive working environments as a matter of urgency for nurses, midwifes, clinical and medical officers in health centres IV conceived of as referral centres yet not functioning adequately instead of health centres II The ministry of health requested for additional research evidence to back up the relevance of the provision of intrapartum care at health centres II The issue became ‘viral’ as the association of women members of Parliament and the UNHCO took ownership Memos to increase the budget allocation for district health services were tabled by the health and social services committee in Parliament and the UNHCO furthered its advocacy campaign at the district level Decisions to recruit personnel with targeted incentive schemes to retain nurses and midwives in rural health centres starting from health centres IV Concerns raised with the staffing norms at the district level and the nursing and midwifery education. The latter particularly resonated with the then priorities of UNFPA and WHO to boost nursing and midwifery education in order to scale up universal access to emergency obstetrical care The investments for servicing of health centres IV were top-ranked by donors coordinating mechanisms as exhibited by the health sector strategic investment plan By the end of 2014, several internationally funded research projects led by Ugandan researchers and their international peers on skilled birth attendance and servicing of health centres in Uganda were completed or ongoing (Sewankambo 2015)
		REACH-PI Uganda secretariat and a task force of officials from the ministry of health co-produced the evidence brief (Nabudere, 2013) and co-hosted two stakeholder dialogues in August 2011. The attendance comprised health authorities, representatives from CSOs and private not-for-profit healthcare organizations, women members of parliament, UN agencies and researchers