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Building the Field of Health Policy and Systems Research: Social Science Matters

Future Health Systems

Gilson L, Hanson K, Sheikh K, Agyepong IA, Ssengooba F, et al. (2011) Building the Field of Health Policy and Systems Research: Social Science Matters. PLoS Med 8(8): e1001079. doi:10.1371/journal.pmed.1001079


This is the second 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.

  • All researchers hold a knowledge paradigm that frames their understanding of reality and of the functions and nature of research. Some disciplines are dominated by a particular paradigm and some are spread across paradigms.
  • The criticisms that Health Policy and Systems Research (HPSR) is too context specific, does not offer clear lessons for policy makers, and is not rigorous are partly a reflection of differences in knowledge paradigms between those with predominantly clinical, biomedical, and epidemiological backgrounds, underpinned by a positivist paradigm, and those with social science backgrounds underpinned by a relativist paradigm.
  • Health policies and systems are complex social and political phenomena, constructed by human action rather than naturally occurring. Relativist social science perspectives are, therefore, of particular relevance to HPSR as they recognise that all phenomena are in essence constructed through human behaviour and interpretation.
  • Social science insights that can advance the science of HPSR include approaches to generalising from rich understanding of context; supporting policy learning; and enhancing research rigour and quality.