Monday, August 22, 2011

[EQ] Building the Field of Health Policy and Systems Research: Framing the Questions

Building the Field of Health Policy and Systems Research:
Framing the Questions

Kabir Sheikh1*, Lucy Gilson 2,3, Irene Akua Agyepong 4, Kara Hanson 3, Freddie Ssengooba 5, Sara Bennett 6

1 Public Health Foundation of India, New Delhi, India, 2 School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa, 3 Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom, 4 Ghana Health Service/University of Ghana School of Public Health, Accra, Ghana, 5 School of Public Health, Makerere University, Kampala, Uganda, 6 Health Systems Programme, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America


PLoS Med 8(8): e1001073. doi:10.1371/journal.pmed.1001073 - August 16, 2011


Available online at:

PLoS Medicine Series on HPSR

Following the First Global Symposium on Health Systems Research in Montreux in November 2010, PLoS Medicine commissioned three articles on the state-of-the-art in Health Policy and Systems Research (HPSR).

Three Policy Forum articles, authored by a diverse group of global health academics, critically examine the current challenges to the field and lay out what is needed to build capacity in HPSR and support local policy development and health systems strengthening, especially in low- and middle-income countries.

Paper 1.
Kabir Sheikh and colleagues. Building the Field of Health Policy and Systems Research: Framing the Questions.

Paper 2.
Lucy Gilson and colleagues. Building the Field of Health Policy and Systems Research: Social Science Matters.

Paper 3.
Sara Bennett and colleagues. Building the Field of Health Policy and Systems Research: An Agenda for Action.

Summary Points

This is the first of a series of three papers addressing the current challenges and opportunities for the development of Health Policy and Systems Research (HPSR). HPSR is a multidisciplinary and interdisciplinary field identified by the topics and scope of questions asked rather than by methodology. The focus of discussion is HPSR in low- and middle-income countries.


Topics of research in HPSR include international, national, and local health systems and their interconnectivities, and policies made and implemented at all levels of the health system. Research questions in HPSR vary by the level of analysis (macro, meso, and micro) and intent of the question (normative/evaluative or exploratory/explanatory).

•           Current heightened attention on HPSR contains significant opportunities, but also threats in the form of certain focus areas and questions being privileged over others; “disciplinary capture” of the field by the dominant health research traditions; and premature and inappropriately narrow definitions.

•           We call for greater attention to fundamental, exploratory, and explanatory types of HPSR; to the significance of the field for societal and national development, necessitating HPSR capacity building in low- and middle-income countries; and for greater literacy and application of a wide spectrum of methodologies.



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