Future Health Systems: Making Health Systems Work for the Poor

At a time of unprecedented worldwide focus on health, a Research Programme Consortium(RPC) in the theme of Health Systems, Economics and Financing, of seven organizations from developing and developed countries has been formed. The RPC is supported by Dfid. The consortium wants to ensure that real health gains for the poor are achieved. Through research and partnership, the members of the consortium want to inform and influence the health systems of the future in Nigeria, India, Uganda, Bangladesh, China and Afghanistan. The endeavours will be innovative, future looking and tackle health problems with new ideas. This consortium will focus on meeting the future health needs of the poor and vulnerable in developing countries by thinking differently about poverty.

The principal outcomes of interventions that the RPC members propose to research are: improved benefit-incidence in targeting of health services; increased equity in the use of health services, higher quality of both public and private health services; improved financial protection; better information around diseases and treatments that disproportionately affect the poor; strengthened public sector capacity to enter into regulatory and contractual arrangements with private sector providers; and improved local political processes and involvement of civil society to protect the interests of the poor in health.

The RPC will emphasise influencing policies and practices. The country teams will involve policy-makers, managers and other stakeholders from the very beginning and they will include dissemination in the study design. The net result is to ensure that health sector and development initiatives serve disadvantaged groups – a key to reducing poverty and achieving the MDGs.

Bangladesh Programme

At the initial phase, the Bangladesh programme will work in a remote upazila (sub-district), Chakaria, in the southeast part of the country. This area has been one of the low performing areas in terms of health and development indicators. The first phase activities are devoted to analysis of stakeholders, institutions, and assessment of programmatic risk. In addition, an analysis of the existing health systems also has been carried out during the first phase. Based on the findings from the first phase activities, interventions to make the health systems work for the poor will be developed and evaluated.

Since influencing policies and practices is a very important goal, policy-makers, managers and other stakeholders are being involved from the very beginning. Advocacy is a key element in influencing policy and therefore dissemination has also been included in the study design. The findings and research methods will also be integrated into teaching courses run by partner institutions, and the results will be published in local and international scientific journals. The net result will be to ensure that health sector and development initiatives serve disadvantaged groups – a key to reducing poverty and achieving the MDGs.