By Racha Fadlallah (Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon; Member of HSR2020 Program Working Group), Fadi El-Jardali (Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon; Co-chair of HSR2020 Program Working Group), and Sara Bennett (John Hopkins University, Baltimore, USA; Co-chair of HSR2020 Program Working Group)
A few months ago, we had the pleasure of announcing that “Re-imagining health systems for better health and social justice” has been chosen as the theme for the Sixth Global Symposium on Health Systems Research (HSR2020) which will be held on 8-12 November, 2020 in Dubai. The winning bid was put forward by the Mohammed Bin Rashid School of Government in Dubai, in coordination and close collaboration with the American University of Beirut (AUB) through its Knowledge to Policy (K2P) Center in Lebanon. As we near the opening date for submission of abstracts, we would like to take the opportunity to reflect on the journey leading up to the theme and sub-themes. Through this blog, we aim to document the systematic approach to theme and sub-themes development, which combined both science and art, as well as reflect on the factors and aspirations that shaped our overall thinking, which could help inform future conferences.
Preparations for the Sixth Global Symposium commenced while we were still at the Fifth Global Symposium in Liverpool. Inspired and energized by the discussions and debates that were taking place, we were eager to start work on the next symposium, to be hosted in a region that had one of the lowest, if not the lowest, regional participations in all previous symposia. We were thrilled that HSR2020 will be held for the first time in the Eastern Mediterranean Region (EMR) where strengthening and advancing health policy and systems research (HPSR) is much needed. A long time coming, HSR2020 presents a unique opportunity to engage with institutions in the EMR involved in HPSR, and to bring them together as we prepare for this event. Moreover, HSR2020 comes at a time when there are major health and development challenges facing the EMR, including ongoing consequences of the Arab uprisings and their demands for democratization, and continuing conflicts and refugee crises; the changing health needs of a growing and aging population undergoing epidemiological transitions; environmental degradation and existence on the frontlines of climate change; and economic recessions (video). While these phenomena are particularly marked within the region, they are obviously more broadly relevant, and threaten to push the world as we know it into an uncertain future.
In developing the scientific program of the Symposium, a critical first step was to propose a symposium theme with a narrative to support it. We also worked closely with the HSG Board to assure that the Symposium program aligns with HSG’s core values of inclusivity and diversity. To arrive at a theme that resonated with our membership and beyond, we consulted widely to identify a set of ideas the theme should reflect. In the first round of consultations, we received ideas and suggestions through constructive feedback from postcards distributed to all participants in Liverpool; responses to an online survey circulated to HSG members and Thematic Working Groups in addition to key organizations and individuals of relevance to health systems within the EMR and beyond; and Twitterhashtags (#HSR2020, #HSR2018). Beyond the consultations, we conducted a documentary review of the strategic plans of Ministries of Health in EMR countries as well as closely monitoring regional and global health conferences taking place between 2018 and 2020. We conducted thematic analysis of the collective responses. This process stimulated thinking and initiated discussions about potential theme and sub-themes for HSR2020.
We wanted the theme and sub-themes to:
- Motivate participation in the Symposium
- Appeal to multiple audiences from different disciplines and sectors so as to broaden engagement in HPSR
- Inform and shape both global and regional health system agendas (while also resonating with the broader transformations shaping the world’s health systems)
- Provoke paradigm shifts in the status quo and confront issues/ideas that have not been adequately tackled or that remain largely overlooked or absent from mainstream debates by the health system community
- Maintain a balance between cutting-edge, forward-looking ideas and addressing unfinished agendas
- Embrace multiple facets of health policy and health systems work i.e. topics/disciplines/actors.
We were particularly inspired by the observation that 2020 stands at a cross road of two major events: it marks ten years on from the First Global Symposium on Health Systems Research; and ten years away from the 2030 sustainable development agenda. This presented an opportunity to revisit the themes and statements emerging from all previous Symposiums from Montreux to Liverpool (Box 1) – yet, ten years on from the First Global Symposium, health systems around the world are still far from achieving the goal of ‘leaving no one behind’. New threats to health equity and social inclusion arise with wars and conflicts, political turbulence, urbanization, climate change, pandemics, rising nationalism and closing civil space. In the midst of a rapidly changing world, we need to critically rethink and re-orient the way we approach health systems to tackle the unprecedented health and development challenges of today. We also reflected on the slow pace of progress five years into the SDG discussions, and considered the core principles underpinning the 2030 Agenda – universality, leaving no one behind, interconnectedness and indivisibility, inclusiveness, and multi-stakeholder partnerships – which urge us to take bold and transformative steps to shift the world onto a sustainable and resilient path.
Our search for a symposium theme was shaped by these wide-ranging aspirations. We developed a first draft of the proposed theme and sub-themes, which was reviewed by the HSG Board, subsequently refined by us and reviewed one more time by the HSG Board. In the second round of consultations, we solicited discrete feedback from 34 purposively selected key global and regional organizations and experts on the revised theme and sub-themes. We aimed for a balance of representation across high-income and low- and middle-income countries (including the EMR), disciplines (economics, public health, humanitarian health etc.) and sub-themes. Additionally, we solicited inputs across the breadth of HSG membership and Thematic Working Groups. While reviewing the draft, we requested from the target stakeholders to take into consideration a list of prompts (Box 2).
We iteratively discussed, reflected and debated the wide variety of perspectives, while also aiming to give weight to all suggestions as well as balance between regional and global voices. Eventually, we arrived at a final version of the theme and sub-themes, which was sent to the Symposium Executive Committee and the HSG Board for one more round of fine-tuning before being officially announced.
Looking back on the journey, we acknowledge that there is no one perfect way to develop a conference theme. Through our experience, we connected science and art in the collective goal of developing a conference theme and sub-themes that are fresh, inclusive, appealing and resonate with the health system community. While the science is how we gathered ideas and inputs about health systems, art is how we transformed that message, breathed new life into it, and made it appealing to our membership and beyond. The systematic approach, encompassing both a consultative process and a document review, shaped our overall thinking and helped ensure that the ideas generated are inclusive of the contributions from the wide variety of disciplines and communities that make up the growing field of HPSR, as well as attuned to global and regional transformations. It also helped ensure the theme and sub-themes are grounded in many of the key challenges and concerns coming from the region. Moreover, engaging a diverse range of regional and global stakeholders at different stages of the consultation process hopefully had a positive effect on their buy-in and receptiveness to the Symposium, which should help increase their engagement and promote successful outcomes for all involved. The artistic lens prevailed in trying to manage and collectively make sense of the rich and diverse inputs and perspectives brought to the table. The diversity of ideas prompted us to think outside the box, make linkages across concepts and connect the seemingly disconnected as we crafted the theme and sub-themes. Simply put, in crafting the Symposium theme, we hope to have created a platform that enables different pieces of the puzzle to come together in a fashion that will resonate within and beyond HSG community, and for the long-term transformation of health systems.
Summary of the Systematic Approach to Theme and Sub-themes Development
Thank you and Join us!
We thank all those who have contributed to the process of shaping the theme and sub-themes for the Sixth Global Symposium.
We invite you to submit your abstracts when the ‘Call for Abstracts’ opens in September 2019, and to join us in Dubai from 8-12 November, 2020, where we seek to deepen understanding and debate on the selected theme and sub-themes.