Building Capacity in Health Systems Research
On November 16, 2010, 1,200 participants from over 100 countries gathered in Montreux, Switzerland for the First Global Symposium of Health Systems Research to deliberate the appropriate strategies for promoting health systems research for accelerated universal coverage. The symposium was organized by the World Health Organization, the Special Program for Research and Training in Tropical Diseases (TDR) and several other organizations and donors. The symposium considered many important issues for improving universal coverage and strengthening the functionality of health services delivery systems. One of the key objectives was to identify mechanisms for strengthening capacities – individual, institutional and infrastructural – for research on health systems in low- and middle-income countries. (For a full list of objectives, please see the symposium's Web site).
A health system is considered as strong as the sum of its components. Information is crosscutting and integral to all six health system components (information, health workforce, service delivery, medical products, governance, and financing). A system without a good information base is like a man trying to look at his own face without a mirror. It is obvious the only thing he will see and know is what he tells himself (feelings) or what others tell him (conjecture). Meeting attendees came to a consensus on continuous research. When based on scientific rigor, research is integral to a good functional health system that is supportive of universal coverage.
The capacity to generate this type of research is weak or even absent in most low- and middle-income countries (LMICs). To develop capacity for health system research (HSR), experts suggested a reorientation, a paradigm shift; a new orientation that promotes research in LMICs by or with substantive collaboration with LMIC scholars and addressing the problems of LMICs. These types of strategies must adopt a multilevel framework to capacity building, with the levels being individual, institution and context or environment.
To determine appropriate interventions at each level, two case studies were presented; one representing a strong HSR capacity and another representing a weak HSR regime. These were done to identify the levers and inhibitors to capacity building in these contexts and offer lessons for developing a strong HSR capacity in areas where such capacity is lacking. A case study in China was presented to illustrate successful capacity building for HSR, and a case study in Africa was presented to illustrate a weak system.
MEASURE Evaluation continues to work towards strengthening health systems in host countries by using a multi-layered, technical approach. MEASURE Evaluation's technical approaches flow from a conceptual framework that emphasizes a cycle of generating demand for information, improving data collection, making data more available, and facilitating the use of information to inform decisions.