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Systems transformation: learning from change in 60 countries

Jeffrey Braithwaite (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Kristiana Ludlow (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Kate Churruca (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Wendy James (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Jessica Herkes (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Elise McPherson (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Louise A. Ellis (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)
Janet C. Long (Australian Institute of Health Innovation, Macquarie University, Sydney, Australia)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 30 August 2019

Issue publication date: 4 May 2020

Abstract

Purpose

Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments dissected and analyzed internationally. The purpose of this paper is to address this knowledge gap by examining the lessons learned from health system reform and improvement efforts in 60 countries.

Design/methodology/approach

In total, 60 low-, middle- and high-income countries provided a case study of successful health reform, which was gathered into a compendium as a recently published book. Here, the extensive source material was re-examined through inductive content analysis to derive broad themes of systems change internationally.

Findings

Nine themes were identified: improving policy, coverage and governance; enhancing the quality of care; keeping patients safe; regulating standards and accreditation; organizing care at the macro-level; organizing care at the meso- and micro-level; developing workforces and resources; harnessing technology and IT; and making collaboratives and partnerships work.

Practical implications

These themes provide a model of what constitutes successful systems change across a wide sample of health systems, offering a store of knowledge about how reformers and improvement initiators achieve their goals.

Originality/value

Few comparative international studies of health systems include a sufficiently wide selection of low-, middle- and high-income countries in their analysis. This paper provides a more balanced approach to consider where achievements are being made across healthcare, and what we can do to replicate and spread successful examples of systems change internationally.

Keywords

Citation

Braithwaite, J., Ludlow, K., Churruca, K., James, W., Herkes, J., McPherson, E., Ellis, L.A. and Long, J.C. (2020), "Systems transformation: learning from change in 60 countries", Journal of Health Organization and Management, Vol. 34 No. 3, pp. 237-253. https://doi.org/10.1108/JHOM-01-2019-0018

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited