Recommended Reading

Western Cape Province HPSR Journal Club

CHESAI also includes activities such as seminars and journal clubs which provide space for reflection and the exchange of information. Of particular importance has been the Western Cape Province HPSR Journal Club which aims to create a space for debate and reflection, for collaboration and conversation, between local health systems practitioners and researchers. At the Club shared areas of interest are discussed in the context of current research papers. It is attended by colleagues from the five HPSR research institutions in Cape Town, as well as senior- and middle-level managers and policy makers from the provincial and municipal departments of health.

Starting in 2013 the HPSR Journal Club meets on a regular basis and the papers presented by both academics and practitioners cover topics such as systems change, maternal health, leadership, organisational culture, practice-research engagement, policy implementation, community accountability and quality of care. With a mailing list of close to a hundred people, the journal club is regularly attended by approximately 20 participants. It has been identified as a space of collaborative thinking, which has created important spin-offs and ideas for policy development and implementation.

“Not Just a Journal Club – It’s Where the Magic Happens”: Knowledge Mobilization through Co-Production for Health System Development in the Western Cape Province, South Africa

Building the field of HPSR

  • Sheikh et al. (2011) Building the Field of Health Policy and Systems Research: Framing the Questions. PLoS Med 8(8): e1001073. doi:10.1371/journal.pmed.1001073 [Open Access Download]
  • Gilson et al. (2011) Building the Field of Health Policy and Systems Research: Social Science Matters. PLoS Med 8(8): e1001079. doi:10.1371/journal.pmed.1001079 [Open Access Download]
  • Bennett et al. (2011) Building the Field of Health Policy and Systems Research: An Agenda for Action. PLoS Med 8(8): e1001081. doi:10.1371/journal.pmed.1001081 [Open Access Download]

Community accountability

  • Cleary et al (2013). "Resources, attitudes and culture: an understanding of the factors that influence the functioning of accountability mechanisms in primary health care settings." BMC Health Services Research 13(1): 1-11. DOI:10.1186/1472-6963-13-320 [Open Access Download]
  • Maluka et al (2011). Implementing accountability for reasonableness framework at district level in Tanzania: a realist Evaluation. Implementation Science 6:11.

Community engagement

  • Botes and Van Rensburg (2000). Community Participation in development: nine plagues and twelve commandments. Community Development Journal 35: 41-58.
  • Cornwall and Leach (2010). Putting the politics back into ‘public engagement’: participation, mobilization, and citizenships in the shaping of health services. Brighton: IDS

Evidence to practice

  • Oliver, Lorenc and Innvaer (2014). New directions in evidence-based policy research: a critical analysis of the literature. Health research policy and systems 12: 34.
  • El Jardali et al (2014). Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries. Health Policy Management 3: 399-407.

Health system responsiveness

  • Fredriksson, M. & Tritter, J.Q. (2017). Disentangling patient and public involvement in healthcare decisions: why the difference matters. Sociology of Health and Illness 39(1): 95-111 [View]
  • Lodenstein, E., Dieleman,M., Gerretsen, B. & Broerse, J.E.W. (2017). Health provider responsiveness to social accountability initiatives in low- and middle-income countries: a realist review. Health Policy and Planning32(1): 125-140 [View]
  • Navarro, V. (2001). The new conventional wisdom: An evaluation of the WHO report Health Systems: Improving Performance. International Journal of Health Services 31(1): 23–33 [View]

Health systems leadership

Health systems resilience

  • Kruk, M. E., M. Myers, S. T. Varpilah and B. T. Dahn. (2015). "What is a resilient health system? Lessons from Ebola." The Lancet 385(9980): 1910-1912. DOI:
  • Thomas, S., C. Keegan, S. Barry, R. Layte, M. Jowett and C. Normand. (2013). "A framework for assessing health system resilience in an economic crisis: Ireland as a test case." BMC Health Services Research 13(1): 1-8.
  • Lengnick-Hall, C. A., T. E. Beck and M. L. Lengnick-Hall. (2011). "Developing a capacity for organizational resilience through strategic human resource management." Human Resource Management Review 21(3): 243-255.   doi:10.1016/j.hrmr.2010.07.001

Health systems transformation

  • Best et al. (2012). Large system transformation in health care: A Realist Review. The Milbank Quarterly (90) 3: 421–456. [Open Access Download]
  • Ortiz Aragon (2010). A case for surfacing theories of change for purposeful organisational capacity development. IDS Bulletin (41) 36-46. http://doi: 10.1111/j.1759-5436.2010.00135.x

