International health systems that breathe the same air
This blog post is part of a wider HSG blog series in the lead up to the Universal Health Coverage Forum 2017, which takes place in Tokyo, Japan from 12 – 15 December. In this series, HSG members provide their perspectives on how Health Policy and Systems Research is fundamental to acheiving Universal Health Coverage by 2030.
By Tyrell Junius
Universal Health Coverage (UHC) and Health Policy and Systems Research (HPSR) have the potential to bridge cultural understanding with quality global open-sourced datasets. As it stands, underperformance of health systems is very much connected to insufficient and inaccurate data. HPSR also has the perception, at least in developing countries, of being a pilot. Yet, these countries are moving away from pilots and into phased and tactical implementations, and HPSR will inevitably contribute to the continuum and point of care health services. This creates an important space where we need to collaborate and learn from each other, and respect different cultural understandings of health and the world around it but ultimately understand that we all breathe the same air.
Imagine a world where we can learn new treatment methods using quality HPSR data to prevent illnesses and epidemics. The how is easy – HSPR will undoubtedly influence the end of health disparities in people and management systems by effectively utilizing data. Collaboration between governments, academia, the private sector, and civil societies will advance research-based implementation to accelerate UHC and social health insurance where it is most needed. The why is compelling – never has the world been in a better position to provide quality care to the world’s most marginalized. So, why not?
Insight from HPSR field implementations
Most developing countries receive international aid to improve various sectors, including the health sector. Whilst funding is essential, money alone is not the solution. It is crucial that health policy and systems research is taken into account, to ensure the solution is not only financially viable, but also based on sound research and stakeholder feedback. In this way, HPSR can help to transform the UHC system landscape.
A typical example of this is when aid organizations allow bids for the best technical approaches to collect and analyze data to inform health policies and health system strengthening. This approach is outdated and ineffective, and often a waste of resources. Collecting data from the point of care and harmonizing digital data collection efforts is the best way to achieve UHC by 2030.
The World Health Organization (WHO) states in one UHC health system strengthening report that “there is no one-size-fits-all approach to achieving UHC – strategies will depend on local circumstance and national dialogue.” Local populations, health professionals, and passionate researchers will take the lead on developing best research practices, methodologies, and quality data collection to confidently present and publish findings for HPSR experts, the private sector, and international stakeholders to play an active role. Otherwise, results will be viewed as inaccurate.
The value chain of health services also play a pivotal role in creating and delivering UHC. Each health professional – from the doctor, nurse, health administrator, nutritionist, etc. – needs to have a defined role and accurate evidence to contribute to the realization of UHC by 2030. And these essential healthcare workers must be rewarded for contributing to the overall goal!
Last mile system and policy integration approaches
There is a direct correlation between gross domestic product (GDP) and a country’s ability to connect its citizens to the internet. This digital divide, present in many countries, fails to find innovative ways of integrating last mile populations to the national networks. All too often, generalizations, paired with an exacerbation of silo systems between industries, hinders progress towards UHC. For health systems to inform policy, it is essential to have data that speaks from the end-user.
Until the time policy makers, researchers, and healthcare professionals come together with other industries (such as the private sector, education, agriculture, and tourism) who value health outcomes, robust and integrated health systems for all will continue to be a dream. But I remain hopeful, as I see a new generation of health leaders rising to address the shortcomings of health system research and implementation to reach the populations most in need.
Recommendations for enabling UHC by 2030
End-users must be included in the design and execution of functional and technical requirements. We as HPSR advocates must work with local clinics, health centers, hospitals, and community leaders to mobilize champions to advocate for the importance of evidence in strengthening health systems for UHC.
In addition, public and private sector stakeholders must work together to agree on the best approaches. This momentum will then reach private health providers, insurers, and eventually international audiences to ensure health for all. The Sustainable Development Goals provide a roadmap for global collaboration to tackle challenges on the path to UHC. In the end, however, it will be the end-users of health services who must raise their voices and demand the continuum of healthcare that will benefit everyone.
