Abstract
This article argues that a distinct focus on background system supports can take place through structural indicators, at both national and institutional levels. Development of structural indicators is already taking place for the UN right to the highest attainable standard of health and in recent publications of the European Commission in education contexts. Structural indicators are generally framed as potentially verifiable yes/no answers, they address whether or not key structures, mechanisms or principles are in place in a system. As relatively enduring features or key conditions of a system, they are, however, potentially malleable. A systems of care focus is resonant with structural indicators and moves beyond isolated, fragmented service provision to an integrated whole system of supports. Structural indicators can aid such strategic planning for systems of care. This focus on structural indicators goes beyond a traditional qualitative/quantitative distinction and beyond reliance on sharing models of good practice to seek to identify key structural conditions for good practice. Structural indicators offer a bridge between central strategic direction and local flexibility. The weight of evidence required for a structural indicator may depend on its scope and purpose. Structural indicators can combine a rights, principles and strategic policy based focus with one that is informed by implementation science issues and evidence. They offer a policy relevant bridge between research and practice.
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