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Progress

Health systems researchers are the type of people that want to solve problems. Often, they have a vision of a better world and this inspires them in their work. The values that guide them might include social justice, the reduction of inequities, or improvements in wellbeing. 

Creating more healthy societies is about more than the fixing of a particular illness – it is about transformation, revolution, and seismic change. Working together is an opportunity to profoundly re-organise the way health systems work which can impact upon the societies that they serve.

Many of the resources in this section consider how we should decide which research areas are a priority by assessing their relative benefits. For example, the blog (2016) and paper by Benatar (2017) challenge health researchers consider economic, cultural and political systems in their work and link it to planetary health and ecological systems as a catalyst for positive change.

The paper by Barsdorf and Millum (2017) advances the idea that ethical health research should focus on those most effected by ill-health and those interventions which would benefit the largest number of people. We have included a paper by van de Pas et al. (2017) which explores whether the recent drive for health systems ‘resilience’ takes us nearer or further away from an approach that prioritises equity, global solidarity and justice.

Pratt (2014) suggests that health systems researchers’ efforts to take an equitable approach are hampered by the need to meet global targets that may not align with local need and a one-size-fits all approach to capacity development. This argument is advanced and elaborated on in paper by Pratt and Hyder (2015).

Pratt et al.’s (2015) review of 104 researchers to assess how equity orientated their practice in low- and middle-income countries suggests that there is room for improvement, particularly in terms of the selection of populations upon whom to focus studies. Also included in the resources is Pratt and Hyder’s (2017) assessment of the Maternal and Neonatal Implementation for Equitable Health Systems (Manifest) project and its relation to “research for health justice”.

The editors of the special section of the Health and Human Rights Journal highlight that the dynamics of global health fieldwork and the nature of the relationships that emerge through it have been conspicuously under-explored in global health scholarship. Their focus is on the ways in which participants interact and experience the work of global health. It is an effort to shed light on some of the ethical challenges of fieldwork and to explore terrain that might lead to practical ethical guidance for global health fieldworkers. The articles present a wide array of global health fieldwork ethics challenges, which powerfully illustrate the ways in which global health has not adequately addressed on-the-ground ethics, as well as point to important points of entry to improve our ethical practices and to develop clear guidance and support for fieldworkers in global health.

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