Ahead of the United Nations General Assembly (UNGA) High-Level Meeting (HLM) on Universal Health Coverage on 23 September 2019, HSG members were asked to comment on a set of messages that will be used in the society’s advocacy in the lead-up to and during the meeting. The survey also asked members to propose clear and tangible requests of those involved in the HLM – the ‘asks’.
The response was brilliant, with over 100 contributions coming from across the globe. Importantly, as a membership society, we will be using similar approaches to garner the thoughts of our members in the future.
Based on the responses to the survey we are finalising two messages and ‘asks’ (i.e. tangible actions that Member States of the United Nations, can take to respond to the messages). When it comes to campaigning and advocacy, it is effective when you have a clear message shaped specifically for a targeted audience. In this case, it is the member states at the HLM.
We were also cognizant that as a society concerned with health policy and systems research, the generation and use of evidence should be fundamental to our call to action. So, while it was not possible to incorporate all the responses in this advocacy campaign, we do intend to keep our analysis of the survey and draw on the ideas and suggestions in the near future. The valuable feedback is also being shared with a number of relevant HSG Board committees, as well as the program working group for the Sixth Global Symposium for Health Systems Research (HSR2020), ensuring that those ideas not used for the HLM are still used elsewhere.
What do members think of the messages?
We developed two preliminary messages that call for action – which were proposed to the membership:
Make commitments to evidence to achieve UHC.
Governments must recognize that evidence is a foundation of strong health systems needed to achieve UHC. By embedding research into policy and decision making, we will be able to produce, exchange and use the knowledge needed to respond to threats and challenges facing health systems and the societies they are integral to.
Invest in people so we can achieve ‘health for all’.
UHC will not be possible if we do not invest in people that are at the frontline of finding solutions to health systems challenges and implementing change. Health professionals, policymakers, researchers and practitioners need to be better skilled and resourced so they generate and act on evidence together.
Over 90 respondents agreed with both of the messages, with a few explicitly disagreeing. In relation to Message A, the importance of implementation research came out very strongly – i.e. “implementation research is the need of the hour” and the emphasis on the evidence synthesis and knowledge translation was clear – the notion that evidence is there, but need to make sure it is translated and usable for different actors.
On inclusiveness/community many responses highlighted the importance of the active participation of people and civil society in the decision making processes, and that evaluation and research processes should not be owned by elites in governments, and academia. There was a strong call for data/governance – i.e. data should be collected and analysed more seriously and there needs to be political will to resource and involve HPSR within systems.
The responses to Message B focused on the capacity building and adequate funding – ranging from “capacity building for researchers and key stakeholders to acquaint them with best practices” to “continuously develop workforce skills and support, and invest in increasing participation.”
About quarter of the respondents stated that they were satisfied or happy with the messages and highlighted that given the broad remit that HSG has, they served the objectives well. It should be noted that there were a couple of comments that remarked that the language of ‘equity’ and ‘inequality’ should be incorporated.
We did ask if there are other messages we should be sharing and there were some really valuable suggestions around taking a multi-sectoral approach to enable open and honest discussion and understanding that the determinants of health do not sit within one space. Emphasis was also put on the need to ensure that low- and middle- income countries (LMICs) are supported and resourced to generate and implement research, and that they have the skills and resources in country – comments included, “listen to research from LMIC” and “home-grown” researchers, and give “consideration in difference vis-à-vis research, evidence and use capacity between settings (i.e. LMIC and HIC)”
Given the positive reaction to the two messages, the HSG Board’s advocacy working group has decided to refine these informed by the feedback.
What are we asking member states to do?
For any campaign, it is important to have clear ‘asks’ to put to those that we want to influence. HSG wants to ensure that these asks reflect the messages that will shape our communications and advocacy.
In relation to the message on ‘making commitments to evidence’, we will develop asks calling for ‘context based evidence for design and implementation i.e. “Support more context specific research to identify local challenges and opportunities” and “programme design should be rigorous and evaluated on strength of evidence not just political will” and the need to evaluate and monitor programmes and policies i.e. “governments need to systematically monitor and evaluate policies and programmes throughout the policy cycle and engage academia, think tanks from formulation to evaluation”
With the message on ‘investing in people’, we are proposing the importance of platforms for exchanges and learning i.e. “place researchers into ministries and support research institutions” and “encourage and finance government-academia research collaborations for UHC” and to build the capacity of decision makers and researchers i.e. “build capacity of researchers and policymakers to interact and invest in knowledge brokers” and “work with researchers to train and skill decision makers at multi levels in generation and use of quality evidence for programme design, implementation and evaluation”.
We will shortly be finalising the messages and asks, and using clear examples to bring our points to life. Given that one of the strongest calls was about how to balance the need for context-based responses, and effectively advocating at a global level – we plan to publish a series of blogs focusing on regional understandings of the messages.
We are very committed to hearing the voices of our members and believe that your experiences and diversity only serve to strengthen our messages and advocacy. We intend to expand on this type of consultation in the future, as a mechanism to collectively build awareness of critical issues on health systems analysis and decision making.
We would like to hear thoughts on this, so please get in touch: email@example.com
HSG Advocacy Committee
Image credit: Toby Phillips Photography