STUDY TYPE: Mixed methods.

METHODS: A desk review was conducted relating to HPSR funding, followed by in-depth interviews. Eight countries and areas were selected to represent characteristics of different health systems. Literature reviews included an analysis of available data relating to HPSR funding and national research and development (R&D) budgets, between 2010 and 2019 (inclusive). In-depth interviews were conducted with 23 stakeholders using an approved interview guide, to assess the attitudes of HPSR funding decision makers towards HPSR, determinants for HPSR and health research funding decisions, and proposals to strengthen HPSR funding and output.

RESULTS: There are four main characteristics of HPSR funding in the WPRO: 1) a general absence of studies on HPSR funding and its determinants; 2) no universally accepted understanding of HPSR; 3) an absence of granular health research funding data in general and for HPSR in particular; and 4) HPSR funding is generally perceived to be minimal. In-depth interviews show that HPSR has different interpretations and emphases across WPRO countries, leading to a fragmented landscape where decision makers generally favour biomedical or clinical research. Participants indicate that political involvement increases overall research funding, especially if there is a clear connection between funders, producers and HPSR users. Suggestions from participants to strengthen HPSR include: appropriately using central agencies to generate demand and raise HPSR as a national priority; adopting interdisciplinary HPSR; and building HPSR capacity and organisational structures.

OBJECTIVE: This study aimed to explore experiences related to health literacy in Asian patients with T2DM.

DESIGN: This is a qualitative study using in-depth interviews and focus group discussions. A framework analysis was used to analyse the data.

SETTING AND PARTICIPANTS: articipants (n = 24) were multi-ethnic patients with T2DM (n = 18) and their primary health-care providers (n = 6). This study was conducted in four primary health-care clinics in Malaysia.

RESULTS: Nine subthemes were identified within the four dimensions of health literacy: accessing, understanding, appraising and applying information.

DISCUSSION: Motivated patients actively sought information, while others passively received information shared by family members, friends or even strangers. Language and communication skills played important roles in helping patients understand this information. Information appraisal was lacking, with patients just proceeding to apply the information obtained. Patients' use of information was influenced by their self-efficacy, and internal and external barriers.

METHOD: Using open-ended survey responses and document review, information about accreditation practices was classified using NHWA indicators. We examined practices using this framework and further examined the extent to which the indicators were appropriate for this cadre of healthcare providers. We developed a data extraction tool and noted any indicators that were difficult to interpret in the local context.

RESULTS: Accreditation practices in the five countries are generally aligned with the WHO indicators with some exceptions. All countries had standards for pre-service and in-service training. It was difficult to determine the extent to which social accountability and social determinants of health were explicitly part of accreditation practices as this cadre of practitioners evolved out of community health needs. Other areas of discrepancy were interprofessional education and continuing professional development.

DISCUSSION: While it is possible to use NHWA module 3 indicators there are disadvantages as well, at least for accelerated medically trained clinicians. There are aspects of accreditation practices that are not readily coded in the standard definitions used for the indicators. While the indicators provide detailed definitions, some invite social desirability bias and others are not as easily understood by practitioners whose roles continue to evolve and adapt to their health systems.