Health systems research in fragile and conflict affected states: a qualitative study of associated challengesReport as inadecuate




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Health Research Policy and Systems

, 15:44

First Online: 07 June 2017Received: 31 October 2016Accepted: 10 May 2017DOI: 10.1186-s12961-017-0204-x

Cite this article as: Martineau, T., Woodward, A., Sheahan, K. et al. Health Res Policy Sys 2017 15: 44. doi:10.1186-s12961-017-0204-x

Abstract

BackgroundHigh quality health systems research HSR in fragile and conflict-affected states FCAS is essential to guiding the policies and programmes that will improve access to health services and, ultimately, health outcomes. Yet, conducting HSR in FCAS is challenging. An understanding of these challenges is essential to tackling them and to supporting research conducted in these complex environments. Led by the Thematic Working Group on Health Systems in FCAS, the primary aim of this study was to develop a research agenda on HSR in FCAS. The secondary aim was to identify the challenges associated with conducting HSR in these contexts. This paper presents these challenges.

MethodsGuided by a purposely-selected steering group, this qualitative study collected respondents’ perspectives through an online survey n = 61 and a group discussion at the Third Global Symposium on HSR in September 2014 n = 11. Respondents with knowledge and-or experience of HSR in FCAS were intentionally recruited.

ResultsOf those ever involved in HSR in FCAS 45-61, 75%, almost all 98% experienced challenges in conducting their research. Challenges fall under three broad thematic areas: 1 lack of appropriate support; 2 complex local research environment, including access constraints, weak local research capacity, collaboration challenges and lack of trust in the research process; and 3 limited research application, including rapidly outdated findings and lack of engagement with the research process and results.

ConclusionsThis study shows that those familiar with HSR in FCAS face many challenges in gaining support for and in conducting and applying high-quality research. There is a need for more sustainable support, including commitment to and long-term funding of HSR in FCAS; investment in capacity building within FCAS to meet the challenges related to implementation of research in these complex environments; relationship and trust building among stakeholders involved in HSR, particularly between local and international researchers and between researchers and participants; and innovative and flexible approaches to research design and implementation in these insecure and rapidly changing contexts.

KeywordsHealth systems research Challenges Fragile states Conflict-affected states AbbreviationsFCASfragile and conflict-affected states

HSRhealth systems research

NGOnon-governmental organisation

TWGThematic Working Group

Electronic supplementary materialThe online version of this article doi:10.1186-s12961-017-0204-x contains supplementary material, which is available to authorized users.





Author: Tim Martineau - Aniek Woodward - Kate Sheahan - Egbert Sondorp

Source: https://link.springer.com/







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