Lenses and levels: the why, what and how of measuring health system drivers of women’s, children’s and adolescents’ health with a governance focus

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dc.contributor.authorGeorge, Asha
dc.contributor.authorLeFevre, Amnesty Elizabeth
dc.contributor.authorJacobs, Tanya
dc.contributor.authorKinney, Mary
dc.contributor.authorBuse, Kent
dc.contributor.authorChopra, Mickey
dc.contributor.authorDaelmans, Bernadette
dc.contributor.authorHaakenstad, Annie
dc.contributor.authorHuicho, Luis
dc.contributor.authorKhosla, Rajat
dc.contributor.authorRasanathan, Kumanan
dc.contributor.authorSanders, David
dc.contributor.authorSingh, Neha S
dc.contributor.authorTiffin, Nicki
dc.contributor.authorVed, Rajani
dc.contributor.authorZaidi, Shehla Abbas
dc.contributor.authorSchneider, Helen
dc.date.accessioned2019-07-02T08:12:11Z
dc.date.available2019-07-02T08:12:11Z
dc.date.issued2019
dc.description.abstractHealth systems are critical for health outcomes as they underpin intervention coverage and quality, promote users’ rights and intervene on the social determinants of health. Governance is essential for health system endeavours as it mobilises and coordinates a multiplicity of actors and interests to realise common goals. The inherently social, political and contextualised nature of governance, and health systems more broadly, has implications for measurement, including how the health of women, children and adolescents health is viewed and assessed, and for whom. Three common lenses, each with their own views of power dynamics in policy and programme implementation, include a service delivery lens aimed at scaling effective interventions, a societal lens oriented to empowering people with rights to effect change and a systems lens concerned with creating enabling environments for adaptive learning. We illustrate the implications of each lens for the why, what and how of measuring health system drivers across micro, meso and macro health systems levels, through three examples (digital health, maternal and perinatal death surveillance and review, and multisectoral action for adolescent health). Appreciating these underpinnings of measuring health systems and governance drivers of the health of women, children and adolescents is essential for a holistic learning and action agenda that engages a wider range of stakeholders, which includes, but also goes beyond, indicator-based measurement. Without a broadening of approaches to measurement and the types of research partnerships involved, continued investments in the health of women, children and adolescents will fall short.en_US
dc.identifier.citationGeorge A, LeFevre AE, Jacobs T, et al Lenses and levels: the why, what and how of measuring health system drivers of women’s, children’s and adolescents’ health with a governance focus BMJ Global Health 2019;4:e001316.en_US
dc.identifier.issn2059-7908
dc.identifier.uridoi:10.1136/ bmjgh-2018-001316
dc.identifier.urihttp://hdl.handle.net/10566/4686
dc.language.isoenen_US
dc.publisherBMJen_US
dc.subjectHealth system driversen_US
dc.subjectGovernanceen_US
dc.subjectSocietal lensen_US
dc.subjectService delivery lensen_US
dc.subjectSystems lensen_US
dc.titleLenses and levels: the why, what and how of measuring health system drivers of women’s, children’s and adolescents’ health with a governance focusen_US
dc.typeArticleen_US

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