The 5th Global Health System Research Symposium- A reflection of how far we have come

Monday November 5, 2018

By Nancy Kangwanja and Dennis Waithaka

The year 2018 marks the 40th anniversary of the Alma-Ata Declaration to achieve Health for All. 2018, is also the 70th anniversary of the NHS, the UK’s free health service. Reflecting on these anniversaries was a good background to hold discussions around the current goals for health care in the framework of the Sustainable Development Goals. Throughout the symposium there was energetic and enthusiastic debate around health governance, healthcare needs, health financing, the health workforce, communities as part of the health system, multi-sectoral collaboration and the significance of leaving no one behind.

KEMRI-WT was well-represented at this Global HSR symposium held between 8th to 12th October where government officials, implementing agencies, private sector executives, funding institution representatives, researchers, health journalists and policy makers congregated to share and discuss research, policy and practice from different countries under the theme ‘advancing health systems for all in the SDG era.’

The rich program featured plenary sessions, satellite session, skill-building sessions, oral abstract presentations, TWG sessions and poster presentations. KWTRP had a good showing, with researchers from the KWTRP together with their collaborators involved in various discussions. The work presented by KWTRP spanned different health system areas including health financing and governance, ethics in Health Systems Research, and research methods such as intersectionality analysis and the learning site approach.   Capacity strengthening for health policy and systems was a cross-cutting theme of interest.

Key Take Home Messages
1. The process of policy change is slow and subject to many influences.  As we share findings with policy-makers we also need to think about how we can leverage on civil societies to empower communities to influence governments to take up research findings and change policies.
2. The private sector has an important role in provision of quality health services, products, technologies and information. There is need to move away from polarizing discourse on whether the private sector should be involved in expanding the reach of the health system, towards recognition of the diverse nature of the private sector.  A more inclusive, critical dialogue on how elements of the private sector can engage with the public health system in a way that balances the commercial interests of the private sector and social justice and equity goals of the public sector.
3.  ‘Health is made at home and repaired in hospitals’ that is, health outcomes are often influenced by social determinants outside the health sector, and so there is need to have more collaborations with other sectors in health systems research.
4. Some issues to consider when considering justice in Health Systems Research (HSR) are: does answering the research question contribute to challenging local or global inequities, and their structural drivers; are difference between and among populations considered in sample selection; how are privilege and disadvantage considered in everyday research practice, and in research uptake activities?
5. We need to consider our own power and privilege as we assess and think about how health systems can increase their reach and inclusivity of marginalized populations.

KWTRP presentations at the 5th Global Health System Research Symposium

Activity People Sessions/Topics
Skills building Tsofa, Molyneux, Leli, Muraya, Nzinga -Everyday ethics; Embedded research

-Gender and Leadership

-Intersectionality analysis

-Teaching health policy and systems research

-Governance

Thematic Working Group Molyneux, Kamuya, -Ethics TWG Business meeting
Chair/organise sessions Barasa, Molyneux, Muraya -Justice in health systems research

-UHC essential benefits, gender and human resources

Funder and policymaker engagement initiatives Tsofa, Molyneux, Muraya – Advice to NIHR on approaches to HPSR in LMICs

– Advice to 20 global policy makers on intersectionality analysis

Oral presentations Tsofa, Barasa, Kabia, Oluoch, Munge, Obadha, Nyikuri, Mwinga, -Embedded research

-Poverty, disability access to care

-UHC Essential benefits and lessons in Mhealth

-Parent and nursing experience of neonatal care

Poster presentations Zakayo, Nzinga, Boga, Waithaka, Omboko, Munge -Communications and Emotions Management

-Strike perceptions and experiences

-Ethics reflection

-UHC, Healthcare financing, malaria management