Health Policy and Systems Research - World Health …

1 Health Policy and Systems Research A Methodology Reader Edited by Lucy Gilson Health Policy and Systems Research A Methodology Reader Edited by Lucy Gilson WHO Library Cataloguing-in-Publication Data Health Policy and Systems Research : a methodology reader / edited by Lucy Gilson. Policy . services Research . of Health care. literature. , Lucy. for Health Policy and Systems Research . Health Organization. ISBN 978 92 4 150313 6 (NLM classification: W ). World Health Organization 2012. All rights reserved. Publications of the World Health Organization are available on the WHO web site ( ) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.)

2 : +41 22 791 3264; fax: +41 22 791 4857;. e-mail: Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressed to WHO Press through the WHO web site ( ). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

3 Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication.

4 However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. Printed by the WHO Document Production Services, Geneva, Switzerland Designed by Capria Contents Contents About this Reader .. 11. Part 1. Introduction to Health Policy and Systems Research .

5 19. 1. What is Health Policy and Systems Research ? .. 21. Key characteristics .. 21. Key areas of HPSR .. 22. 2. Health Systems .. 23. Goals .. 23. Elements and characteristics .. 23. Multi-levels of operation .. 24. Interactions and interrelationships .. 25. 3. Health system development or strengthening .. 26. 4. Health Policy .. 28. 5. Health Policy analysis .. 28. Policy actors .. 29. The focus and forms of Policy analysis .. 29. 6. The boundaries of HPSR .. 30. What HPSR is .. 31. What HPSR is not .. 32. The distinction between HPSR and service delivery/disease programme Research .

6 32. Fuzzy boundaries .. 33. 7. Understanding the nature of social and political reality .. 34. Positivism .. 35. Relativism .. 35. Critical realism .. 36. HPSR perspectives on causality, generalizability and learning .. 36. References ..38. Contents 5. Part 2. Doing HPSR: Key steps in the process .. 41. Step 1: Identify the Research focus and questions .. 43. Networking and creative thinking .. 44. Literature search .. 45. Key challenges .. 46. Identifying the purpose of the Research .. 47. Taking account of multidisciplinarity .. 51. Finalizing Research questions.

7 51. Step 2: Design the study .. 52. Using theory and conceptual frameworks to inform the study .. 54. Step 3: Ensure Research quality and rigour .. 55. Step 4: Apply ethical principles .. 58. References ..59. Part 3. Understanding Health Policy and Systems .. 61. Health system frameworks .. 63. Bloom G, Standing H, Lloyd R (2008). Markets, information asymmetry and Health care: Towards new social contracts.. 63. de Savigny D et al. (2009). Systems thinking: What it is and what it means for Health Systems . In: de Savigny D, Adam T, eds. Systems thinking for Health Systems strengthening.

8 63. Conceptual frameworks for HPSR .. 64. Atun R et al. (2010). Integration of targeted Health interventions into Health Systems : a conceptual framework for analysis.. 64. Bossert T (1998). Analyzing the decentralization of Health Systems in developing countries: decision space, innovation and performance.. 64. Brinkerhoff D (2004). Accountability and Health Systems : toward conceptual clarity and Policy relevance.. 64. Franco LM, Bennett S, Kanfer R (2002). Health sector reform and public sector Health worker motivation: a conceptual framework.. 64. Gilson L (2003).

9 Trust and Health care as a social institution.. 64. Kutzin J (2001). A descriptive framework for country-level analysis of Health care financing arrangements.. 64. Vian T (2007). Review of corruption in the Health sector: theory, methods and interventions.. 64. Walt G, Gilson L (1994). Reforming the Health sector in developing countries: the central role of Policy analysis.. 64. 6 Gilson L, ed. (2012). Health Policy and Systems Research : A Methodology Reader Alliance for Health Policy and Systems Research , World Health Organization Part 4. Empirical papers.

10 65. Overview: Research strategies and papers .. 67. 1. Cross-sectional perspectives .. 72. Blaauw D et al. (2010). Policy interventions that attract nurses to rural areas: a multicountry discrete choice experiment.. 75. Glassman A et al. (1999). Political analysis of Health reform in the Dominican Republic.. 83. Morrow M et al. (2009) Pathways to malaria persistence in remote central Vietnam: a mixed-method study of Health care and the community.. 95. Ramanadhan et al. (2010). Network-based social capital and capacity-building programs: an example from Ethiopia.