Health systems strengthening to arrest the global disability burden: empirical development of prioritised components for a global strategy for improving musculoskeletal health.
Journal: BMJ global health
Volume: 6
Issue: 6
Year of Publication:
Affiliated Institutions:
Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia a.briggs@curtin.edu.au.
Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
HealthSense (Aust) Pty, Ltd, Melbourne, Victoria, Australia.
Department of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.
Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Sydney Musculoskeletal, Bone and Joint Health Alliance. Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden.
Health Improvement, Public Health England, London, UK.
Global Alliance of Partners for Pain Advocacy, International Association for the Study of Pain, Washington, DC, USA.
Neil Betteridge Associates, London, UK.
World Federation of Chiropractic, Toronto, Ontario, Canada.
Rehabilitation International (Africa Region), Addis Ababa, Ethiopia.
Medical Park Berlin Humboldtmühle, Berlin, Germany.
International Federation of Orthopaedic Manipulative Physical Therapists Incorporated (IFOMPT), World Physiotherapy, London, UK.
Population Health Institute, Newcastle University, Newcastle upon Tyne, UK.
Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy.
Department of Neurology, University of California, Irvine, California, USA.
Rheumatology Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Consumer and Community Involvement Program, West Australian Health Translation Network, Perth, Western Australia, Australia.
Department of Physical Medicine and Rehabilitation, Santokba Durlabhji Memorial Hospital, Jaipur, India.
AO Alliance Foundation, Davos, Switzerland.
Department of Medicine, University of Cape Town, Cape Town, South Africa.
Norwegian Council for Musculoskeletal Health, Oslo, Norway.
Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.
Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
Global Alliance for Musculoskeletal Health, Kenya.
Department of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, New York University, New York City, NY, USA.
World Federation of Occupational Therapists (WFOT), London, UK.
Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil.
Rheumatology Unit, Internal Medicine Services and University Institute, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Department of Family Medicine and Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA.
Saint Michael's Hospital Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
People with Arthritis and Rheumatism, European Alliance for Associations for Rheumatology (EULAR), Kilchberg, Switzerland.
Bone and Joint Research Group, Royal Cornwall Hospitals Trust, Truro, UK.
Abstract summary
Despite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health.Design: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1-2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions.Phase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening.An empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.
Authors & Co-authors:
Briggs
Huckel Schneider
Slater
Jordan
Parambath
Young
Sharma
Kopansky-Giles
Mishrra
Akesson
Ali
Belton
Betteridge
Blyth
Brown
Debere
Dreinhöfer
Finucane
Foster
Gimigliano
Haldeman
Haq
Horgan
Jain
Joshipura
Kalla
Lothe
Matsuda
Mobasheri
Mwaniki
Nordin
Pattison
Reis
Soriano
Tick
Waddell
Wiek
Woolf
March
Study Outcome
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