TY - JOUR T1 - Health systems strengthening to arrest the global disability burden: empirical development of prioritised components for a global strategy for improving musculoskeletal health JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-006045 VL - 6 IS - 6 SP - e006045 AU - Andrew M Briggs AU - Carmen Huckel Schneider AU - Helen Slater AU - Joanne E Jordan AU - Sarika Parambath AU - James J Young AU - Saurab Sharma AU - Deborah Kopansky-Giles AU - Swatee Mishrra AU - Kristina E Akesson AU - Nuzhat Ali AU - Joletta Belton AU - Neil Betteridge AU - Fiona M Blyth AU - Richard Brown AU - Demelash Debere AU - Karsten E Dreinhöfer AU - Laura Finucane AU - Helen E Foster AU - Francesca Gimigliano AU - Scott Haldeman AU - Syed A Haq AU - Ben Horgan AU - Anil Jain AU - Manjul Joshipura AU - Asgar A Kalla AU - Jakob Lothe AU - Shuichi Matsuda AU - Ali Mobasheri AU - Lillian Mwaniki AU - Margareta C Nordin AU - Marilyn Pattison AU - Felipe J J Reis AU - Enrique R Soriano AU - Heather Tick AU - James Waddell AU - Dieter Wiek AU - Anthony D Woolf AU - Lyn March Y1 - 2021/06/01 UR - http://gh.bmj.com/content/6/6/e006045.abstract N2 - 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. ER -