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The symposium, held from September 30th through October 3rd, addressed the for (a) need universal health care and strengthening health systems, (b) relevant research topics and methods and, (c) knowledge networks and learning. The Global Health Systems Global Thematic Working Groups (TWG) with over 1500 members from more than 90 countries will take the recommendations forward.
2000 participants, including policy-makers, activists, community representatives, managers, researchers and educators from 125 countries shared new information and insights from their experiences with the journey to universal health coverage (UHC), and developed a deeper understanding of people-centered health systems.
Health systems need to respond to people’s emerging health needs, be directly accountable to ordinary people, and respect and ensure the rights and dignity of all people who use health systems and provide health care. UHC should be led by citizens, and local and national governments in line with the needs and priorities of communities and citizens. Multiple disease programs, types of service providers and traditions of health care require effective coordination within health systems.
Community health workers can play an important linking role in enabling inclusive and representative community participation. We need to promote local institutional mechanisms that support inclusive and representative community participation in health. Supportive supervision and high quality, continuing training for health care workers emerged as crucial needs across settings. Supportive and effective working environments for health workers are important, which should include appropriate financial and non-financial incentives. Barriers to access to care must be removed, including financial barriers that exclude the poorest and most marginalized. Governments need to provide sufficient funding for the provision of effective and responsive care, and develop effective financial protection measures.
The following recommendations were made:
Health System Development:
- Promote community participation in planning and monitoring health services, to make them more responsive to people’s needs
- Ensure research is embedded in programs from the point of design
- Promote innovative service-delivery models, including the use of m-health and e-health to ensure quality and continuity of care
- Address inequities in the availability of health systems research training, and expand efforts to strengthen teaching for health systems development and research.
Research topics and methods:
- Promote understanding of civil society and social movements that support people-centeredness
- Further develop our understanding of health workers, particularly mid-level health workers, their felt experiences and how to empower them to provide people-centered health services
- Allow the experience of communities and health workers to be heard, through use of innovative research methods that engage and empower communities including participatory action research, photo-voice, simulations and games
- Understanding scaling-up of health programs in different contexts remains a priority research area
Knowledge networks and learning:
- Build our communities through bringing together diverse groups including policy-makers, activists, community representatives, managers, researchers and educators
- Develop skills to communicate about health systems amongst diverse constituencies
- Journals need to create space for people-centered knowledge and other innovative forms of health systems research
- Promote learning from implementation and capture tacit knowledge
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