Is “health systems governance” becoming the new buzzword in global health? While an increasing number of academic papers are being published on this theme, each trying to lay down the theoretical and foundational elements of what health systems governance is and what it can possibly mean in practice, ideas such as “good governance” or “governance for UHC” are seemingly entrenching themselves and developing roots in the global health discourse.
But what exactly is governance? In the field of international development, the concept is not new. It has been with us since the late 1980s, when the World Bank first coined it in what they called the “crisis of governance” in many Sub-Saharan African countries. But as many critics would point out, governance is an elusive concept; it can be used to mean everything and nothing.
Amanda Edwards, Anne Mills and Lucy Gilson at the conference in Stockholm, Sweden
It was my enormous privilege to attend the 20th anniversary of the formation of the Alliance for Health Policy and Systems Research (AHPSR). Hosted by the Swedish International Development Cooperation Agency, the conference was attended by a broad range of health policy and systems research (HPSR) stakeholders, including a number of multinational funding agencies and researchers from around the globe.
The event was held in Stockholm, Sweden, where the Alliance was established in 1997. The conference served as an important milestone for the Alliance, allowing the opportunity to reflect on the successes and challenges of the last 20 years, and to develop plans and strategies for meeting the ambitious goals of Agenda 2030 in a global health climate that is increasingly complex and unpredictable.
I was invited to attend the conference as the representative of the writing team awarded first prize in the first AHPSR essay competition on the “Future of Health Policy and Systems Research.” The paper, written in collaboration with fellow students* in the Masters in Public Health at the University of Cape Town, sought to describe the challenges faced by global health policy and systems researchers, and explore the potential and possibilities for the Alliance and the field of HPSR from a Southern perspective. The theme of the essay allowed us to explore issues we felt passionate about, and explicate these issues from our own perspective. Little did we realise that these ideas would resonate so deeply with members of the Alliance. I was invited to present the essay in the opening plenary of the conference, alongside HPSR pioneer, Dame Anne Mills.
In this blog, I offer some personal reflections on the experience, and draw out key issues arising from these two days of intensive, reflexive and engaging debate.
The author (left) and the rest of his project group
The mixed methods approach has only recently been conceptualised, but for decades public health researchers have been combining qualitative and quantitative research methods in their studies. Both qualitative and quantitative methods provide a distinctive kind of evidence. When put together, they can complement each other and generate persuasive evidence that can influence both policy and practice. However, collaboration between qualitative and quantitative researchers can be challenging.