Health systems are facing a number of diverse and complex challenges; the 2020 edition of the Geneva Health Forum has designed a thematic, which capitalises on the unique mix of publics in attendance to get to the heart of a number of these challenges, aiming to promote learning global health systems to improve access to health.
To ensure the effectiveness of health systems, decisions, at all levels, must be based on the best available evidence and active analysis of actual practices. Unfortunately, research or evaluations of these activities are developed through long processes that are difficult to reconcile with the need for rapid adaptation of practices. Moreover, the lessons learned do not necessarily translate into a change in policy or practice. It is important that health systems be better organised to become learning systems that can study their own practices to gather lessons that will inform these practices and improve their ability to adapt rapidly to evolving health needs. To achieve these learning systems, research and care practices need to be better connected. Learning processes must be continuous and collaborative, and multidisciplinary work is essential to their success. New communication tools and mass data management offer opportunities to facilitate such systems, but their use must be carefully considered and closely monitored, ensuring compliance to ethical and legal standards.
As part of the 2030 agenda for SDGs (Sustainable Development Goals), WHO and the international community placed health and its determinants at the top of their priorities. In order to reach these goals and indeed the goal of achieving Universal Health Coverage by 2030, an estimated 18 million health workers will need to be trained, with recruitment and training of health workers essential for health system capacity building. It is important that the nurses at the front line of health care system are recognised for their crucial work, and that their experiences are fed in to learning health systems, particularly with regard to their changing responsibilities. The patient voice is crucial for true learning health systems, with patients given a real say in the care they receive. More patient-oriented health systems should be encouraged, including giving patients a say in the management and use of their data.
Digital health has invigorated the global health community, with several prominent successes; however, the true effectiveness and impact of some of these approaches are questioned. A lack of interoperability between solutions, the high volume of pilot projects, the replication of effort and funding for parallel projects, and the difficulty in measuring tangible impacts are cited among the key challenges. We will investigate how we can learn from the experiences of all actors in launching and operating such approaches to modify future endeavours and avoid “Pilotitis”. We also recognise that digital technologies and data science alone will not provide the solutions; rather these approaches need to be integrated with social and life sciences to be truly impactful, as outlined at the GHF 2018 under the theme of “Precision Global Health”.