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Empirical data on the impact of research-to-policy interventions are scant, with the few attempts mainly focusing on ensuring policymakers' timely access to evidence and evidence-informed dialogs. This article reflects on how the Thanzi Programme cultivates an approach of research-to-policy engagement in health economics. The program is structured around 3 interrelated pillars comprising research evidence generation, capacity and capability building, and research-and-policy engagement. Each pillar is described and examples from the Thanzi Programme are given, including illustrating how each pillar informs the other. Limitations and challenges of the approach are discussed, with examples of a way forward. This program supports health system strengthening through addressing gaps identified by program partners. This includes providing health economics training and research and strengthened partnerships between in-country researchers and health policymakers, as well as between national and international researchers. Platforms bringing together researchers and policymakers to shape the research agenda, disseminate evidence, and foster an evidence-based dialog are institutionalized at country and regional levels. Health Economics and Policy Units have been established, which sit between the Ministries of Health and Universities, to augment policymakers and health economics researchers' engagements on priority health policy matters and determine researchable policy questions. The establishment of the Health Economics Community of Practice as a substantive expert committee under the East Central and Southern Africa Health Community bolsters the contribution of health economics evidence in policy processes at the regional level. The Thanzi Programme is an example of how a research-and-policy partnership framework is being used to support evidence-informed health resource allocation decisions in Africa. It uses a combination of high-quality multidisciplinary research, sustained research and policymakers' engagement and capacity strengthening to use research evidence to guide and support policy makers more effectively. • Available research-to-policy frameworks cannot adequately explain the uptake of evidence in low-income countries. Empirical data on the impact of research-to-policy interventions in Africa are scant, with the few attempts mainly focusing on ensuring policymakers' timely access to evidence and evidence-informed dialogs. Suboptimal skills in evaluation and interpretation of results, lack of methodological rigor, poor linkages between evidence and budget processes, use of jargon, and poor dissemination impede the uptake of evidence from economic evaluations. • Evidence-informed resource allocation decisions can be improved through a combination of high-quality research, research-to-policy engagement, and capability and capacity strengthening. These 3 interrelated pillars of activity work together to support research-to-policy partnerships, namely, robust and locally relevant research evidence generation, strengthened institutional capacity and individual capability to generate and use evidence, and engagement between researchers and policymakers to share evidence and engender common learning. • Impactful research-to-policy interactions require multiple approaches and partnership working that build the required skills, institutionalize researcher policy engagements, and ensure rigor in generation of locally relevant multidisciplinary evidence that is linked to planning and resource allocation frameworks. A broader perception of partnerships is beneficial to leverage expertise in evidence generation and galvanize action at national, subregional, and regional levels. [ABSTRACT FROM AUTHOR]

Focusing on the East, Central, and Southern African region, this study examines both regional and country-level initiatives aimed at promoting multisectoral collaboration to improve population health and the methods for their economic evaluation. We explored the interventions that necessitate cooperation among policymakers from diverse sectors and the mechanisms that facilitate effective collaboration and coordination across these sectors. To gain insights into the demand for multisectoral collaboration in the East, Central, and Southern African region, we presented 3 country briefs, highlighting policy areas and initiatives that have successfully incorporated health-promoting actions from outside the health sector in Zimbabwe, Uganda, and Malawi. Additionally, we showcased initiatives undertaken by the Ministry of Health in each country to foster coordination with national and international stakeholders, along with existing coordination mechanisms established for intersectoral collaboration. Drawing on these examples, we identified the primary challenges in the economic evaluation of multisectoral programs aimed at improving health in the region. We illustrated how decision making in reality differs from the traditional single-sector and single-decision-maker perspective commonly used in cost-effectiveness analyses. To ensure economic evaluations can inform decision making in diverse settings and facilitate regional collaboration, we highlighted 3 fundamental principles: identifying policy objectives, defining the perspective of the analysis, and considering opportunity costs. We emphasized the importance of adopting a flexible and context-specific approach to economic evaluation. Through this work, we contribute to bridging the gap between theory and practice in the context of intersectoral activities aimed at improving health outcomes. • The World Health Organization has been emphasizing the importance of multisectoral collaboration to improve health for decades. However, multisectoral resource allocation and priority setting requires mechanisms and initiatives for articulating interdependencies, harmonizing strategies, and elaborating pathways to change. • We explore the practice and the methods of economic evaluation that could be adopted to facilitate more effective and efficient multisectoral coordination for improvement of population health in the East, Central, and Southern Africa Health Community region. We first provide an example of cross-sectoral coordination for health at the East, Central, and Southern African region level, then focus on 3 countries—Zimbabwe, Uganda, and Malawi. • With this work we illustrate that, despite the complexities of intersectoral decision-making, economic evaluation tools offer a systematic approach for allocating scarce resources effectively. [ABSTRACT FROM AUTHOR]

We highlight the importance of undertaking value assessments for health system inputs if allocative efficiency is to be achieve with health sector resources, with a focus on low- and middle-income countries. However, methodological challenges complicated the application of current economic evaluation techniques to health system input investments. We undertake a review of the literature to examine how assessments of investments in health system inputs have been considered to date, highlighting several studies that have suggested ways to address the methodological issues. Additionally, we surveyed how empirical economic evaluations of health system inputs have approached these issues. Finally, we highlight the steps required to move toward a comprehensive standardized framework for undertaking economic evaluations to make value assessments for investments in health systems. Although the methodological challenges have been illustrated, a comprehensive framework for value assessments of health system inputs, guiding the evidence required, does not exist. The applied literature of economic evaluations of health system inputs has largely ignored the issues, likely resulting in inaccurate assessments of cost-effectiveness. A majority of health sector budgets are spent on health system inputs, facilitating the provision of healthcare interventions. Although economic evaluation methods are a key component in priority setting for healthcare interventions, such methods are less commonly applied to decision making for investments in health system inputs. Given the growing agenda for investments in health systems, a framework will be increasingly required to guide governments and development partners in prioritizing investments in scarce health sector budgets. • A majority of health system budgets are spent on health system inputs. • The application of economic evaluation methods to health system inputs is complicated by several methodological challenges. • The development of a comprehensive framework for the application of economic evaluation to health system inputs is the key to achieving allocative efficiency in the health system. • This article highlights the challenges, proposals to date, and key steps that are required in the development of a framework enabling full value assessments of health system inputs. [ABSTRACT FROM AUTHOR]