Makes the case for systems thinking in an easily accessible form for a broad interdisciplinary audience, including health system stewards, programme implementers, researchers, evaluators, and funding partners.
Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.
Patient safety in health systems has become more and more important as a theme in health research, and so it is not surprising to see a growing interest in applying systems thinking to healthcare. However there is a difficulty – health systems are very complex and constantly adapting to respond to core drivers and fit needs. How do you apply systems thinking in this situation, and what methods are available? National health authorities, international donors and research practitioners need to know the “how-to” of conducting health systems research from a systems thinking perspective. This book will fill this gap and provide a range of tools that give clear guidance of ways to carry out systems thinking in health. These methodologies include: System dynamics and causal loops Network analysis Outcome mapping Soft systems methodology Written by an international team of experts in health research, this handbook will be essential reading for those working in or researching public health, health policy, health systems, global health, service improvement and innovation in practice.
How did seven low- and middle-income countries, inspired by the landmark Alma-Ata Declaration, dramatically improve citizen health by focusing on primary health care? The Alma-Ata Declaration of 1978 marked a potential turning point in global health, signaling a commitment to primary health care that could have improved the safety of air, food, water, roads, homes, and workplaces in all 180 countries that signed it. Unfortunately, progress in many countries stalled in the 1980s. The declaration was, however, embraced by a number of countries, where its implementation led to substantial improvement in citizen health. Achieving Health for All reveals how, inspired by Alma-Ata, the governments of seven countries executed comprehensive primary health care systems, deploying new cadres of community-based health workers to bring relevant services to ordinary households. Drawing on a set of narrative case studies from Bangladesh, Indonesia, Ethiopia, Nepal, Ghana, Sri Lanka, and Vietnam,the book explains how a primary health care focus succeeded in improving population health. The book also conclusively demonstrates that comprehensive, multisector, community-controlled, and population-level primary health care is a viable strategy that, against the odds, has led to sustainable, scalable good health at lower cost. Bringing together a group of experts to analyze the forty-year legacy of the Alma-Ata Declaration, Achieving Health for All is a fascinating look at the work needed to transform nations from places that make people sick to places where they stay healthy. An inspiring array of lessons learned along the way shows how readers can make policies that support the health of all people. Contributors: Onaopemipo Abiodun, Vinya Ariyaratne, John Koku Awoonor-Williams, Kedar Prasad Baral, Ayaga A. Bawah, Pedro Más Bermejo, Fred N. Binka, David Bishai, Carolina Cardona, Dennis Carlson, Chala Tesfaye Chekagn, Hoang Khanh Chi, Svea Closser, Luc Barrière Constantin, Zufan Abera Damtew, Marlou de Rouw, Nadia Diamond-Smith, Philip Forth, Mignote Solomon Haile, Nguyen Thanh Huong, Taufique Joarder, Alice Kuan, Seblewengel Lemma, Sasmira Matta, Ahmed Moen, Rituu B. Nanda, Frank K. Nyonator, Ferdous Arfina Osman, Claudia Pereira, Henry B. Perry, James F. Phillips, Meike Schleiff, Melissa Sherry, Rita Thapa, Kebede Worku
This document presents the World Health Organization (WHO) operational framework for building climate resilient health systems. The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis and health systems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed in light of the increasing evidence of climate change and its associated health risks; global, regional and national policy mandates to protect population health; and a rapidly emerging body of practical experience in building health resilience to climate change. Primarily intended for public health professionals and health managers, this framework would also help guide decision-makers in other health-determining sectors, such as nutrition, water and sanitation, and emergency management. International development agencies could use this framework to focus investments and country support for public health, health system strengthening and climate change adaptation. The objective of this framework is to provide guidance for health systems and public health programming to increase their capacity for protecting health in an unstable and changing climate. By implementing the 10 key components laid out in this framework, health organizations, authorities and programs will be better able to anticipate, prevent, prepare for and manage climate-related health risks. Least developed countries and countries in the process of developing the health components of National Adaptation Plans (NAPs) under the UN Framework Convention on Climate Change (UNFCCC) (4) may find this document particularly useful in their efforts to design a comprehensive response to the risks presented by short-term climate variability and long-term climate change.
After outlining a new five-year strategic plan in 2021, the Alliance for Health Policy and Systems Research has been working this year to broaden its horizons beyond tradition health systems to consider the wider determinants of health. The Alliance supported 15 ongoing projects, representing 145 grants across 80 countries. Find out more about these projects and how they are contributing to the achievement of the Alliance's objectives: advancing knowledge, catalysing change and empowering leaders. We also look at the impact of some of the Alliance’s projects.
This book provides a multi-disciplinary framework for developing and analyzing health sector reforms, based on the authors' extensive international experience. It offers practical guidance - useful to policymakers, consultants, academics, and students alike - and stresses the need to take account of each country's economic, administrative, and political circumstances. The authors explain how to design effective government interventions in five areas - financing, payment, organization, regulation, and behavior - to improve the performance and equity of health systems around the world.
Human health depends on the health of the planet. Earth’s natural systems—the air, the water, the biodiversity, the climate—are our life support systems. Yet climate change, biodiversity loss, scarcity of land and freshwater, pollution and other threats are degrading these systems. The emerging field of planetary health aims to understand how these changes threaten our health and how to protect ourselves and the rest of the biosphere. Planetary Health: Protecting Nature to Protect Ourselves provides a readable introduction to this new paradigm. With an interdisciplinary approach, the book addresses a wide range of health impacts felt in the Anthropocene, including food and nutrition, infectious disease, non-communicable disease, dislocation and conflict, and mental health. It also presents strategies to combat environmental changes and its ill-effects, such as controlling toxic exposures, investing in clean energy, improving urban design, and more. Chapters are authored by widely recognized experts. The result is a comprehensive and optimistic overview of a growing field that is being adopted by researchers and universities around the world. Students of public health will gain a solid grounding in the new challenges their profession must confront, while those in the environmental sciences, agriculture, the design professions, and other fields will become familiar with the human consequences of planetary changes. Understanding how our changing environment affects our health is increasingly critical to a variety of disciplines and professions. Planetary Health is the definitive guide to this vital field.