Creating an Applied, Multi-disciplinary Research Field: The World Health Organization and Health Systems Research 1960–2000

Abstract

Summary From the 1960s, the World Health Organization (WHO) sought to reconcile ambitious international goals with scarce resources and the socio-economic realities of low- and middle-income countries by developing a field called Health Systems Research (HSR). This field remained small, marginal and largely confined to WHO during the second half of the twentieth century. The WHO worked to promote HSR, apply it to concrete problems and define its scope and methodologies while linking it to policymaking. Results were seriously limited by lack of interest from policymakers, confusion about its scope and methods, and competition from numerous disciplines working on overlapping subjects, notably economic analysis. This latter rivalry originated with debates about Primary Health Care versus Selective Primary Healthcare in the late 1970s and was overcome, rhetorically, in the late 1980s. Tensions however remained, and by the end of the twentieth century, economic analysis had temporarily triumphed at the WHO.