History, time and sequencing in HPSR

  • Goetz K.H. & Meyer-Sahling J.-H. (2009). "Political time in the EU: dimensions, perspectives, theories." Journal of European Public Policy 16(2): 180-201. [View]
  • Grundy J., Hoban E., Allender S. & Annear P. (2014). "The inter-section of political history and health policy in Asia – The historical foundations for health policy analysis." Social Science & Medicine 117: 150-159. [View]
  • Luboga S.A., Stover B., Lim T.W., Makumbi F., Kiwanuka N., Lubega F., Ndizihiwe A., Mukooyo E., Hurley E.K., Borse N., Wood A., Bernhardt J., Lohman N., Sheppard L., Barnhart S. & Hagopian A. (2016). "Did PEPFAR investments result in health system strengthening? A retrospective longitudinal study measuring non-HIV health service utilization at the district level." Health Policy and Planning, DOI: 10.1093/heapol/czw009. [View]
  • Marks S. (1997). "What is colonial about colonial medicine? And what has happened to imperialism and health?" Social History of Medicine 10(2): 205-219. [View]
  • Pettigrew A.M. (1990). "Longitudinal field research on change: Theory and practice." Organization science 1(3): 267-292. [View]

HPSR Reference Materials

Health Policy and Systems Research – A Methodology Reader

This Reader aims to provide a basis of understanding, ideas and experience to strengthen the quality of HPSR – including a collection of high quality papers that demonstrate the application of different HPSR strategies and methods. Edited by Lucy Gilson of the University of Cape Town and London School of Hygiene and Tropical Medicine, this publication provides guidance on the defining features of HPSR and the critical steps in conducting research in this field. It showcases the diverse range of research strategies and methods encompassed by HPSR. The target audience for the Reader includes researchers, teachers and students, as well as those working within health systems, and particularly those working in low-and middle-income countries.

Participatory Action Research in Health Systems – A Methods Reader

The purpose of the methods reader is to inform, motivate and strengthen the practice of participatory action research. It is organized in five parts and seeks to explain: key features of participatory action research and the history and knowledge paradigms that inform it; processes and methods used in participatory action research, including innovations and developments in the field and the ethical and methods issues in implementing it; and communication, reporting, institutionalization and use of participatory action research in health systems. Published by EQUINET, AHPSR, WHO and IDRC Canada.  Read more. 

Implementation Research in Health: A Practical Guide

The Guide was created with the aim of boosting implementation research capacity, particularly in LMICs. Intended for newcomers to the field, those already conducting implementation research, and those with responsibility for designing and implementing programmes and policies, the guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many exciting opportunities that it presents.

WHO Strategy on Health Policy and Systems Research

The WHO Strategy on Health Policy and Systems Research, Changing Mindsets, advocates for greater generation and use of research evidence in health policy and builds a case for further investment in this critical area of research. It is the first-ever global-level strategy on HPSR and is intended for a wide network of health systems actors including researchers, policy-makers, implementers, and other practitioners.


Inter-sectoral collaboration and action

  • Adeleye OA, Ofili AN. (2010). Strengthening Inter-sectoral Collaboration for Primary Health Care in Developing Countries: Can the Health Sector Play Broader Roles? Journal of Environmental and Public Health, doi:10.1155/2010/272896  [View]
  • Fabbro LD, Minniss FR, Ehrlich C, Kendall E. (2016). Political Challenges in Complex Place-Based Health Promotion Partnerships: Lessons From an Exploratory Case Study in a Disadvantaged Area of Queensland, Australia. International Quarterly of Community Health Education, 37:1 [View]
  • Kim SS, Avula R, Ved R, Kohli N, Singh K, Van den Bold M, Kadiyala S, Menon P. (2017).Understanding the role of inter-sectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India: a qualitative study. BMC Public Health,17:161 [View]
  • Lasker RD, Weiss ES, Miller R. (2001). Partnership synergy: a practical framework for studying and strengthening the collaborative advantage. The Milbank Quarterly, 79:2 [View]

Maternal health in health systems

  • Iyer, Sen and Sreevathsa (2013): Deciphering Rashomon: An approach to verbal autopsies of maternal deaths. Global Public Health: An International Journal for Research, Policy and Practice,
  • Human Rights Watch (2011) “Stop Making Excuses; Accountability for Maternal Health Care in South Africa” -  HRW New York.

