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Blog

Filtering by Category: JHSPH

Including marginalised people in ‘people centred health systems’

Future Health Systems

At the upcoming Global Symposium on Health Systems Research, we will be running a participatory session that builds on research from Uganda, Bangladesh and Nepal, entitled Amplifying Marginalised Voices: Towards Meaningful Inclusion in Social Accountability Mechanisms for Health. This session applies an intersectional lens to accountability mechanisms, asking about the inclusion of specific, marginalised categories within communities in mainstream accountability initiatives.

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How can health systems research inform the development of ethics guidance for greater health equity and justice?

Future Health Systems

Helping improve health systems for disadvantaged and marginalised populations is an important value motivating health systems research in low and middle-income countries (LMICs). However, simply undertaking health systems research in LMICs does not necessarily generate the knowledge needed to achieve that goal.

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Naming the moment

Future Health Systems

We had three days. That was it. We had three days: to gather, to share ideas and experiences, to make new connections, to strengthen existing ones, and to wrestle with the conceptual beast that is “accountability.” The aim? To bring sharp minds, creative problem-solvers and pragmatic innovators together under one roof so that we might get a few steps closer to our common goal of greater health equity. Did it work? Yes. With caveats. You can be the judge.

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Onions, elephants and lenses; reflections on the accountability for health equity workshop

Future Health Systems

By Ligia Paina, FHS Researcher

What happens when you bring 80+ social activists, anthropologists, health systems researchers and policy makers together for a three day workshop and ask them to further the collective understanding of accountability and its role in health equity?

I am going to leave that question for the team from the Institute of Development Studies that hosted the workshop, but here I wanted to share some reflections on what was a fascinating event. 

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G20 leaders need to prioritize public health to keep pandemics at bay

Future Health Systems

In 1895, poet Joseph Malins described an ill-starred town shadowed by a cliff. Citizens would regularly tumble off the cliff, so the town mercifully pays for a public ambulance. The poet berates the town for not building a fence at the rim of the cliff. As the G20 come together this July in Hamburg, they should take heed and learn the lessons from this fenceless town. Addressing global health security challenges like pandemics and resistance to antibiotics requires not just an ambulance, but a fence too. 

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Investing in ​​health is not​ cheap, but it is not a luxury either

Future Health Systems

While Ebola, Zika and yellow fever may seem like distant threats to most people living in the developed world, the lessons from these global crises should resonate across health services in all countries.

At the G7 meeting in Ise-Shima, Japan, and the world health assembly in Geneva this week, world leaders and health policymakers have a prime opportunity to take action. They need to lead the way in shaping health systems that can cope with both public health emergencies and the longer-term challenges of ensuring access to affordable health services for all.

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Harnessing the power of networks for building HSR capacity in the Global South

Future Health Systems

Inspired by the power of networks to strengthen capacity in health systems research, colleagues at Johns Hopkins Bloomberg School of Public Health convened a panel titled “The network approach to strengthening health systems research capacity: experiences from the Global South” for the Global Forum for Health Research (Forum 2015) held in Manila, Philippines from 24-27 August. Four networks engaged in capacity building for health policy and systems research (HPSR) were showcased. Here are the reflections of the Chair (NJ) and the panelists (CM, EE, RR and SG). 

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Down the Rabbit-Hole: A Glimpse into the Sunbelt Social Network Analysis Conference

Future Health Systems

"For a few days in June I felt like Alice in Wonderland: tumbling down a rabbit hole, only to find myself lost in a maze of rooms. Overwhelmed by the unfamiliar. Curious about what next. I opened one door and saw indistinguishable mathematical formulas flash on the screen across the hall. I opened another door and could barely see through the multitude of hands raised in question." Nasreen Jessani tells the story of her experience at the annual Sunbelt Conference of the International Network for Social Network Analysis (INSNA) held in Brighton, UK from 23-28 June 2015. 

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Future Health Systems at the ResUp MeetUp, Nairobi, 9-12 February 2015

Future Health Systems

Future Health Systems and Africa Hub partners will be participating at the ResUp MeetUp Symposium and Training Exchange in Nairobi from 9 to 12 February 2015, which will bring together members of the ResUp MeetUp community to share learning and best practice, and build capacity for research uptake

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The conversion of a complex adaptive systems modeling sceptic

Future Health Systems

During the past few years complex adaptive systems theory has suddenly become very popular in the health systems research field. However, I have to admit that, until recently, I was something of a complex systems modeling sceptic. A couple of recent events, notably the FHS workshop and an NIH conference, have changed my perspective. Here's what has driven my change in thinking.

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Ten things to know about causal loop diagrams (CLDs)

Future Health Systems

As discussed at a methods workshop held in Baltimore in June 2014, systems mapping and conceptualization – a key part of the puzzle of intervening in complex systems – is a process of developing diagrams to illustrate system boundaries and the connections between variables.

