Identifying health policy and systems research priorities on multisectoral collaboration for health in low-income and middle-income countries

Abstract

IntroductionWhile efforts to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) have reinvigorated interest in multisectoral collaborations (MSCs) among the global health and development community, there remains a plethora of questions about how best to conceptualise, plan, implement, evaluate and sustain MSCs. The objective of this paper is to present research priorities on MSC for health from researchers and policymakers around the globe, with an emphasis on low-income and middle-income countries.MethodsThe authors identified 30 priority research questions from two sources: (1) 38 review articles on MSC for health, and (2) interviews and focus groups with a total of 81 policymakers, including government officials (largely from ministries of health and state/provincial departments of health, but also offices of planning, public service, social development, the prime minister and others), large multilateral or bilateral organisations, and non-governmental organisations. In a third phase, questions were refined and ranked by a diverse group of researchers from around the globe using an online voting platform.ResultsThe top-ranked questions focused predominantly on pragmatic questions, such as how best to structure, implement and sustain MSCs, as well as how to build stakeholder capacity and community partnerships. Despite substantial variation between review articles, policymakers’ reflections and online ranking by researchers, two topics emerged as research priorities for all three: (1) leadership, partnership and governance structures for MSCs; and (2) MSC implementation strategies and mechanisms. The review articles underscored the need for more guidance on appropriate study designs and methods for investigating MSCs, which may be a prerequisite for other identified research priorities.ConclusionThese findings could inform efforts within and beyond the health sector to better align research objectives and funding with the evidence needs of policymakers grappling with questions about how best to leverage MSCs to achieve UHC and the SDGs.

Methodological gaps and opportunities for studying multisectoral collaboration for health in low- and middle-income countries

“…These gaps constrain the specificity of insights about MSCs, resulting in high-level recommendations that, while conceptually sound and intuitively appealing, leave many important questions unanswered (4).…”

“…A paper by Glandon et al identifying health policy and systems research (HPSR) priorities on MSC for health in low and middle income countries (LMICs) demonstrated a clear need for more evidence on MSCs and a lack of clarity on the types of research designs and methods that can best generate that evidence (4). In this paper, we appraise the underlying research papers from the previously published HPSR priority-setting exercise to address our first two aims, namely to: 1) identify key research question domains ("meta questions") currently addressed in the MSC literature; and 2) describe research methods used to answer those questions (4). We also draw on participant input from a skill-building workshop at the Health Systems Research (HSR) Symposium in Liverpool, UK (8-12 October, 2018) to address our third aim: to identify methodological gaps and opportunities for MSC research, with a focus on LMICs.…”

Efeitos do Programa Saúde na Escola em indicadores municipais de saúde

“…É mencionada a carência de sistemas de monitoramento governamentais profícuos, que permitam a utilização de informações pertinentes como fonte de aprimoramento das ações propostas (Bennett et al, 2018;L. M. T. Garcia et al, 2014;Glandon, Meghani, Jessani, Qiu, & Bennett, 2018;Loewenson, 2013;Ndumbe-Eyoh & Moffatt, 2013;Sadana, Brown, Lee, Goldblatt, & Hosseinpoor, 2010).…”

“…A análise de políticas públicas usualmente remete à um processo cíclico dividido nas seguintes etapas sequenciais, mas interdependentes: formação de agenda; formulação de alternativas; tomada de decisão, implementação; avaliação (Frey, 1996;Howlett, Ramesh, & Perl, 2013;Secchi, 2010 (Glandon et al, 2018;Sadana et al, 2010).…”

“…Apesar da notável importância do monitoramento, estudos mostram que na prática ainda há um longo caminho a ser percorrido, lembrando que a carência de ações para combater problemas relacionados a inequidades em saúde pode ser parcialmente explicada pela falta de informações adequadas para subsidiar propostas (Glandon et al, 2018;Ndumbe-Eyoh & Moffatt, 2013;Rantala et al, 2014 (Marmot et al, 2008). Nesse contexto, é imprescindível a criação de indicadores pertinentes a atividades intersetoriais, capazes de retratar as conexões entre as áreas a partir de dados advindos de cada parte.…”