Strategies to enhance the use of health systems research for health sector reform.

In spite of frequent claims to the contrary, there is very little evidence that health systems research actually influences policy-making. Based on a case study from Thailand and a literature review, we develop a stakeholder-oriented model of policy-making. We argue that only if stakeholders' needs are taken into consideration during design and implementation of scientific projects and dissemination of the results, research will have a chance to influence the policy process. From this model, we derive a five-step approach to enhance the use of research by various stakeholders. We then propose institutional arrangements and conditions to make the use of research for policy-making more sustainable. 'The world of ideas and the world of action are not separate, but inseparable parts of each other. Ideas are true forces that change the tangible world. The man and woman of action has no less responsibility to understand the world than the scholar'. Donabedian (1986)