Building health research systems: WHO is generating global perspectives, and who’s celebrating national successes?

Abstract

In 2016, England’s National Institute for Health Research (NIHR) celebrated its tenth anniversary as an innovative national health research system with a focus on meeting patients’ needs. This provides a good opportunity to reflect on how the creation of the NIHR has greatly enhanced important work, started in 1991, to develop a health research system in England that is embedded in the National Health Service.In 2004, WHO identified a range of functions that a national health research system should undertake to improve the health of populations. Health Research Policy and Systems (HRPS) has taken particular interest in the pioneering developments in the English health research system, where the comprehensive approach has covered most, if not all, of the functions identified by WHO. Furthermore, several significant recent developments in thinking about health research are relevant for the NIHR and have informed accounts of its achievements. These include recognition of the need to combat waste in health research, which had been identified as a global problem in successive papers in the Lancet, and an increasing emphasis on demonstrating impact. Here, pioneering evaluation of United Kingdom research, conducted through the impact case studies of the Research Excellence Framework, is particularly important. Analyses informed by these and other approaches identified many aspects of NIHR’s progress in combating waste, building and sustaining research capacity, creating centres of research excellence linked to leading healthcare institutions, developing research networks, involving patients and others in identifying research needs, and producing and adopting research findings that are improving health outcomes.The NIHR’s overall success, and an analysis of the remaining problems, might have lessons for other systems, notwithstanding important advances in many countries, as described in papers in HRPS and elsewhere. WHO’s recently established Global Observatory for Health Research and Development provides an opportunity to promote some of these lessons. To inform its work, the Observatory is sponsoring a thematic series of papers in HRPS focusing on health research issues such as funding flows, priority setting, capacity building, utilisation and equity. While important papers on these have been published, this series is still open to new submissions.

A call for action to establish a research agenda for building a future health workforce in Europe

“…These gaps hamper the opportunities of advising policy-makers on how to develop and govern a health workforce that is both quantitatively and qualitatively able to support the needs and demands being made on health systems as well as to implement policy reforms that allow health system performance and sustainability to improve. If we agree that there is ‘no health without a workforce’ [ 13 ], then the next step must be to close these knowledge gaps and advance problem-oriented research [ 21 , 88 ]. The occupational structure of healthcare is inherently conservative, but various opportunities for change are currently emerging, among others, in the education systems, more integrated service and people-centred (persons, patients, users, populations) delivery models, new technologies, and new emergent roles of professional groups [ 9 – 11 , 26 , 44 , 83 , 89 , 90 ].…”

Understanding the concept and importance of the health research system in Palestine: a qualitative study

“…The importance of the system is fully appreciated by most of the experts as a major gain, while neglecting it is recognised as a great loss. However, the goals and functions of the system, as delineated [ 4 , 8 , 18 ], were sufficiently recognised. Moreover, the concept of HRS correlates with improvement approaches [ 9 ], where most respondents linked HRS to developmental ideas (e.g.…”

“…The concept has undergone numerous refinements, including the development of a conceptual framework for National Health Research Systems (NHRSs) [ 5 ] in an attempt to correct the 10/90 gap, whereby less than 10% of global research funds are devoted to diseases that account for 90% of the global disease burden [ 6 , 7 ]. In addition to establishing the Global Forum for HR to address HR gaps [ 6 ], WHO launched an HR strategy focusing on HR culture, priorities, capacity, standards and translation [ 3 , 8 ].…”

Governance of health research funding institutions: an integrated conceptual framework and actionable functions of governance

“…number of highly cited papers), impact on healthcare quality, health status or the economic value of patented products (i.e. new devices) [3], and public engagement [4][5][6]. While there is no international consensus on the best indicators for health research [7], and there are limitations inherent to its metrics (time, attribution, etc.…”