Come Together: Greetings from Liverpool and HSR2018

By Brittany Iskarpatyoti, MPH, Technical Specialist in M&E—This blog presents Brittany's first impressions from Liverpool and the Fifth Global Symposium on Health Systems Research and reflections on the vision of health for all.
Come Together: Greetings from Liverpool and HSR2018

Puppet from Liverpool's Giant Spectacular

LIVERPOOL, ENGLAND—October 9, 2018

Brittany Iskarpatyoti, MPH, Technical Specialist in M&E, MEASURE Evaluation

Greetings from England! I arrived in Liverpool for this year’s Health Systems Research symposium, and it seems just in time for the Giant Spectacular, a larger-than-life street theater performance. Thousands have flocked to the city to watch enormous marionette-like creatures roam the streets. And while the figures themselves are quite impressive—the numbers of people and effort expended are what caught my attention. Each marionette requires up to 44 puppeteers (called Lilliputians), lunging and whirling through the air on an intricate pully system to gather enough momentum for forward progression.

In a metaphorical sense, this is what health systems are like. Different sectors, governments, organizations, and people throwing themselves into this work with an ultimate goal of progress. But as we all know, efforts of one can counteract the efforts of another. Systems are complex and require coordinated and responsive interventions, monitoring, and evaluation. And the metrics aren’t always there to know how far we have (or have not) gone.

This week’s conference will bring global health services experts together to discuss advances towards the Alma Atavision of “Health for All.” Forty years after its declaration, Alma Ata continues to stand as a giant—one that has lived on in various incarnations, most recently reflected in Goal 3 of the Sustainable Development Goals (SDGs). But how far have we really come? Are we coordinated enough and doing the right things to move the giant? How are we measuring progress?

I’ll be exploring these questions over the next week through various lenses. I encourage you to follow me on Twitter at @bschriv for real-time thoughts. And look for my next blog coming soon!

1 The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care (PHC), Almaty (formerly Alma-Ata), Kazakhstan (formerly Kazakh Soviet Socialist Republic), 6–12 September 1978. [1] It expressed the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all people.


The Giant: a massive 33-foot-high figure needing 44 Lilliputians (puppeteers). Photo by Brittany Iskarpatyoti, MEASURE Evaluation.

Giant 2
Close-up on the Lilliputians hurling themselves in pairs to maneuver The Giant. Photo by Brittany Iskarpatyoti, MEASURE Evaluation.
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