Why are we running this

course?

IHPSR Presentation 1

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Introduction to Health Policy and Systems Research

Health systems matter

• To individuals– care and support when sick and

vulnerable– treatment and cure for sickness

• To societies– part of ‘fabric of society’, not just

about sickness/death

Those working in public health

• Need to: – think about health systems and how

to improve them– do research on these issues to

support health system development

Discussion of importance of studying

health systems• WHO Report 2000• 2004 Mexico Ministerial Summit on Health

Research• 2008 Bamako call to action on research for

health• 2010 HSR Symposium• 2012 HSR Symposium

– Health Systems Global formed• 2014 HSR Symposium: Cape Town

http://hsr2014.healthsystemsresearch.org/

‘At its best, HPSR should function as the GPS of health decision-

making, providing navigational support to

the decision-maker, locating the starting point for the journey (the health problem),

the desired destination (the health outcome)

and options for getting there (health solutions)’.

WHO 2012

Course aim

By the end of the course we expect students to be able, confidently, to identify

substantively relevant health systems and policy research questions, select appropriate

research strategies for answering these questions in their own contexts and think through approaches bringing the research and policy/management worlds to support the use of research evidence in decision-

making. …

Learning outcomesBy the end of the course we expect participants to be able to:

1. Identify researchable health policy and systems issues, including those focused on action to strengthen health systems and the processes of policy change.

2. Formulate substantively relevant health policy or health systems research questions, by drawing on relevant empirical work, practice knowledge, and theoretical insights.

3. Be familiar with the range of research purposes, questions and strategies used within HPSR.

4. Identify appropriate research strategies and study designs for different HPSR issues, purposes and question types.

5. Show awareness of critical issues in, and approaches to, ensuring rigour in HPSR.

6. Be aware of critical ethical issues for HPSR.

Course learning outcomes (continued)

7. Be able to source HPSR materials and critically appraise HPSR empirical papers.

8. Appreciate the value of multiple perspectives (positional and disciplinary) in conducting HPSR.

9. Have some understanding of how the complex and socially constructed nature of health policy and health systems is addressed in HPSR methodology.

10. Plan activities that support the use of research evidence for and in decision-making, through researcher–policy maker/practitioner engagement.

11. Recognise that personal skills, such as reflexivity, listening and facilitation, are critical to being a health policy and systems researcher.

Threshold concepts Health policies and systems

A. Health policies and systems are socially constructed; they exist within contexts and histories.

B. Health policy and policy processes are always political.

C. Health systems consist of ‘hardware’ and ‘software’.

D. Actors (and their interests, values and power) are key to understanding policy.

E. People are at the centre of the health system, driven by values and contexts.

F. Policy comes alive through practice.

G. The health system is knowable and changeable.

H. Managing policy processes requires political awareness.

Threshold concepts (continued)

HPSRA. HPSR is intentionally multidisciplinary and embraces multiple

perspectives.

B. Substantive relevance is critical for the development of sound and ethical HPSR questions.

C. Phenomena that cannot be quantitatively measured are important to health policy and systems and can be researched.

D. The precise wording of HPSR questions is important.

E. Health care services/interventions/programmes provide a lens through which to investigate policy and systems issues in HPSR (i.e. they are not the primary focus of the research).

F. Exploratory and explanatory research (that deepens our understanding of health policy and system phenomena) offers policy-relevant insight.

Threshold concepts, HPSR (continued)

G. Flexible study designs are the most appropriate design for some HPSR phenomena.

H. Good (i.e. sound) research design requires that the study design fits the question, issues and purpose.

I. There is no hierarchy of study design in terms of quality and rigour in HPSR; and quality and rigour are always important.

J. Researcher curiosity, attentiveness and reflexivity are the basis of rigorous HPSR.

K. Analytic generalisability is legitimate.

L. Theoretical ideas and concepts have value (as a guide for study design and analysis in HPSR).

M. The researcher is the primary research instrument.

N. Ethical HPSR requires the responsible use of power and accountability.

O. The HPSR researcher is a policy activist.

Threshold skills for HPSR (that are addressed in this course)

1. Recognising where the boundaries of HPSR lie and the types of issues that are addressed (what is HPSR).

2. Conducting a literature review (becoming familiar with the field).

3. Framing various types of HPSR research questions.

4. The ability to identify a range of research strategies and study designs.

5. Knowing ‘the’ appropriate research strategy and study designs to use to address different types of HPSR issues and questions.

6. Critical analysis (knowing what is rigorous and relevant).

7. Being familiar/comfortable with different perspectives, and able to work with and across them.

8. Facilitation of small groups.

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Citation of this work must follow normal academic conventions. Suggested citation:

Introduction to Health Policy and Systems Research, course presentation, Presentation 1. Copyright CHEPSAA (Consortium for Health Policy & Systems Analysis in Africa) 2014, www.hpsa-africa.org www.slideshare.net/hpsa_africa

This document is an output from a project funded by the European Commission (EC) FP7-Africa (Grant no. 265482). The views expressed are not necessarily those of the EC.

The CHEPSAA partners

University of Dar Es SalaamInstitute of Development Studies

University of the WitwatersrandCentre for Health Policy

University of GhanaSchool of Public Health, Department of Health Policy, Planning and Management

University of LeedsNuffield Centre for International Health and Development

University of Nigeria Enugu Health Policy Research Group & the Department of Health Administration and Management

London School of Hygiene and Tropical MedicineHealth Economics and Systems Analysis Group, Depart of Global Health & Dev.

Great Lakes University of KisumuTropical Institute of Community Health and Development

Karolinska InstitutetHealth Systems and Policy Group, Department of Public Health Sciences

University of Cape TownHealth Policy and Systems Programme, Health Economics Unit

Swiss Tropical and Public Health InstituteHealth Systems Research Group

University of the Western CapeSchool of Public Health