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Inaugural KEYSTONE Course on Health Policy and Systems Research 2015

Health Systems and Health Policy (HSHP)Wrap up

   

 

KEYSTONE

HSHP - Wrap up 

Kabir Sheikh

23 February 2015 

   

 

KEYSTONE

Scope of HPSR

• Distinguished by issues and questions considered, not by a disciplinary base, and includes:– research focused on health services as well as promotion of health

– concern for global and international issues as well as national and sub-national issues

– research on or of policy – addresses politics of health systems and health systems services

• Promotes work that explicitly seeks to influence policy

Courtesy CHEPSAA

   

 

KEYSTONE

Scope & nature of HPSR (continued)

HPSR is not:• Clinical or basic science

• Only rooted in health economics or focused on financing issues (though both important)

• Focused on disease distribution, causes and interventions (but rather generic organisational & societal‘structures’ through which interventions are implemented)

Courtesy CHEPSAA

   

 

KEYSTONE

Scope & nature (continued)

Specific services/disease programmes:

• Often a tracer for understanding systems issues e.g. maternal health services; the impact of district strengthening on child health outcomes

• May be researched because they have system wide effects e.g. antiretroviral therapy

• Must think BEYOND the programme/service!

Courtesy CHEPSAA

   

 

KEYSTONE

Programmatic and health systems perspectives on tuberculosis (TB) research

Systems goal Disease programme perspective

Health systems perspective

Thinking broad (beyond the disease)

Izoniazid (INH) prophylaxis for prevention

Secondary prevention for TB and other common diseases

Thinking cross-cutting (underlying functions)

Implementing a TB patient register

Improvement in information systems

Thinking scale (e.g. facility to district, province)

Strengthening facility Directly Observed Treatment, Short Course (DOTS) support systems

Strengthening district community-based services

Thinking comprehensive delivery platforms

Running a TB service Building a primary health care system that is available, affordable and acceptable/responsive

Thinking about systems not programmesCourtesy CHEPSAA

   

 

KEYSTONE

Considerations while identifying your researchable health system issue / rationale..

• Is it acceptable and recognizable as a health system problem?• Is it associable with at least one of the "building blocks”? • If it relates to a particular disease, health programme or 

service, is it because it is a tracer for understanding broader system issues / because it has system wide effects? If so, how?

KEYSTONE VERTICAL MILESTONE: DAY 2

   

 

KEYSTONE

Research plan template• Background and rationale (1 page)• Brief review of literature (2 pages)• Research question(s) • Approach(es) and design (2 pages)

– Choice of approach and reasons– Study design and conceptual framework

• Methodology (2 pages)• Ensuring research quality (< 1 page)• Ethical considerations (< 1 page)• Outcomes (2 pages)

– Audience and beneficiaries– Impact pathways

• Timeline • Financial plan

   

 

KEYSTONE

Reading for tomorrow• Sheikh, K. et al., 2011. Building the Field of Health Policy and Systems 

Research: Framing the Questions. PLoS Med, 8(8)• World Health Organization, 2007. Everybody’s business–strengthening 

health systems to improve health outcomes: WHO’s framework for action (esp. pages 1-27)

• Roberts, M.J. et al., 2003. Getting health reform right. a guide to improving performance and equity, New York. Oxford.: Oxford University Press. (esp. Chapter 1)

• Frenk, J., 1994. Dimensions of health system reform. Health Policy (Amsterdam, Netherlands), 27(1), pp.19–34.

• Sheikh, K., Ranson, M.K. & Gilson, L., 2014. Explorations on people centredness in health systems. Health Policy and Planning, 29 Suppl 2, pp.ii1–5.

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