Browsing by Author "Sheikh, Kabir"
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- ItemOpen AccessBuilding the field of health policy and systems research: an agenda for action(Public Library of Science, 2011) Bennett, Sara; Agyepong, Irene Akua; Sheikh, Kabir; Hanson, Kara; Ssengooba, Freddie; Gilson, LucyThe lack of clarity and shared understanding regarding the scientific foundations of Health Policy and Systems Research (HPSR) [1] potentially has very negative consequences for the field [2]. Disagreement over the value of different types of theoretical frameworks and research methods can lead to inappropriate evaluations of research proposals, contradictory reviews of the same paper, and delays in publication. Excessive time may be spent communicating broad frameworks to other researchers within HPSR, inhibiting progression to more detailed and specific conversations. Communication barriers may discourage inter-disciplinary collaboration, driving researchers back to their disciplinary safety zones, and creating potential for conflict that may discourage younger researchers who may be less secure in their career from staying in the field. As the second paper in this series concluded [1], there is an urgent need to build understanding across disciplinary boundaries. This final paper in the "Building the Field of HPSR" series turns to practical questions concerning how to remove structural barriers that currently inhibit the development of the HPSR field and thus unlock HPSR capacities. HPSR suffers from many of the same problems as other branches of health research in low- and middle-income countries (LMICs): major imbalances between the resources available in high- versus low- and middle-income contexts [3], acute shortages of skilled researchers (especially senior ones), and relatively few organizations that house HPSR expertise [4]. Historically, low levels of funding for HPSR compared to clinical or biomedical research have compounded these problems. Many papers provide relevant recommendations to address health research capacity issues in LMICs [5]–[8]. However, there is also a nexus of issues specific to HPSR that currently constrains development of the field. This paper builds on the analysis of the previous papers in this series [1],[9] to investigate the practical problems faced and then develops an agenda for building the HPSR field.
- ItemOpen AccessBuilding the field of health policy and systems research: framing the questions(Public Library of Science, 2011) Sheikh, Kabir; Gilson, Lucy; Agyepong, Irene Akua; Hanson, Kara; Ssengooba, Freddie; Bennett, SaraIn the first of a series of articles addressing the current challenges and opportunities for the development of Health Policy & Systems Research (HPSR), Kabir Sheikh and colleagues lay out the main questions vexing the field.
- ItemOpen AccessBuilding the field of health policy and systems research: social science matters(Public Library of Science, 2011) Gilson, Lucy; Hanson, Kara; Sheikh, Kabir; Agyepong, Irene Akua; Ssengooba, Freddie; Bennett, SaraThe first paper in this series on building the field of Health Policy and Systems Research (HPSR) in low- and middle-income countries (LMICs) [1] outlined the scope and questions of the field and highlighted the key challenges and opportunities it is currently facing. This paper examines more closely one key challenge, the risk of disciplinary capture - the imposition of a particular knowledge frame on the field, privileging some questions and methodologies above others. In HPSR the risk of disciplinary capture can be seen in the current methodological critique of the field, with consequences for its status and development (especially when expressed by research leaders). The main criticisms are reported to be: that the context specificity of the research makes generalisation from its findings difficult; lack of sufficiently clear conclusions for policy makers; and questionable quality and rigour [2]. Some critique is certainly warranted and has come from HPS researchers themselves. However, this critique also reflects a clash of knowledge paradigms, between some of those with clinical, biomedical, and epidemiological backgrounds and those with social science backgrounds. Yet, as HPSR is defined by the topics and questions it considers rather than a particular disciplinary approach, it requires engagement across disciplines; indeed, understanding the complexity of health policy and systems demands multi- and inter-disciplinary inquiry [3].
- ItemOpen AccessPeople-centred science: strengthening the practice of health policy and systems research(BioMed Central, 2014-04-17) Sheikh, Kabir; George, Asha; Gilson, LucyHealth policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. Change occurs at many layers of a health system, shaped by social, political, and economic forces, and brought about by different groups of people who make up the system, including service users and communities. The seeds of transformative practice in HPSR lie in amplifying the breadth and depth of dialogue across health system actors in the conduct of research – recognizing that these actors are all generators, sources, and users of knowledge about the system. While building such a dialogic practice, those conducting HPSR must strive to protect the autonomy and integrity of their ideas and actions, and also clearly explain their own positions and the value-basis of their work. We conclude with a set of questions that health policy and systems researchers may wish to consider in making their practice more people-centred, and hence more oriented toward real-world change.