From 31 October to 3 November, 2012, 1,775 participants from
over 110 countries gathered in Beijing, China for the Second
Global Symposium on health systems research. Around the
theme of inclusion and innovation towards Universal Health
Coverage (UHC), the Second Symposium reviewed state-of-the
art research and discussed strategies for strengthening the field
of health systems research.
Over four days comprising nearly 200 program events including
keynotes, plenaries, concurrent sessions, satellites, posters, films
and informal discussions and debates, the following action points
related to the inclusion and innovation themes have emerged:
• In our endeavor to achieve UHC, we must ensure the
centrality of social and gender equity. UHC is not only a
health system's task but a societal goal that requires
inclusion of diverse actors, different types of knowledge and
innovation across local, district, national, regional and global
contexts.
• Effective inclusion recognises the paramount priority of the
collective development of indicators that can be used tomonitor
countries’ progress towards the goal of UHC, as well as being
used by civil society to hold governments accountable. Such
measures must be relevant to local and national contexts, first and
foremost, and amenable to global comparisons.
• Most urgently, local capacities for critical health systems’
analysis is required for individual countries to understand
what aspects of their health systems (in terms of service
delivery, financing and governance) require change so as to
make real progress to UHC with equity.
• The social, methodological and technical innovations shared
in this Symposium provide a well-spring of knowledge and
an enormous opportunity,provided they can be appropriately
integrated to bring about systemic change to accelerate
progress towards UHC.
Key ideas for action that have emerged related to the objectives
of the program include:
• The cutting edge of health systems research should be
advanced by supporting analysis of politics and policy;
community action interventions; fiscal innovations; equity-
oriented health metrics; and longitudinal methods to capture
dynamism and long-term impact of interventions.
• Symposium participants want more research on: social
inequalities in health, including urbanisation and ageing;
social exclusion; governance; and the balance of sectors,
including informal, private, and public.
• The development of social science methodologies, health
metrics and monitoring and evaluation systems in a
balanced manner should be encouraged in order to
appreciate the complexity of health systems, policies and
implementation processes and capture their historical
origins, current status and future long-term impacts.
• Other innovations that warrant support include strengthened
data surveillance systems; better documentation of financial
flows at all levels; nesting research and incorporation of
knowledge uptake in research design for improved
monitoring and accountability, including by communities, in
implementation of UHC.
• Knowledge translation should be facilitated by developing
communities of practice and trust between researchers,
practitioners and policymakers; drawing from multiple
sources of knowledge and evidence, including real-world
experiences; strengthening open-access databases; and
enhancing South-South exchange of innovations to achieve
UHC.
• Long term and public financing for public research
institutions for health systems research is desired. Interest
groups and partnerships should be supported for various
forms of training in health systems research, that include
communication, values, power relations and context analysis
as capacities at all levels.
We note with pride some accomplishments of key milestones
committed to in Montreux, 2010
1. The launch of the WHO Strategy on Health Policy and
Systems Research represents a significant step forward for
the field. It calls for increasing the relevance and utility of
Health Systems Research by making it more demand driven.
It suggests options for action by member states to embed
research into decision-making to ensure that HPSR is
grounded in political realities and at the same time, the
grounding of policy processes in evidence and science.
The creation of a first international society for health systems
research. With more than 1400 members and 11 newly
elected board members, Health Systems Global held its first
Board and Annual General Meeting and began on its path to
catalyse and convene its membership to strengthen the field
of health systems research in the pursuit of more just and
equitable health systems.
Furthermore to meet the expectation, clearly expressed in
Montreux, that HSR inform policies more systematically,
participants contributed to the first meetings of the global
consultation on health in the post-2015 development agenda
as part of the United Nations Secretary General’s High-Level
Panel process. Understanding how to build on the MDGs,
address emerging issues, measuring new goals, and linking
these to accountability mechanisms relevant to each country
requires continued contributions by the health systems
research community.
In support of the Symposium themes and recommendations,
funders expressed broad support for the establishment of a new
mechanism, a Research Consortium for UHC (RC UHC), to
improve the coordination of resources to accelerate the
knowledge and know-how for universal health coverage. With a
committed core of funders and a clear agenda for research, the
development and operationalization of RC UHC will be finalised
and launched in 2013.
In 2014, we will gather for a Third Global Symposium on Health
Systems Research to continue to evaluate progress, share
insights and recalibrate the agenda of science to accelerate
universal health coverage. Following a call for proposals,
applications from South Africa and Canada, are being reviewed
by the Board of HS Global with a decision expected by the end of
2012.
______________________________
source: Approved by the Executive Committee of the Second Global
Symposium on Health Systems Research