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HERG & WHO: Strengthening health research systems to improve health systems, achieve SDGs and tackle COVID-19

Stephen Hanney WHO 920x540

Over 19 years Brunel's Health Economics Research Group (HERG) has worked with the World Health Organisation to identify ways to strengthen National Health Research Systems (NHRSs). But, coming in an age of COVID-19, new publications from these joint efforts have never been more timely.

In mid-May 2020 a team led by Profs Steve Hanney and Subhash Pokhrel from HERG published a synthesis of the international evidence on strengthening NHRSs in WHO Europe’s Health Evidence Network series.  They were joined by HERG’s Drs Teri Jones and Lucy Kanya (who is now at the LSE), and Prof Annette Boaz from Kingston University and St George’s, University of London.

 They followed this up on 23 June with a paper outlining and analysing the review’s key findings including in the context of the unprecedented research cooperation to treat and prevent COVID-19.  For strengthening NHRSs, the key policy recommendations drawn from the review and paper are: 

  • start with a contextual analysis to inform a comprehensive strategy;
  • develop and sustain a comprehensive and coherent strategy;
  • engage stakeholders, including in designing the research strategy and research priority-setting;
  • adopt evaluation tools focused on system objectives, including assessing the impact on improved healthcare; and
  • promote partnerships.

 In 2001 WHO first approached HERG to see how they might draw on HERG Payback Framework in their work to strengthen health research systems. Monitoring and evaluation was seen as a key component of a NHRS, but the WHO team saw the importance of widening its scope beyond traditional evaluation of academic outputs.

In the mid-1990s Prof Martin Buxton and Steve Hanney had originally developed the Payback Framework to assess the payback, or societal impact, from health research at the request of the R&D Division of the Department of Health. They further refined it in the work conducted with WHO, and published a paper examining the use of research in health policymaking . This article was one of the first papers published in a new journal, Health Research Policy and Systems, established by BioMedCentral in collaboration with WHO to publish research on health research systems. Steve Hanney co-edited the journal from 2006-17.  

The work of the WHO team highlighted the value of adopting a systems approach because it can be used to identify all the activities required if research is to operate effectively, and collate them into a health research system framework. Following team meetings held from Bali to Brunel, the WHO team that published such a framework in 2003 .

Steve Hanney commented: When the WHO team flew into Heathrow, the way to Brunel was very familiar to Prof Zulfiqar Bhutta, one of the world’s leading medical academics from the Aga Khan University in Karachi, Pakistan, because he had undertaken some of his training as a registrar at The Hillingdon Hospital. And many congratulations to Zulfi who had the immense honour of being elected as a Fellow of the Royal Society (London) in April 2020.”

WHO’s main objective in identifying and promoting ways to strengthen NHRSs has always been to improve health systems and population health. Specific attention has been given to ways of achieving Universal Health Coverage and, more latterly, meeting the health-related Sustainable Development Goals. Both the new report and publication identify an ultimate aim as being, where appropriate, the integration of the health research system into the health system so as to improve the healthcare delivered.

Steve Hanney said: “The aim of brining the local health (and wider) research system and health systems together is central to the work of Brunel Partners Academic Centre for Health Sciences (BPACHS). The Partnership includes Brunel and the local NHS and plans had been developed for BPACHS to host the UK launch of the WHO report. These plans were derailed by the coronavirus, but eventually it is hoped some event will be still be possible around this stream of work which could be increasingly important to Brunel in the future.”

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