A man presenting to a room full of people

The 1st Global
Symposium on
Health Systems

Montreux, Switzerland
16-19 November 2010

Three people sat at a table as a man speaks to them

Take a look back at HSR2010

Science to Accelerate Universal Health Coverage

Executive summary

The 1st Global Symposium in Montreux has played a crucial, catalytic role in convening a global community dedicated to strengthening health systems and building the field of health systems research.

The 1st Global Symposium on Health Systems Research was organized as the result of a growing awareness among politicians, policy-makers, healthcare providers and researchers that the evidence base to support the theory and practice of strengthening health systems is not strong, especially in low-and middle-income countries. Moreover, the scientific foundations for this type of research are in need of significant development and improvement. The Symposium was dedicated to improving the scientific evidence needed by health policy-makers and practitioners to inform their decisions related to accelerating universal health coverage.

The Montreux Symposium attracted over 1,200 participants from more than 100 countries and produced a clear message about what, how and why health systems research should be strengthened to contribute to universal health coverage.

The specific objectives of the Symposium were to:

  • Share state-of-the art research on universal health coverage
  • Develop a global agenda of priority research on accelerating progress towards universal health coverage
  • Facilitate greater research collaboration and learning communities across disciplines, sectors, initiatives and countries
  • Strengthen the scientific rigor of the field of health systems research, including concepts, frameworks, measures and methods
  • Identify mechanisms for strengthening capacities – individual, institutional and infrastructural – for research on health systems, particularly in low- and middle-income countries.

One year later, comments from members on anything that can be improved from the last Symposium, relating to the organization of the Symposium? (for example, registration, catering, on-site assistance, scheduling, timing)

  • 5 out of 10 said the Symposium was logistically very well organized. 1 out of 10 stated it was difficult to register for the conference as a group
  • “You had areas where people could meet but it was a little too spread out to be able to move about from one part of the Symposium to another.”
  • “Have people develop action plans or key areas that need to be followed so that subsequently people can report back on what has been done. There could have been some commissioned actions that could have been done by regions which could then have been reported back to the next conference, otherwise it just becomes a convening. I think selecting a few countries to be test points to follow up on some critical areas that need global attention for research and having those places be where things are done – I think that can be a wonderful way in shaping up the conference.”
  • “What I missed was the third world practical approach. There are many things that are quite revolutionary and I felt that the actual thinking of the symposium was dominated by people in big universities and big systems in North America and Europe, that the only significant contribution that was made from Africa was from South Africa.”
  • “The lessons that can be learned from first world countries were not presented, especially the lessons from France, Britain, etc. These were not presented from health systems problems – skills drain, limiting resources, growing cost, clinical effectiveness, priority setting, where there are things can be learned from the third world. India is generating so many ideas, and quite often the US. For example, [a speaker from the London School of Hygiene and Tropical Medicine (LSHTM)] is sitting there talking about issues in third world countries, when LSHTM does so much work in London. They should talk about that. This is very true of South Africa. Look at comparisons between Britain and South Africa, that would be much more realistic and exciting. I don’t appreciate being told what to do by people who are not here.”
  • “There seemed to be a bit of a problem with the speaker at the dinner – an awful lot of heckling towards him. I found him interesting but some people didn’t like it because he wasn’t from a public health background, and his talk was clearly one that was given elsewhere so it really didn’t connect clearly enough with him, especially when he was introduced as a surgeon. There was quite a lot of background noise. A lot of what he said was relevant but wasn’t connecting at the conference. I don’t think after a hard day people were willing to connect.
  • 1 out of 10 said they did not enjoy sessions where people giving the presentations were not from the topic country or region: “For example I know the system in Djibouti, Cote D’Ivoire. I remember a presentation on financing and health services in that country without involving some people from that country – it’s not so easy to give recommendations, even if someone has worked for a long time in that country.” 1 out of 10 said they became more convinced as to the importance of health systems work: “By listening to various speakers I became more convinced as to its importance. I was previously critical of the fluffiness of health systems research and it became much more real to me.” 2 out of 10 mentioned going back to the website to use presentations and reports in their work
  • 3 out of 10 said it reinforced their strategies in health systems research 2 out of 10 said it redirected some of their research work
  • 7 out of 10 people conducted health systems research. 7 out of 10 people said the Symposium impacted their research in some way
  • 8 out of 10 people were involved in training researchers or supporting their training
  • 7 out of 10 people thought the Symposium impacted their teaching and training
  • “Some interesting approaches put forward that I hadn’t come across, particularly related to TB, models for international transfers of programs. Particularly related to global programs and national health systems research.”
  • “I use some new concepts and new vision on some aspects of financing and health coverage [in my teaching]- the symposium synthesizes the state of art of health examples.”
  • “The Symposium brought us a knowledge platform, although the methodological stream of the symposium for next year could be even stronger than it was in Montreux.”
  • 1 out of 10 stated there was quite reasonable attendance from people in developing countries and to continue supporting researchers from developing countries to attend
  • 2 out of 10 delegates wanted more focus to the theme of the Symposium
  • 1 out of 10 delegates said that two projectors were necessary to show some PowerPoint presentations adequately in teaching post Symposium, and for a resource-poor setting this was unfeasible.