Building Learning Health Systems to Accelerate Research and Improve Outcomes of Clinical Care in Low- and Middle-Income Countries

Abstract

Achieving universal coverage that supports high-quality care will require that health systems are designed to integrate the delivery of health services with the generation of new knowledge about the effectiveness of these services. System strengthening and research will need to be better integrated to achieve this in low- and middle-income countries (LMIC) so that changes in coverage, quality, and impact are measured, costs are contained, and health systems are responsive to users’ needs and concerns. In high-income countries, learning health systems (LHS) are emerging to meet similar needs. The LHS vision aspires to engage policy makers, researchers, service providers, and patients in learning that uses and strengthens routinely collected data to conduct pragmatic, contextually appropriate research, promote rapid adoption of findings to improve quality and outcomes, and promote continuous learning. Although there are significant challenges, we should begin to develop LHS in LMIC for their immediate and longer term benefits and to avoid having to retrofit health systems with the capability to promote learning at a later date and even greater cost. A global coalition on how to build LHS effectively that shares accumulating learning could enable such a strategy.