29 Responses to HSR consultation – 3. Are there specific topics or issues in HSR that you think the society should address?

  1. Cornelia Ndifon says:

    • President elected by registered members
    • Appointed Manager(s) for technical day-to-day management of affairs
    • Support staff
    • Headquarters
    • Regional/sub-regional offices/directors etc

  2. Cornelia Ndifon says:

    • The greatest health system issues today are in developing countries
    • Many health systems have not improved with regards to access for rural dwellers and people living in difficult terrains
    • Mental health is inadequately addressed in developing countries
    • Access to healthcare for the elderly
    • Maternal and child health/rights have not been catered for adequately in many health systems in Africa, Latin America and Asia
    • Present health systems are too medicalised (waiting for people to come with diseases); the society should promote prevention

  3. Dr. Eliudi Eliakimu says:

    Specific topics/issues may include the following:
    (i) Health Systems Research Core Competencies;
    (ii) Health Systems issues related/influencing the quality of services provided; and
    (iii) Translation of available body of knowledge in health systems research into actions in developing countries.

  4. Kabir Sheikh says:

    I agree with Bennett that new thematic areas could be allowed to emerge organically from the discussions that take place in the Society. It will be important to guide these discussions to have a close bearing on real-world issues in LMIC, as much as on global health goals. This will strengthen the relevance of the Society’s work within those countries, and create impact within and beyond the health sectors of the countries. Topics that could emerge include:

    Health System Ethics
    Health Markets
    Health Governance
    Gender and Health
    Health Workforce

    The current formation of the thematic groups has only one groups that deals directly with disciplinary issues: “methods to measure health systems performance”. The Society may want to give more attention to disciplinary breadth, and to developing and expanding the scope of the research field, including attention to neglected methods (such as social and political research) that go beyond measures.

  5. Leslie London says:

    My preference is to go with Di’s suggestion (universal coverage as focus) since it is broad enough to capture a wide range of content areas.
    My particular interest is in participation and civil society agency as instrumental to realising health rights. That sits quite comfortably under the rubric of universal coverage (what is it, and how do we get there … for example).
    Similarly, issues of Human Resources for Health, Health Equity, Governance, etc could all be subsumed under a broad banner of universal coverage

  6. Jane says:

    -Whether complaints to OCR for HIPAA violations are really making a difference
    -What proportion of HIPAA violations are actually reported to OCR (not sure how you’d study this)
    -Compassionate care and culture change in medical training – if you listen to medical students, there is an incredible focus on the money to be made, but less on the other reasons for getting into medicine
    -Medicalization driven by Big Pharma and Psychiatry, but facilitated by physicians
    -Over-reliance on medication and under-use of other remedies
    -The differential between what Americans pay for drugs and what the rest of the world pays for drugs
    -The safety of drugs and the continued weakening of FDA policies, staffing, regulation, and enforcement
    -Increasing the amount of research on patient empowerment
    -Increasing the amount of research in end-of-life care and hospice
    -Continued research on how physician ties to industry affect patient care and costs

  7. Camilo Valderrama says:

    1. Accountability
    2. Citizen participation in the health sector
    3. Decentralization and health governance
    4. Leadership

  8. Sara Bennett says:

    It makes sense to have interest groups or focal topics within the Society given the diversity of disciplines and programmatic areas that society members are likely to be interested in. But instead of ‘fixing’ topics in advance, I would let these groups emerge organically, and instead focus on developing clear procedures for nominating and approving such interest groups. In the first instance I think the society should allow a broad array of such groups to evolve – if there is sufficient demand among members, but in this case I suspect that the interest groups should not expect substantial support from the Society, but rather should be self-sustaining, drawing upon the Society primarily for legitimacy and reach into the community.

  9. Lucy Gilson says:

    I would like topics that can stand the test of time — that need a constant focus because they remain persistent challenges for health systems or because they are important to strengthening the field of research and application. Equity and health systems, governance and capacity development are three such examples.

  10. chinyere mbachu says:

    • Health systems in different contexts – developing vs developed countries; LIC vs LMIC vs MIC vs HIC; private sector vs public service delivery; primary vs secondary vs tertiary levels of care
    • Use of different frameworks in HSR and analysis
    • Interactions of different HS building blocks
    • Role of politics and policies in HS especially human resources for health, health financing and governance arrangements

  11. Kun Zhao says:

    Under the perspective of resource scarcity, policy priority setting of health system may be a specific topic in developing countries

  12. Dick Jonsson says:

    Efficient and equitable health service delivery, quality of health care, fair and sustainable health financing, HRH management, drugs and medical supply, capital investment/maintenance, monitoring and evaluation, community participation, good governance, financial management, accountability and public and private partnership.