CLDs are one type of system map, but they are by no means the only one. What makes CLDs particularly useful is that, in addition to mapping a system structure, they help build understanding of connections between a range of variables.

The increased momentum around complexity and tools such as the CLDs begin to raise issues that question the very core of the paradigms in which we generally operate in public health. That creates demand for understanding what CLDs are and when to develop and use them. It also creates an opportunity to drop some of the communication barriers that exist between disciplines and to push the boundaries of our understanding of complex systems.

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This is not a love-fest

Future Health Systems

On July 6th, the Private Sector in Health Symposium will convene for the third time in six years before the International Health Economics Association (iHEA) World Congress, and builds upon a well-attendedwebinar series in the run-up to the symposium.. The symposium attracts a broad spectrum of scholars from multiple disciplines. It won’t just be economists, and it won’t be a love-fest for unleashing free market economics in health care systems. The private sector in health is problematic, but we are going to have to live with it for quite some time -- so it’s a good thing so many intrepid scholars have joined forces to find ways to get the private sector to effectively deliver high quality services, to reach the poor, and to reduce the financial jeopardy for patients who access it.

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Where have all the taxis gone? Complex Adaptive Systems in Action in Beijing

Future Health Systems

I was cold, and I was wet – having waited for a taxi home for about an hour. And despite my interest in the subject, I somehow took little solace in the fact that getting soaked was the failure of a complex adaptive system. In order to keep Beijing taxi drivers in check, local government made the drivers themselves directly responsible for the costs associated with an accident. That may help keep speeding and reckless driving to a minimum when the skys are blue(ish -- it is Beijing after all), but when it comes to driving in more difficult road conditions, when demand is at its peak, in means that taxi drivers make something of a different economic calculation and stay off the roads. Talk about unintended consequences. But the local transport system was not the only complex adaptive system (CAS) on show here in Beijing. As a PhD student who is currently grappling with understanding Uganda’s complex health workforce dynamics for my dissertation research, I was unsure what to expect to hear about complex adaptive systems (CAS) at the 2nd Global Symposium on HSR. I was fortunate to have participated in the 1st Global Symposium on HSR in Montreux in 2010, which included a handful of discussions on this topic. In Montreux, the discourse was focused on conceptualizing CAS and systems thinking, asking what it they are and why should we apply them in health systems research.

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The 2nd Symposium on HSR: As daunting as Kabul?

Future Health Systems

I’ve just arrived in Beijing, China, after a long journey from Kabul, Afghanistan. To say it’s a change of pace is an understatement. The sheer scale of the city is impressive – if a bit daunting – as is the 2nd Global Symposium on Health Systems Research, which I’m here for. I hear there are more than 1,850 participants, which sounds like a lot to me, but is but a mere drop in the ocean of Beijing. The poster session will be a first for me, though I’m lucky to have practiced such an activity in one of my epidemiology classes at the Johns Hopkins Bloomberg School of Public Health. The poster presentation was the relatively easy practical element of the aforementioned epidemiology class, which just goes to reinforce a conclusion I came to a long time ago: the tougher classes are the ones that equip students best for work outside the classroom!

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Forgetting John Snow at the Beijing HSR Symposium

Future Health Systems

This week the world will gather at the 2nd Global Symposium on Health Systems Research in Beijing meeting to collectively forget everything that John Snow stood for. Almost all the programming is about improving the delivery and financing of medical services. Attendees will forget that the best solutions are local solutions based on local data used by local health advocates in harmony with their local community. Few presenters seem to notice that the best and most important part of any health system is not the gleaming hospitals and ICUs. The part that of the health system that creates health changes the social and physical determinants of health through good old fashioned public health practice. Most participants are content to sway to the siren’s song of universal coverage and pretend that doctors are the solution to every malady. The good news is that at least one woman in Beijing remembers John Snow. Dr. Afisah Zakariah is Director of Policy, Planning, Monitoring, and Evaluation for the Ministry of Health in Ghana.

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Health Systems Global – why care????

Future Health Systems

As colleagues from around the world converge on Beijing, I am stuck in Washington, D.C. with the flight departure screens displaying a never-ending list of cancelled flights. Here in DC not many people are aware of the symposium in Beijing, and not many people care about Health Systems Global – or as I would prefer it to be called, the new Society for Health Systems Research. I am reminded of an email written by a friend when I wrote suggesting that he stand to be a Board member – he wrote back, saying (and I paraphrase): “Why should I care about this, I don’t think this new global society will have much impact on my country, or the things that I care about.” From a wind and rain-swept, election-obsessed DC, it is easy to feel the same. But I do care, and I am upset that I will not be there for the opening of the Symposium. Why is this?

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