Institute of Development Studies (IDS)
IDS is an international centre of excellence in multi-disciplinary analysis, teaching, and practice of development based at the University of Sussex in Brighton, UK. Its areas of expertise include poverty dynamics, social policy analysis, processes for involving stakeholders, strategies for making health services more accountable to their community; and research methods that combine quantitative and qualitative evaluation of performance of health systems. The organisation has experience working on health and social protection in China, Uganda, and other Asian and African countries, innovative strategies to improve provider performance in China and Bangladesh, and developing analytic frameworks to bring together development and public health approaches to understanding health systems.
Who we work with at IDS
- Dr Gerry Bloom (FHS publications, Profile at IDS, Google Scholar profile)
- Jeff Knezovich, FHS Policy Influence and Research Uptake Manager (FHS publications, Profile at IDS, Google Scholar profile)
- Dr Henry Lucas (FHS publications, Profile at IDS)
- Dr Hilary Standing (FHS publications, Profile at IDS)
- Dr Hayley MacGregor (FHS publications, Profile at IDS)
- Dr Linda Waldman (FHS publications, Profile at IDS)
Recent FHS publications involving IDS
This is an open access resource targeted primarily at post-graduate students intending to undertake field research on health systems interventions in resource-poor environments.
The book consists of twelve chapters addressing theory, methodology, analysis, and influencing policy. Each consists of both original text and links to relevant, open access, web-based journal and multi-media materials, including selected case studies.
It has been argued that in every country, ‘social, educational, technological, and economic development fundamentally depends on the advancement of science through research … and [it] benefits from having a … network of actors engaged in promoting and using scientific research’. This applies in particular to life sciences research in low- and middle-income countries (LMICs), given that many such countries face the heaviest burdens of disease. However, Langer et al. lamented in 2004, that ‘In the fields of medicine and public health … papers where researchers from developing countries are the sole authors represent a very low proportion of published manuscripts’. The reasons identified for this include: poor access to scientific literature, poor participation in publication-related decision-making processes, and the bias of journals. Much has changed since then, with a dramatic growth in the number of journals addressing public health concerns, many of which are based in LMICs or which include LMIC researchers on their editorial boards. There have been substantial initiatives, most notably Hinari, to provide LMIC researchers with access to the scientific literature. However, though the number of LMIC publications has increased substantially, a recent publication found no LMIC in the top forty countries in terms of publications per capita.
MacGregor H and Bloom G (2016) Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale, Developing World Bioethics, 16(3): 158–167, doi:10.1111/dewb.12115
This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes.
Achieving universal health coverage by 2030, as stated in UN Global Goal 3, will require substantial increases in health spending and the proportion funded through taxation or social insurance to make health care affordable for all. Not only will institutions need to be established to ensure sustainable arrangements for social finance, it will also be vital to ensure that health financing is resilient to economic and other shocks if Global Goal 3 is to be realised. This presents a major challenge in Africa, where an economic downturn is projected in a number of resource-dependent countries, such as Mozambique and Guinea Bissau and where countries such as Sierra Leone have weakened health systems. The response to these challenges by governments and development partners, will have important effects on how well people, and the health services on which they rely, cope in the short term and longer-term evolution of health coverage.
Buckland Merrett GL, Bloom G, Wilkinson A and MacGregor H (2016) Towards the just and sustainable use of antibiotics, Journal of Pharmaceutical Policy and Practice, 9:31, DOI: 10.1186/s40545-016-0083-5
The emergence and spread of antibiotic resistant pathogens poses a big challenge to policy-makers, who need to oversee the transformation of health systems that evolved to provide easy access to these drugs into ones that encourage appropriate use of antimicrobials, whilst reducing the risk of resistance. This is a particular challenge for low and middle-income countries with pluralistic health systems where antibiotics are available in a number of different markets. This review paper considers access and use of antibiotics in these countries from a complex adaptive system perspective. It highlights the main areas of intervention that could provide the key to addressing the sustainable long term use and availability of antibiotics.
This brief outlines some of the challenges of incorporating gender analysis into existing research programmes, along with ways in which Research in Gender and Ethics (RinGs): Building Stronger Health Systems has responded to them. RinGs is a cross research programme consortium (RPC) bringing together three health systems RPCs – Future Health Systems, ReBUILD, and RESYST – to better understand gendered dynamics in health systems and to galvanise gender analysis in HSR.
Recent FHS blogs from IDS
The experience of the West African Ebola epidemic and its devastating impact on health and also the capacity of health services to carry out basic public health functions has led to a growing interest in ways to make health systems more resilient. This is the theme of the forthcoming symposium of the Fourth Global Symposium on Health Systems Research
It is important to differentiate between the contributions of a health system to social resilience and the factors that make a health system resilient to health crises. Both are important. In fact, the dimensions of the relationship between resilience and health systems are also interlinked.
There are about 7 billion mobile users globally, and no less than 95% of people are covered by at least 2G network. Via smartphones, people have access to over 40,000 health apps. As a result, globally there is much interest in eHealth, especially in addressing various barriers related to access to healthcare. However, from the health equity standpoint, we have to ask, who has access to quality health information through electronic platforms (eHealth)?
Launched this week is a major report on tackling the growing resistance to antibiotics by the UK Government and the Wellcome Trust. The authors of this blog post fully support its call for the G20 and the UN to take the lead in building a global coalition for action to address this urgent issue, and urge world leaders to consider the unmet needs of the poorest as central to a solution.
As the World Health Assembly and the G7 Summit meet next week, their recommendations must recognise that very large numbers of people still do not have access to antibiotic treatment when they have an infection. Action on antibiotic resistance should not undermine the continuing need to ensure everyone has access to the medicines they require to live full and healthy lives - a goal which has not yet been consistently reached outside of richer countries.