Abstract
BackgroundThere is an established body of evidence linking systems of social protection to health systems and health outcomes. The Sustainable Development Goals (SDGs) provide further emphasis on this linkage as necessary to achieving health and non-health goals. Existing literature on social protection and health has focused primarily on cash transfers. We sought to identify potential research priorities concerning social protection and health in low and middle-income countries, from multiple perspectives.MethodsPriority research questions were identified through two sources: 1) research reviews on social protection interventions and health, 2) interviews with 54 policy makers from Ministries of Health, multi-lateral or bilateral organizations, and NGOs. Data was collated and summarized using a framework analysis approach. The final refining and ranking of the questions was completed by researchers from around the globe through an online platform.ResultsThe overview of reviews identified 5 main categories of social protection interventions: cash transfers; financial incentives and other demand side financing interventions; food aid and nutritional interventions; parental leave; and livelihood/social welfare interventions. Policy-makers focused on the implementation and practice of social protection and health, how social protection programs could be integrated with other sectors, and how they should be monitored/evaluated. A collated list resulted in 31 priority research questions. Scale and sustainability of social protection programs ranked highest. The top 10 research questions focused heavily on design, implementation, and context, with a range of interventions that included cash transfers, social insurance, and labor market interventions.ConclusionsThere is potentially a rich field of enquiry into the linkages between health systems and social protection programs, but research within this field has focused on a few relatively narrowly defined areas. The SDGs provide an impetus to the expansion of research of this nature, with priority setting exercises such as this helping to align funder investment with researcher effort and policy-maker evidence needs.
Highlights
There is an established body of evidence linking systems of social protection to health systems and health outcomes
The priority setting process involved three key steps: (1) an overview of reviews to identify what areas of social protection for health have been studied to date and what research questions have arisen as a result, (2) consultations with policy-makers across the WHO regions, those from Low and middle-income countries (LMIC), to identify current priorities related to social protection for health in the context of the Sustainable Development Goals, and (3) an online interactive activity using the Co-Digital platform [18] where researchers from around the world were invited to refine and rank the identified research priorities
While cash transfer programs dominated the literature, researchers sometimes included components examining specific social protection initiatives such as services to link vulnerable households to other social welfare programs, or interventions related to improving livelihoods
Summary
There is an established body of evidence linking systems of social protection to health systems and health outcomes. The 17 Sustainable Development Goals (SDGs) embody a systems-oriented approach to understanding the connections between human health, poverty, economic development and the environment. While there are a number of targets within this goal, a significant one (1.3) states that countries will “Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable.”. At their simplest, systems of social protection exist to protect people against risks, risks of falling into poverty, and to mitigate the effects of such risks when adverse events do occur. The starting point for this work was the recognition of significant and extensive linkages between systems of social protection and health systems
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