Partners’ HPSR report – 2021
Of the country’s 37 universities and more than 200 NGOs, research centres and think tanks, only seven institutions can be said to conduct HPSR: six in Beirut and one in Mount Lebanon (Fanar, Matn District). Six are university-based institutions and one is an NGO.
HPSR has informed health policy and programmes across a range of topics in Lebanon, from revising the performance-based contracting system for hospitals, to informing national guidelines for infection prevention and control. HPSR has also informed aspects of Lebanon’s COVID-19 pandemic response. Its growing influence is driven by political will to address critical health issues, a greater appreciation among selected health policy-makers of the value of research, support from external sources for HPSR initiatives and an expanding pool of relevant HPSR knowledge. However, HPSR is not yet institutionalized in the decision-making process in Lebanon.
Institutions by type
List of HPSR institutions
|Faculty of Public Health of Lebanese University (FSP UL) | La Faculté de Santé Publique de l’université Libanaise||Fanar, Lebanon||University|
|Health Management and Policy Department, Faculty of Health Sciences, University of Beirut (HMPD/FHS/AUB)||Beirut, Lebanon||University|
|Higher Institute of Public Health – Saint Joseph of Beirut University (ISSP) | Institut Supérieur de Santé Publique – Université Saint Joseph de Beyrouth||Beirut, Lebanon||University|
|Knowledge to Policy (K2P) Center, American University of Beirut||Beirut, Lebanon||University|
|Lebanese American University (LAU)||Beirut, Lebanon||University|
|National Institute for Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB) | Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie||Beirut, Lebanon||Local NGO|
|University of Balamand Faculty of Health Sciences (UB-FHS)||Beirut, Lebanon||University|
The number of HPSR-related reports increased from 46 in 2018 to 59 in 2020, with the American University of Beirut (AUB) publishing more than half of the reports produced in 2020.
Average number of reports produced per institution each year in Lebanon and overall
Engaging policy-makers and the public
HPSR has informed health policy across a range of topics in Lebanon in recent years: integrating palliative care into third-party reimbursement schemes; revising the performance-based contracting system for hospitals; establishing a pharmacovigilance system at national level; and informing national guidelines for infection prevention and control and the antimicrobial stewardship programme. HPSR has also influenced key programmes from the Ministry of Public Health, most notably the Emergency Primary Health Care Restoration Project towards Universal Health, and the Integration of Non-Communicable Disease Services within Primary Health Care. More recently, HPSR has informed aspects of the COVID-19 pandemic response, including the preparedness of hospitals and primary health care.
There is political will to address these critical issues, a growing understanding among policy-makers of the value of research, and technical and financial support from international organizations for some initiatives. The pool of knowledge that is relevant for policy-making is expanding through collaborations with researchers and academia, but this collaboration is mostly anchored to individual, rather than institutional, positions.
More effort is needed to produce policy-relevant HPSR and promote its uptake in decision-making and action. There was little change in the number of meetings with policy-makers from 2018 to 2020 (rising slightly from 5 to 7) or in the number of newspaper articles related to HPSR for a public audience (62 compared to 64).
The Knowledge to Policy (K2P) Center within the Faculty of Health Sciences at AUB uses a range of knowledge translation products and tools to influence health policy-making processes. These include priority-setting exercises with policy-makers and stakeholders to identify and shape policy priorities; knowledge translation products to synthesize and package evidence; policy dialogues that bring policy-makers, researchers and stakeholders together; and follow-up on implementation, including policy tracing.
The K2P Center was also a co-host for the Sixth Global Symposium on Health Systems Research (HSR2020). HSR2020 provided a catalyzing platform for awareness, capacity, support and partnerships within and beyond Lebanon and the region. It re-emphasized the importance of evidence-informed health policy-making and of measures to ensure individuals, communities and institutions contribute to (and benefit from joining) a growing global HPSR community.
Average number of meetings held with policy-makers per institution each year in Lebanon and overall
Average number of media articles published per institution each year in Lebanon and overall
Academic and institutional capacity
Few of the 37 universities and more than 200 health NGOs, think tanks and research entities mapped across Lebanon have a stated mission to generate HPSR policy outputs, to teach or conduct HPSR or to support health policy development. HPSR tends to reside within the faculty of health science or the faculty of medicine, departments of health management and policy, community/public health or epidemiology, rather than in stand-alone HPSR departments. There is also a notable absence of NGOs, think tanks and other independent research institutes focused on HPSR.
There has, however, been some progress in recent years. The number of faculty and staff engaged in HPSR-related work has increased from 59 in 2018 to 69 in 2020, and the number of participants (including students) on HPSR-related courses and trainings has almost doubled, rising from 130 in 2018 to 253 in 2020.
Several universities report the introduction of new graduate courses or the revision of current courses to make them more relevant to HPSR. The Faculty of Health Sciences within AUB has established the K2P Center to promote evidence-based health policy-making and action. The K2P Center is training cohorts of researchers and policy-makers on HPSR through a mentorship programme supported by the Alliance for Health Policy and Systems Research and is developing supportive and sustainable institutions for evidence-informed health policy-making and action in Lebanon, the Eastern Mediterranean region and globally. The Saint Joseph University (USJ) has launched a PhD programme in health systems and policy, and the AUB plans a similar initiative.
Training curricula and courses for HPSR are limited, and HPSR training remains largely confined to students on formal postgraduate programmes and courses. However, the Executive Master of Healthcare Leadership (EMHCL) within the Department of Health Management and Policy at the Faculty of Health Sciences at AUB is noteworthy for targeting professionals and executives with significant responsibilities in the health care sector. In addition, the Saint Joseph University has launched a twinning programme involving public-private partnerships to strengthen emergency health preparedness. Several universities are also starting to collaborate with international universities on joint training programmes and research opportunities.
The Ministry of Public Health (MoPH), the World Health Organization (WHO) and the AUB Faculty of Health Sciences (FHS) signed a tripartite agreement in 2018 to establish a Policy Support Observatory (PSO) at the MoPH (managed by FHS). The PSO aims to support rational policy- and decision-making in the health sector by institutionalizing a reliance on robust evidence to inform health policies and programmes. Measures to strengthen the relationship between the MoPH and researchers include informal collaborations, joint or adjunct appointments in academic and research institutions, attendance of MoPH staff at research events, and researcher participation in MoPH policy advisory committees.
Further capacity-building for HPSR processes is critical to promote the uptake and use of HPSR evidence in decision-making. Further progress requires the strengthening of postgraduate teaching in academia and the establishment of more entities dedicated to HPSR production and translation.
Total number of HPSR faculty and staff
Total number of participants in HPSR-related short courses
There is no explicit national funding or budget line for HPSR and no clear resource mobilization strategy for this area.
Current funding for HPSR comes predominantly from external sources, particularly international and bilateral agencies. Another notable source of funding is through sub-contracts with larger research consortia, often led by researchers in high-income countries. Some private universities have seed funding for some of their internal research, but the funds allocated to a given project tend to range from just US$ 10 000 to US$ 20 000. In 2019, it was estimated that universities and NGOs engaged in HPSR-related activities invested a combined total of US$ 220,000 in HPSR for teaching and training, HPSR research and the dissemination and implementation of research.
The Government of Lebanon has a very limited role in HPSR funding. This might be expected in a country where health research is dominated by biomedical and clinical research. This funding bias has created an imbalance in HPSR capacity development and contributed to the poor recognition of HPSR as a distinct field of research. The situation is further exacerbated by the country’s lack of a national strategy and framework for health research.
Total institutional expenditure
Credits and disclaimers
Partners’ health policy and systems research report, 2021
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