PT  - JOURNAL ARTICLE
AU  - Briggs, Andrew M
AU  - Huckel Schneider, Carmen
AU  - Slater, Helen
AU  - Jordan, Joanne E
AU  - Parambath, Sarika
AU  - Young, James J
AU  - Sharma, Saurab
AU  - Kopansky-Giles, Deborah
AU  - Mishrra, Swatee
AU  - Akesson, Kristina E
AU  - Ali, Nuzhat
AU  - Belton, Joletta
AU  - Betteridge, Neil
AU  - Blyth, Fiona M
AU  - Brown, Richard
AU  - Debere, Demelash
AU  - Dreinhöfer, Karsten E
AU  - Finucane, Laura
AU  - Foster, Helen E
AU  - Gimigliano, Francesca
AU  - Haldeman, Scott
AU  - Haq, Syed A
AU  - Horgan, Ben
AU  - Jain, Anil
AU  - Joshipura, Manjul
AU  - Kalla, Asgar A
AU  - Lothe, Jakob
AU  - Matsuda, Shuichi
AU  - Mobasheri, Ali
AU  - Mwaniki, Lillian
AU  - Nordin, Margareta C
AU  - Pattison, Marilyn
AU  - Reis, Felipe J J
AU  - Soriano, Enrique R
AU  - Tick, Heather
AU  - Waddell, James
AU  - Wiek, Dieter
AU  - Woolf, Anthony D
AU  - March, Lyn
TI  - Health systems strengthening to arrest the global disability burden: empirical development of prioritised components for a global strategy for improving musculoskeletal health
AID  - 10.1136/bmjgh-2021-006045
DP  - 2021 Jun 01
TA  - BMJ Global Health
PG  - e006045
VI  - 6
IP  - 6
4099  - http://gh.bmj.com/content/6/6/e006045.short
4100  - http://gh.bmj.com/content/6/6/e006045.full
SO  - BMJ Global Health2021 Jun 01; 6
AB  - Introduction Despite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health.Methods Design: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1–2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions.Results Phase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening.Conclusion An empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.All data relevant to the study are included in the article or uploaded as supplemental information.