Action learning for health system governance : the reward and challenge of co-production
Date
2014
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Publisher
Oxford University Press
Abstract
Health policy and systems research (HPSR) is centrally concerned with people,
their relationships and the actions and practices they can implement towards
better health systems. These concerns suggest that HPS researchers must work
in direct engagement with the practitioners and practice central to the inquiry,
acknowledging their tacit knowledge and drawing it into generating new
insights into health system functioning. Social science perspectives are of
particular importance in this field because health policies and health systems are
themselves social and political constructs. However, how can social science
methodologies such as action research and narrative and appreciative enquiry
enable such research, and how can methodologies from different disciplines be
woven together to construct and make meaning of evidence for ‘this’ field?
This article seeks to present ‘methodological musings’ on these points, to prompt
wider discussion on the practice of HPSR. It draws on one long-term
collaborative action learning research project being undertaken in Cape Town,
South Africa. The District Innovation and Action Learning for Health System
Development project is an action research partnership between two South
African academic institutions and two health authorities focused, ultimately, on
strengthening governance in primary health care.
Drawing on this experience, the article considers three interrelated issues:
The diversity and complexities of practitioner and research actors involved in
co-producing HPSR;
The nature of co-production and the importance of providing space to grapple
across different systems of meaning;
The character of evidence and data in co-production.
There is much to be learnt from research traditions outside the health sector, but
HPSR must work out its own practices—through collaboration and innovation
among researchers and practitioners. In this article, we provide one set of
experiences to prompt wider reflection and stimulate engagement on the
practice of HPSR for people-centred health systems.
Description
Co-published with The London School of Hygiene and Tropical Medicine
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Journal Article (peer-reviewed)
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Keywords
HEALTH SYSTEM, HEALTH POLICY, RESEARCH CAPACITY, METHODOLOGY, GOVERNANCE, DATA ANALYSIS, RESEARCH METHODS, SYSTEMS ANALYSIS
Citation
Lehmann, U., & Gilson, L. (2014). Action learning for health system governance: the reward and challenge of co-production. Health Policy and Planning:1-7. doi:10.1093/heapol/czu097