Mental Health in Health Systems

  • Petersen I., Fairall L., Bhana A., Kathree T., Selohilwe O., Brooke-Sumner C., Faris G., Breuer E., Sibanyoni N., Lund C. & Patel V. (2015). "Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan." The British Journal of Psychiatry, published online October 7, 2015. doi: 10.1192/bjp.bp.114.153726. [View]
  • Semrau M., Lempp H., Keynejad R., Evans-Lacko S., Mugisha J., Raja S., Lamichhane J., Alem A., Thornicroft G. & Hanlon C. (2016). "Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: systematic review." BMC Health Services Research 16:79. doi: 10.1186/s12913-016-1323-8. [View]

Monitoring and Evaluation and Health Systems Learning

  • Behn, RD. (2003). Why Measure Performance? Different Purposes Require Different Measures.Public Administration Review, 63(5): 586-606. [View]
  • Davies, HTO and Nutley, S.M. (2000). Developing learning organisations in the new NHS. BMJ, 320:998–1001 [View]

Non State Providers

  • McLoughlin, C. (2011). Factors affecting state-non-governmental organisation relations in service provision: key themes from the literature. Title of Paper 2: Patouillard, E., Goodman, C.A.,
  • Hanson, K.G., Mills, A.J. (2007). Can working with the private  for-profit sector improve utilisation of quality health sevices by the poor? A systematic review of the literature. International journal for equity in health 6: 17

Organisational culture in health systems

  • Hartmann and Khademian (2010). "Culture change refined and revitalized: The road show and guides for pragmatic action." Public Administration Review Nov-Dec: 845-852.
  • Fattore and Tediosi (2013). "The importance of values in shaping how health systems governance and management can support universal health coverage." Value in Health 16(1): S19-S23.

Policy Implementation

  • Exworthy, Berney, and Powell (2002). ‘How great expectations in Westminster may be dashed locally’: the local implementation of national policy on health inequalities. The Policy Press; 30 (1):79-96.
  • Chapman (2004). System failure: Why governments must learn to think differently. Demos: London (Exec Summary & Chapter 10)

Programmes and PHC

  • Lafond et al (2015). Drivers of routine immunization coverage improvement in Africa: findings from district-level case studies. Health policy and planning 30: 298-308.
  • Rao et al (2013). When do vertical programmes strengthen health systems? A comparative assessment of disease-specific interventions in India. Health policy and planning 1-11.

Public values

  • Benington J. (2009). Creating the Public In Order To Create Public Value? International Journal of Public Administration, 32(3-4):232-249. [View]
  • Blair RA, Morse BS, Tsai LL. (2017). Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia. Social Science and Medicine, 172:89-97. [View]
  • Ozawa S, Paina L, Qiu M. (2016). Exploring pathways for building trust in vaccination and strengthening health system resilience. BMC Health Services Research, 16(Suppl 7):639. [View]

Quality of Care

  • Rubenstein et al (2014). How can we recognize continuous quality improvement? International Journal for Quality in Health Care. Vol 26 pp 6-15
  • Dixon-Woods et al (2014). Culture and behaviour in the Englsh National Health Service: overview of lessons from a large multimethod study. BMJ Quality and Safety. Doi: 10.1136/bmjgs-2013-001947.

Social determinants of health


  • Baker P, Friel S, Kay A, Baum F, Strazdins L, Mackean T. (2018). What Enables and Constrains the Inclusion of the Social Determinants of Health Inequities in Government Policy Agendas? A Narrative Review. International Journal of Health Policy and Management, 7:2 [View]
  • Tung EL, Cagney KA, Peek ME, Chin MH. (2017).Spatial Context and Health Inequity: Reconfiguring Race, Place, and Poverty. Journal of Urban Health, 94:757–763. [View]

Street-level bureaucracy / governance as processes & relationships

  • Hupe, P. & Hill, M. (2007). Street-level Bureaucracy and Public Accountability. Public Administration 85(2): 279-299 [View]
  • Honig, M.I. (2006). Street-Level Bureaucracy Revisited: Frontline District Central-Office Administrators as Boundary Spanners in Education Policy Implementation. Educational Evaluation and Policy Analysis 28(4): 357-383  [View]

Understanding complexity in health systems

  • Stephanie M Topp, Julien M Chipukuma and Johanna Hanefeld. (2014). Understanding the dynamic interactionsdriving Zambian health centre performance: a case-based health systems analysis. Health Policy and Planning 1–15
  • Joe Varghese, V Raman Kutty, Ligia Paina and Taghreed Adam. (2014). Advancing the application of systems thinking inhealth: understanding the growing complexity governing immunization services in Kerala, India. Health Research Policy and Systems 12:4

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