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Health policy and systems research: towards a better understanding and review of ethical issues
  1. Valerie Ann Luyckx1,
  2. Nikola Biller-Andorno1,
  3. Abha Saxena2,
  4. Nhan T Tran3
  1. 1 Institute of Biomedical Ethics and History of Medicine, Universität Zürich, Zürich, Switzerland
  2. 2 Global Health Ethics Unit, World Health Organization, Geneva, Switzerland
  3. 3 Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
  1. Correspondence to Dr Valerie Ann Luyckx; valerie.luyckx{at}uzh.ch

Abstract

Given the focus on health systems in the post-millennium development goal era and moving towards the sustainable development goals, there is a compelling need for a common framework for health policy and systems research ethics to guide researchers and facilitate review by research ethics committees. A consultation of global health policy and systems research and ethics experts was convened to identify ethical considerations relevant to health policy and systems research based on existing knowledge and to identify knowledge gaps through a scoping review and further expert deliberation. Health policy and systems research is highly complex and, in the absence of guidance documents, there is significant variability in ethics review. Although fundamental ethical principles pertain to both traditional clinical research and health policy and systems research, the application of these principles requires a comprehensive understanding of the nature of health policy and systems research with its distinct challenges. Such awareness must be raised among researchers and research ethics committees. Current research ethics committees lack familiarity with health policy and systems research and because health policy and systems research is conducted in real-world contexts, committees often have difficulties in determining whether a project is indeed research and/or requires ethical review. Given the strong current focus on health policy and systems research to rapidly improve health and health systems functioning globally, greater engagement and dialogue around the ethical concerns is required to optimise research review and research conduct in this rapidly evolving field.

  • Health policy and systems research
  • ethical principles
  • research ethics committees
  • ethics review
  • capacity building

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors NTT, AS, NB-A and VAL all participated in planning of the manuscript.

    VAL wrote the first draft of the manuscript.

    All authors participated in draft revisions and approval of the final version.

  • Funding The meeting was funded and organized by the Alliance for Health Policy and Systems Research and the Global Health Ethics Unit at the WHO and was hosted and supported by the Institute of Biomedical Ethics and History of Medicine, University of Zurich.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no additional unpublished data relating to this manuscript. The Scoping Review conducted prior to this consultation has now been published and is included as a full reference in this manuscript.

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