Norwegian launch of Cochrane People, Health Systems and Public Health – An interview with Simon Lewin

Next month, Cochrane’s People, Health Systems and Public Health Thematic Group will be welcoming colleagues to join a seminar in Trondheim, Norway and online for the Norway launch of the new group. To find out more about the group’s plans, we caught up with Simon Lewin, Professor of Health Management and Health Systems at the Norwegian University of Science and Technology (NTNU) and the South African Medical Research Council, and co-lead of the new Thematic Group.

Simon, thanks for talking to us. Can you tell us about your role in the new Thematic Group and how you came to be involved?

“For several years, I coordinated Cochrane Effective Practice and Organisation of Care (EPOC), together with Sasha Shepperd at the University of Oxford in the UK. When Cochrane EPOC closed in March this year, we considered it important to continue to identify priorities for systematic reviews in the field of health systems; to further our work on methods for undertaking reviews in this area; and to sustain our longstanding network of editors and review authors, including in the global South. Considering our close collaboration with the Cochrane Public Health and Cochrane Consumers and Communication review groups, and shared methodological challenges and approaches, it was a logical step to unite and establish a new Thematic Group. As a co-leader in this group, I work closely with my colleagues from other partner institutions. I have a particular interest in developing the Group’s work on person-centred health systems and exploring the intersections with public health.”

Can you elaborate on why this new Thematic Group has been created?

“Absolutely! The creation of this new Thematic Group stems from our belief that merging the wide-ranging scope of the three Cochrane entities will enable us to tackle priority topics that aren't confined to specific clinical groups, populations, or settings. By adopting this perspective, we aim to generate evidence that addresses priorities at various levels - community or population, systems, and individual. These priorities encompass challenges related to the quality and safety of care, including transitions between health settings, fragmented care, multimorbidity, and behavior change among healthcare providers and consumers.

We see person-centred approaches as increasingly crucial in ensuring that health and public health system interventions, along with their implementation strategies, meet the needs of consumers (which include patients, family members, and caregivers), communities, and other stakeholders. These approaches encourage engagement, empowerment, and equity, and are widely recognised as prerequisites for safe, high-performing health and public health systems. By amalgamating evidence on person-centred care with evidence from the fields of health and public health systems, we aspire to ensure that Cochrane caters to the needs of consumers and other stakeholders, while fostering a culture of partnership.”

“We see person-centred approaches as increasingly crucial in ensuring that health and public health system interventions meet the needs of consumers”

How does this Thematic Group plan to improve the impact on individuals and communities globally?

“This Thematic Group is committed to making a global impact by focusing on health and public health systems interventions that can have substantial effects on peoples’ lives. For instance, the scope of the Thematic Group is central to almost all people’s interactions with health and public health systems. This is because the quality and impacts of these interactions are linked closely to whether the care and advice offered is congruent with people’s needs and are delivered in ways that involve them as partners.

Our scope also includes effective ways of governing, financing and delivering health and public health services. By focusing on these areas, we hope to contribute to global debates on the roles of systems in achieving Universal Health Coverage (SDG target 3.8). This includes exploring ways of including service users as partners in these arrangements – another area that has broad impacts on people and communities. We aim to have a global reach and will leverage our experience working with partners based in low- and middle-income countries (LMICs).”

“We aim to have a global reach and will leverage our experience working with partners based in low- and middle-income countries”

Can you share some examples of the expertise that the members of this Thematic Group bring to the table?

“We share methodologically related expertise associated with evidence synthesis of complex interventions embedded in varied contexts. This includes experience in conceptualising and organising these syntheses in ways that help review authors and others to address the challenges of more complex review questions. We have been leaders in developing innovative methods within Cochrane for novel areas of synthesis, including incorporating logic models into syntheses; undertaking syntheses of qualitative evidence; and conducting effects reviews that include a wide range of study designs. Furthermore, we are one of the most experience groups within Cochrane on processes for stakeholder involvement in reviews, including co-production approaches.”

What are some of the challenges that you anticipate as the group starts its journey?

“Thematic Groups are a new structure within Cochrane, so we need to understand the roles that these can play and how Thematic Groups will interact with other key entities including the Central Editorial Service and the planned Evidence Synthesis Units. We also have a broad scope so processes to identify priority areas for our work will be important.

In addition, the academic and policy user communities around the areas of consumer engagement, health systems and public health can have different approaches and standpoints and we will need to develop a coherent approach across these areas. Of course, funding is also a challenge, and we are discussing how we can weave aspects of the work into wider funding proposals in which the co-leads may be involved.”

Thanks for talking to us, Simon. Before we go, what are your own ambitions for the group’s future and its impact?

“Bringing together the networks of the three former Cochrane review groups will help to develop an understanding of synthesis priorities that bridge our scope and engage with the cross-cutting agenda of health and public health systems and personal, social and environmental contexts. This, in turn, will contribute to building health and public health systems that are more responsive, sustainable, resilient and effective. We already have strong links with key partners at national, regional and global levels and this will help to ensure that our work is both relevant and impactful.”