Article type
Year
Abstract
Background: The Alliance for Health Policy and Systems Research recently funded a two-year initiative in South Africa to conduct four systematic reviews on health systems questions. Central to the initiative was engagement with stakeholders to identify and select priority review questions. While the priority setting process was rich and very broad, these broad questions were not always easily translated into questions that could be addressed by a review with limited budget and timeframes.
Objective: To share lessons learned in turning a broad health systems policy priority question about effective accountability interventions, into a pragmatic systematic review question.
Results: Through the process of stakeholder engagement 39 priority review questions were shortlisted. The four highest-ranking questions for which no published or ongoing review existed were selected for further investigation. One of these questions focused on the effectiveness of interventions to improve the accountability of public sector health personnel and management. While enhanced accountability is important to policy makers and managers, we soon realised the broad and abstract nature of this concept raised challenges in relation to definition, operationalisation and measurement. Through a process of literature review, consultation and discussion we explored the components of accountability, and how it might be operationalised within the health system. This process led us to shift our focus to health systems performance monitoring, as a proxy measure of accountability. The result was a revised review question on the effectiveness of interventions to improve health information systems. Improved health information systems are an essential tool for measuring progress and accountability and for filtering information for better decision-making.
Conclusion: Policy priorities as articulated by stakeholders may not be easily translated into systematic review questions. Thus flexibility and ongoing dialogue are required between researchers and policy stakeholders when identifying health systems systematic review topics collaboratively.
Objective: To share lessons learned in turning a broad health systems policy priority question about effective accountability interventions, into a pragmatic systematic review question.
Results: Through the process of stakeholder engagement 39 priority review questions were shortlisted. The four highest-ranking questions for which no published or ongoing review existed were selected for further investigation. One of these questions focused on the effectiveness of interventions to improve the accountability of public sector health personnel and management. While enhanced accountability is important to policy makers and managers, we soon realised the broad and abstract nature of this concept raised challenges in relation to definition, operationalisation and measurement. Through a process of literature review, consultation and discussion we explored the components of accountability, and how it might be operationalised within the health system. This process led us to shift our focus to health systems performance monitoring, as a proxy measure of accountability. The result was a revised review question on the effectiveness of interventions to improve health information systems. Improved health information systems are an essential tool for measuring progress and accountability and for filtering information for better decision-making.
Conclusion: Policy priorities as articulated by stakeholders may not be easily translated into systematic review questions. Thus flexibility and ongoing dialogue are required between researchers and policy stakeholders when identifying health systems systematic review topics collaboratively.