Defining global health: findings from a systematic review and thematic analysis of the literature

Abstract

IntroductionDebate around a common definition of global health has seen extensive scholarly interest within the last two decades; however, consensus around a precise definition remains elusive. The objective of this study was to systematically review definitions of global health in the literature and offer grounded theoretical insights into what might be seen as relevant for establishing a common definition of global health.MethodA systematic review was conducted with qualitative synthesis of findings using peer-reviewed literature from key databases. Publications were identified by the keywords of ‘global health’ and ‘define’ or ‘definition’ or ‘defining’. Coding methods were used for qualitative analysis to identify recurring themes in definitions of global health published between 2009 and 2019.ResultsThe search resulted in 1363 publications, of which 78 were included. Qualitative analysis of the data generated four theoretical categories and associated subthemes delineating key aspects of global health. These included: (1) global health is a multiplex approach to worldwide health improvement taught and pursued at research institutions; (2) global health is an ethically oriented initiative that is guided by justice principles; (3) global health is a mode of governance that yields influence through problem identification, political decision-making, as well as the allocation and exchange of resources across borders and (4) global health is a vague yet versatile concept with multiple meanings, historical antecedents and an emergent future.ConclusionExtant definitions of global health can be categorised thematically to designate areas of importance for stakeholders and to organise future debates on its definition. Future contributions to this debate may consider shifting from questioning the abstract ‘what’ of global health towards more pragmatic and reflexive questions about ‘who’ defines global health and towards what ends.

Twenty-First Century Global ADR Management: A Need for Clarification, Redesign, and Coordinated Action

“…In order to consider the wider impact of medications in various areas (including society and economics), a novel paradigm of drug risk management relating directly to public health is needed. For such purpose, the definition of Global Public Health may be useful: “Global health emphasis transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population-based prevention with individual-level clinical care.” [ 25 ] Global Public Health needs to encompass medicines risk management strategies and tactics as part of a more inclusive interdisciplinary approach. Tools, such as indicators for assessing the global impact of identified and validated side effects within a more defined parameters (nation, region, etc.)…”

What is Global Health Equity? A Proposed Definition

“…Terminology describing global health activities has changed and expanded over past decades as our values in this space have changed [ 1 ]. Early on, tropical medicine focused on maintaining a labor force in the colonial tropics.…”

The challenges of defining global health research

“…[3][4][5][6] In a recent article published in BMJ Global Health, Salm et al reported a comprehensive systematic review and thematic analysis of the definitions of global health over an 11-year period. 7 They found that most definitions of global health in the articles meeting their inclusion criteria fell within one of the following four main themes: (1) a multiplex approach to worldwide health improvement taught and pursued through research institutions; (2) an ethical initiative that is guided by justice principles; (3) a form of governance that yields national, international, translational and supranational influence through political decision making, problem identification and allocation and exchange of resources across borders and (4) a polysemous concept with historical antecedents and emergent future. 7 Salm et al conclude that 'global health' means many different things, and the definitions are conditioned by who makes them and the purpose and target recipients of its practice or research.…”

“…7 They found that most definitions of global health in the articles meeting their inclusion criteria fell within one of the following four main themes: (1) a multiplex approach to worldwide health improvement taught and pursued through research institutions; (2) an ethical initiative that is guided by justice principles; (3) a form of governance that yields national, international, translational and supranational influence through political decision making, problem identification and allocation and exchange of resources across borders and (4) a polysemous concept with historical antecedents and emergent future. 7 Salm et al conclude that 'global health' means many different things, and the definitions are conditioned by who makes them and the purpose and target recipients of its practice or research. They propose that global health could be defined as 'an area of research and practice committed to the application of overtly multidisciplinary, multisectoral and culturally sensitive approached for reducing health disparities that transcend national borders'.…”

“…They propose that global health could be defined as 'an area of research and practice committed to the application of overtly multidisciplinary, multisectoral and culturally sensitive approached for reducing health disparities that transcend national borders'. 7 On the 'what': the quest for equity in health within nations and among nations should be what drives research efforts in global health. The structural determinants of health underpin disparities in health worldwide-whether between or within nations.…”