The Long and Winding Road: Partnerships, Self-Reliance, and the Path Forward

By Brittany Iskarpatyoti, MPH, MEASURE Evaluation

LIVERPOOL, ENGLAND—It’s a wrap! The Global Health Systems Research (HSR) Symposium 2018 has officially ended. Posters have been taken down, booths have been packed up, delegates have flown back home—and now the real work happens.

But what is the path forward? In the final plenary session, the new Health Services Global Chair, Asha George, underlined the need to recommit to ensuring health for all, and to bring this spirit forward into current debates and action on the Sustainable Development Goals. (You can read the full statement here). Her thesis had a fundamental point: “We see silos and parallel conversations dividing the terrain into sectors, disciplinary perspectives, and groups—between North and South, practitioners and researchers, technical versus relational approaches. . . . We must nurture our brokers and bridge builders.”  

She discussed multisectoral action, private-public partnerships, and aligning health and market forces. These concepts were not hers alone. The idea of expanding beyond approaches strictly for public health was ubiquitous at this year’s conference. Multisectoral action enables approaches that address underlying determinants of health and their interactions. Sessions were held throughout the week on engagement with sectors such as education, agriculture, and finance. As this rhetoric is turned to action, it is important we match complex approaches with methods that are appropriate for understanding how interventions interact to ensure positive outcomes. It also requires information systems that are integrated and interoperable for joint decision making.  

Additionally, as we reorient the way aid is delivered to emphasize self-reliance, more conversations arise about diversified approaches. More than 50 percent of outpatient visits in low- and middle-income countries are to private providers. Acknowledging this, HSR included “engaging the private sector” as a subtheme. Private sector participation in health can bring new technologies, access to services where the public sector is lacking, and additional investment resources. However, it is healthy to scrutinize the role and interest the private sector has in public health. We need more information on who visits these services and the outcomes to understand who is and is not included in private public health efforts.

Conferences are always buzzing with possibilities and new connections. The desire to work together always seems strongest in these contexts; but this is not a sprint. This is a marathon down a long and winding road. 

The ACC in Liverpool—site of the Global Health Systems Research (HSR) Symposium 2018