Albert Domingo / World Health Organization Regional Office for the Western Pacific
Albert Domingo (3rd from right) with WHO/WPRO interns and volunteers and Dr Shin (5th from right), WHO Regional Director for the Western Pacific.
Work-based placement: NCDs and Health Systems Strengthening
When the School of Social and Political Science first discussed the possibility of a work-based placement as a master’s dissertation, I saw it as an opportunity to apply theories and concepts I would learn while at The University of Edinburgh in the real world context of a leading development institution. Being in the MSc Health Systems and Public Policy programme of the Global Public Health Unit, I took it upon myself to plan for and organize an Internship at the World Health Organization Regional Office for the Western Pacific (WHO/WPRO), based in Manila, the Philippines.
My main duties at WHO/WPRO centred on investigating the extent to which the noncommunicable disease (NCD) programme can be used as a focus for the ‘diagonal’ strengthening of health systems. NCDs are a global health concern. The UN General Assembly adopted a Political Declaration that includes a commitment for its Member States to undertake the comprehensive strengthening of health systems for NCD prevention and control. In that regard, the UNGA called for governments to support primary health care by delivering services for NCD prevention and control across the continuum of care, at all levels of care, and throughout the life-course (Anon 2011b). This commitment has been affirmed by the World Health Assembly when it decided to adopt a global action plan for NCD prevention and control (Anon 2013a). Meanwhile, there have been proposals for health system strengthening to be through a diagonal approach. This has been described as a “strategy in which we use explicit intervention priorities to drive the required improvements into the health system, dealing with such generic issues as human resource development, financing, facility planning, drug supply, rational prescription and quality assurance” (Gounder and Chaisson 2012, p.1426, citing Frenk). WHO/WPRO has been helping its Member States implement commitments made in the Political Declaration on NCDs (Anon 2011a, 2013b), including using the NCD programme as the focus for health system strengthening.
My WBP was unique in that it involved examining programme theory while in the field, without actually doing “field work”. However, my deployment to WHO/WPRO gave me the benefit of interacting with policymakers, influencers, and agents behind the scenes. This allowed me to experience firsthand the research methods of realist synthesis, as explained by Pawson (2006, p.100):
“Realist synthesis is theory-driven. The tasks of identifying the review question, articulating key theories to be explored and choosing an overall analytic theme cannot occur meaningfully in the absence of input from practitioners and policy-makers, because it is their questions and their assumptions about how interventions work that form the focus of analysis.”
I am grateful for support provided by The University of Edinburgh, particularly the School of Social and Political Science, financially to cover for travel expenses, administratively through the Practice Programme’s supervision, and academically through the guidance of my dissertation supervisor, Dr Mark Hellowell. My work-based placement has been a thoroughly fulfilling experience of policy research in practice, and I would recommend that future students consider it as an essential part of their study.
Anon. Regional Committee for the Western Pacific. (2011a) Expanding and Intensifying Noncommunicable Disease Prevention and Control. WPR/RC62.R2. World Health Organization.
Anon. United Nations. (2011b) Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. UNGA Res 66/2.
Anon. World Health Assembly. (2013a) Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. WHA66.10. Geneva: World Health Organization.
Anon. Regional Committee for the Western Pacific. (2013b) Noncommunicable Diseases. WPR/RC64.R6. World Health Organization.
Gounder, C.R. and R.E. Chaisson. (2012) A diagonal approach to building primary healthcare systems in resource-limited settings: women-centred integration of HIV/AIDS, tuberculosis, malaria, MCH and NCD initiatives. Tropical Medicine & International Health, 17(12), pp.1426-1431.
Pawson, R. (2006) Evidence-Based Policy: A Realist Perspective. ed. London: SAGE Publications.