  13. Research that is focused on results pertinent to reaching equitable UHC.
    Operations research: what are the contextual factors that enable or disable implementing evidence-based policies and strategies.
    gather evidence on innovative yet practical/feasible ways to measure social and financial barriers to equitable UHC, using existing data available to national and sub-national managers.
    Rigorously investigate if increased access leads to changes in health outcomes. (e.g. UHC is simply a means to the end of equitable and improved health outcomes)
    Define quality and other criteria for UHC using evidence-based benchmarks, so that impact is measurable.

  14. Deon Canyon says:

    I like the MSH list which can be found in their book entitled “Health Systems in Action: an ehandbook for leaders and managers”

    1. Achieving Results by Strengthening Health Systems
    2. Leading and Managing: Critical Competencies for Health Systems Strengthening
    3. Promoting Good Governance in Public and Private Health Organizations
    4. Planning the Work and Working with the Plan
    5. Managing Human Resources
    6. Managing Finances and Related Systems
    7. Managing Medicines and Health Products
    8. Managing Information: Monitoring and Evaluating
    9. Managing Health Service Delivery

  15. David Bishai says:

    Agree with Bill Brieger. We get hung up on health “care” systems when we need broader answers to the question what can local and national governments do to improve health?

    Local public health departments are paid to address this question broadly and too often get stuck with narrow solutions related to medical care. Academics groups need to help everyone escape the seductive medicalization of health.

  16. Freddie Ssengooba says:

    These are some thoughts for this:

    • Build conceptual and theoretical framework(s) that should guide the generation, synthesis and accumulation of knowledge about complex relationships that make up the health system – from global to national and entities in between;
    • Develop consensus on core competences and curricular for future health system practitioners and scientists (this can take the form of MBA for business community);
    • Develop quick online training about health systems governance to orient health leadership from different backgrounds;

  17. Yanira Xirinachs-Salazar says:

    1. Equity Analysis
    2. Efficiency Analys
    3. Quality Analysis
    4. Develop and standardize appropriate methodologies

  18. Bill Brieger says:

    What is often left out of consideration is functional interface between local primary health care services and community systems.

  19. Di McIntyre says:

    There seem to already be nine priority themes that have been decided on for the society (see http://www.healthsystemsglobal.org/ThematicWorkingGroups.aspx). There clearly are diverse views on priority areas to focus on, so this is going to be a difficult one. But, I believe in starting small (there are limited resources – money and time of very busy people) …. would it not be a good idea to focus on a few core areas for which there is a lot of support among members – in this way, we could make a substantial impact on a few issues rather than possibly ‘spreading ourselves too thinly’. My vote goes to issues such as universal coverage (it is receiving priority international attention and so we have a window of opportunity which we should use maximally – this is included as one of the priorities in the list of thematic working groups) and health system equity (which is surprisingly not included in the list of thematic working groups, but which I think is critical – in order to improve the health of our populations and improve our health systems, we need to constantly strive to narrow the gaps between the rich and the poor, those who have access and those that don’t, etc. – we need to do this both within our own countries and at the global level).

  20. Shishir Dahal says:

    1. ICT in health care

  21. Collins Chansa says:

    1. Equity Analysis
    2. Governance
    3. ICTs in health care
    4. Results-Based Financing

  22. Alex Hakuzimana says:

    As the health systems is complex, the society should be focusing on the interdependence and complementarity of health systems functions for a better improved health systems that is HRH, Health Information, governance and stewardship, services delivery, pharmaceutical and supply chain management, and financing

  23. Gavin Mooney says:

    To research into how best to reflect local values in health systems to seek to ensure that health systems aim to deliver what the critically informed citizens want from their health system.

  24. Bernard Kadio says:

    No it should as open as possible as far as improving HS remains the motto

  25. Hyacinth Ichoku says:

    Yes.
    How the political economy of different countries affect the availability of resources for the health system.
    Comparative analysis of the influence of political economy on the institutional strengths and weaknesses of health systems in developing countries

  26. Let us not forget that traditional medicine is an important part of health systems. As the WHO says: “In some Asian and African countries, 80% of the population depend on traditional medicine for primary health care.” “In many developed countries, 70% to 80% of the population has used some form of alternative or complementary medicine”.
    http://www.who.int/mediacentre/factsheets/fs134/en/

    We need to consider how to effectively integrate traditional and complementary medicine in health systems and include these forms of healthcare in our research work.

  27. Asha George says:

    a. Qualitative research in health systems
    b. Ethics in health systems research
    c. Governance
    d. Intersectionality in health systems: Analysis of gender, race, class, etc
    e. Funding for collaborative research across institutions

  28. Kaveri Mayra says:

    1. Issues in the area of Nursing Governance in developing countries should be looked at
    2. Nurses involvement in Nursing Governance and policy making

  29. Benjamin Uzochukwu says:

    a. Priority setting in HSR
    b. Use of HSR evidence for policy making especially in LMIC
    c. Develop and standardize appropriate HSR methodologies

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