Research methods
Health policy and systems research draws on varied disciplines, methodologies and methods. RESYST researchers used a number of innovative approaches to conduct research across the projects including:
- Multi-country, comparative case studies to assess strategic purchasing, the functioning of tax collection agencies and gender and leadership in health systems.
- Action-learning, participatory research in the Kenya and South Africa learning sites to explore over time health system governance issues including devolution, hospital priority-setting, everyday resilience and leadership development.
- Longitudinal cohort studies to track the job choices and movements of nurses over time.
- Experimental economic games to isolate the effects of different payment mechanisms on doctors' behaviour.
A long-term approach
Action learning research
In Kenya and South Africa, researchers sought to better understand health systems by seeing their complexity through the eyes of those working at the front line of health care delivery.
The research method, also known as a learning sites approach, entailed a long-term process of engagement, action learning and reflective practice with health workers and managers, through which they worked together to define research questions, identify appropriate methodologies and generate shared knowledge.
10 year cohort study
For 10 years (2008-2018), researchers tracked a cohort of nurses in South Africa to find out where they work, when they move, where they move to, and the reasons for the decisions. The cohort of 377 new nursing graduates was established in 2008 as a Consortium for Research for Equitable Health Systems (CREHS) research project and maintained 98% follow-up after two years.
Between 2012-2018, the project continued to monitor the nurses. There are plans to continue collecting data post-RESYST. For more information, contact Prudence [dot] Ditlopo1 [at] wits [dot] ac [dot] za
Gender and intersectionality analysis
As part of the RinGs initiative, RESYST endeavoured to include gender and ethics analysis in the research. Intersectionality was used as a lens to investigate gender issues in the gender and leadership study, whereby researchers re-analysed data to understand how identity, and specifically the intersection of multiple identities (i.e. gender, race, ethnicity etc.) mediates the career trajectories, leadership approaches and capacities of senior healthcare managers.