Why Health Systems Research?
Research on various aspects of medicine and public health from a systems perspective is health systems researchs. Systems perspective is the key here. A health systems perspective in research analyzes medicine and public health as interconnected, dynamic and complex systems underlying medical and health care experience of a society and contributing to population health status. It bridges clinical care with population-based interventions, focusing on systems thinking to improve health outcomes, equity, and service delivery by analyzing how various factors—actors, institutions, and technologies—interact. Health Systems Research often involves multiple disciplines, requires an interdisciplinary outlook and is application-oriented. There is a subtle difference between 'health care systems' and 'health systems'. Health care systems usually refer to the system of medical and health service provision. Health systems mean the whole of systems, policies and context to health and hence, includes health care systems.
Health Systems Research (HSR) focuses on improving how health systems are organized, financed, and managed to achieve better health outcomes, equity, and efficiency. Key areas include health policy analysis, priority setting, comparative study of national health systems, health systems assessment, vital statistics, epidemiology, health status measurement, health state valuations, demographics, burden of disease, health economics, health care financing, health seeking behaviour, human resources for health, social determinants of health, health informatics, health service delivery, translation & implementation research, healthcare systems performance assessment, and the evaluation of health policies and implementations.
Health Systems Research Work at IHS.
Community-based Management of Acute Malnutrition (CMAM) - Cohort Study.
Acute malnutrition remains one of the leading causes of under-five morbidity and mortality in India. The Community-based Management of Acute Malnutrition (CMAM) approach seeks to institutionalize a continuum of care for addressing severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). It achieves this by leveraging a combined protocol for acute malnutrition through both community- and facility-based approaches within the healthcare system. This model unifies the treatment protocol for children with uncomplicated SAM and MAM in line with the recent CMAM/AMMA protocol released by the Government of India (GOI), adopting simplified diagnostic criteria based on growth monitoring (height and weight) and energy-dense nutrient food (EDNF) supplementation.
Although the approach has been widely adopted, district-level evidence on what happens after a child enters treatment—including recovery rates, time to recovery, relapse, non-response, and mortality—remains limited. This gap constrains efforts to optimize CMAM delivery. This longitudinal cohort study is designed to identify and enroll children with SAM and MAM in close coordination with Anganwadi Centres (AWCs), ensure they receive designed nutrition intervention services, and monitor and follow up with study participants to assess the impact of the CMAM program.
Estimating National Burden of Disease:
World-wide interest in summary measures of population health and descriptive epidemiology intensified following the publication of the Global Burden of Disease (GBD) results in the World Development Report 1993. Subsequently, The World Health Organisation (WHO) launched a Global Program on Evidence and Information for Health Policy. The IHS has been associated with the GBD studies right from the inception of these studies at the Harvard Burden of Disease Unit. The AP Burden of Disease (APBD) study was one of the first National Burden of Disease (NBD) studies taken up after publication of the GBD 1993 report. The APBD study started at the IHS in 1994 in collaboration with the Administrative Staff College of India. Subsequently the study moved in 1997 to the IHS full time. The APBD study focused on the issue of anchoring of NBD estimates to local data. Accordingly, it engendered a suite of related studies, for example, the community-based health state valuation study and the cause of death studies described elsewhere.
Several other studies contributed to the burden of disease estimate, including the following:
- Cause of Deaths Statistics for National Burden of Disease Study
- Health State Valuation Study
- Descriptive epidemiology of Tuberculosis
Results of the AP Burden of Disease study was published in 2001.