Tracing the evolution of health policy and systems research over 20 years (1996-2016)
The first-ever, World Report on Health Policy and Systems Research, was launched today at a special meeting, organized to commemorate the 20th anniversary of the inception of the Alliance in Stockholm, Sweden. The meeting was co-hosted by the Norwegian Agency for Development Cooperation (Norad) and the Swedish International Development Cooperation Agency (Sida) and was co-sponsored by the World Health Organization (WHO) and the World Bank.
The World Report
“This World Report on Health Policy and Systems Research (HPSR) reflects the importance of monitoring and measuring developments in the field. It provides evidence that allows national policy-makers and funders to see how their investments contribute to the generation and use of policy-relevant knowledge,” says, Dr Marie-Paule Kieny, WHO Assistant Director-General, for Health Systems and Innovation.
Historically, biomedical and clinical research dominated the health arena. There was little focus on systems and policy research. Over the past 20 years, more stakeholders have recognized the potential of this research to enhance the performance of health systems. From 1990 to 2015, there has been a five-fold surge in the number of HPSR publications produced annually. Increasingly, these are being generated by authors in low-and-middle-income countries (LMICs).
The report describes the evolution of the field and provides figures on the number of publications produced, funding trends and institutional capacity in LMICs to conduct HPSR. It provides insight into how the multidisciplinary and systems approach used in HPSR can help countries advance the Sustainable Development Goal (SDG) agenda.
Funding for this field has also steadily grown, showing that donors are increasingly recognizing the value of HPSR to address health system failures. Between 2000 and 2014, there was a four-fold rise in contributions to HPSR. Of the US$ 246 billion spent on health development aid projects in LMICs, approximately US$ 4 billion was spent on HPSR.
"Despite this progress, much remains to be done. The production of HPSR in low-income countries (LICs) in particular is inadequate,” explains Dr Abdul Ghaffar, Executive Director of the Alliance. In 2014, for example, researchers based in LICs produced less than 7% of all HPSR publications focusing on issues relevant to LMICs; authors based in middle-income countries (MICs) produced 43% of these publications.
With regards to research capacity, efforts have focused on strengthening individual level capacity through training and career development. More investment is needed to bolster the research capacity of institutions to create an enabling environment that would support researchers to generate the evidence needed by policy-makers. Similarly, while financial contributions to HPSR have gradually increased; ten donors account for over 90% of funds committed. There is a need for diversified and long-term funding.
In the Sustainable Development Goal era, where tackling inequity is centre stage, the report calls upon donors and ministries of health to:
- Increase international and domestic funding for HPSR;
- Establish mechanisms for improved networking among LIC researchers; and
- Connect researchers and policy-makers so that the knowledge generated is demand-driven and used in decision-making.
“This report could not be more timely and relevant,” says Professor David Peters, Chair of the Alliance Board and Chair of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. “HPSR is well-positioned to rise to the challenges presented by the SDGs.”