Following review submitted to the Health Systems newsletter
On 1 November, 2012 at the Second Global Symposium on Health Systems
Research at Beijing, the WHO Alliance for Health Policy and Systems Research launched a strategy document, “Changing Mindsets: Strategy on Health Policy and Systems Research”. The document is an important contribution to the movement towards clarifying and strengthening the scope and reach of health systems research (also health policy and systems research). The document was an outcome of the earlier Montreux Symposium where over 1200 delegates working as researchers, policymakers, practitioners and other actors, called for a strategy in order to align research evidence and decision-making. It contains four sections. It begins in earnest acknowledging the complexity involved in policymaking and implementation but underscores the importance of generating research evidence that is demand-driven and is relevant to decision making in health systems.
It begins with a brief introduction to the value and promise of health systems research, carrying case studies from China, India, Mexico and Thailand. The case-studies however are very brief. In the case of India for example, the setting up of a few institutions at the central and provincial levels and elevation of a government research institute into a department are cited as examples of evidence-generation and incorporation into policy. Thailand’s case (again very brief) however, seems to carry more details on why the institutions established for supporting decision making in that country worked. This is followed by a section that situates health policy and systems research (HPSR) within health research.
The third section on transformational thinking is perhaps at the core of this strategy. Beginning with a quote from Victor Hugo “There is nothing more powerful than an idea whose time has come”, the chapter titled “Changing Perspectives” calls for a shift in mindset in terms of the type of questions that researchers choose for their research, as well as a much greater involvement of policymakers and other actors in research question generation and implementation; these actors are traditionally seen as mere consumers of high quality research. Identifying “triggers of transformation” based on five case studies (again brief) from Chile, Ghana, Nepal, Lebanon and Zambia, the strategy ends with a final section on options for action: (1) embed research within decision-making processes, (2) support demand-driven research, (3) strengthen capacity for research and use of evidence, (4) establish repositories of knowledge, (5) improve the efficiency of investments in research, and (6) increase accountability for actions.
The strategy does not add much in way of clarifying the field or practical guidance to researchers or policymakers. Rather, it consolidates the strong calls being made globally and at national levels on making health research more practical and relevant to decision-makers. It could be a useful guiding document to advocate for similar direction within national and sub-national institutions at country levels.
- The document may be accssed at: http://www.who.int/alliance-hpsr/whostrategyhpsr/en/index.html
- The background papers that informed the strategy document carry much more details on the case studies and are available at the above link for download.
- For 2012, I was invited to be on the steering committee of the symposium, based on my participation in the Emerging Voices initiative of 2010 (my interview then on “creating larger change“)
- A rather boring presentation I made using Camtasia as one of the tutors at the Emerging Voices 2012 initiative at Beijing. This was a presentation explaining my protocol on a realist evaluation of a capacity-building intervention in Tumkur, India, using a Prezi (see below). In a way, this study is my response to trying to ask methodologically difficult, but relevant research questions. The mess that puts me in is altogether another story.