Health Systems Strengthening: Rethinking the Role of Innovation is the fourth Globelics Thematic Review, authored by Rebecca Hanlin and Margrethe Holm Andersen. The review offers a new perspective on the relationship between innovation and health systems, arguing that improving health outcomes requires much more than introducing new medical technologies. Instead, strong health systems emerge from continuous learning, effective institutions, collaboration among diverse actors, and innovations that address both social and technological challenges.
The authors argue that health should be understood as an essential component of both economic and social development rather than simply the absence of disease. This broader definition places wellbeing, equity, and inclusion at the centre of health policy. Likewise, innovation extends beyond pharmaceuticals, medical devices, or scientific discoveries to include organizational, institutional, process, and social innovations that improve the functioning of entire health systems. By combining these broader concepts, the review provides a more comprehensive understanding of how countries can strengthen healthcare while promoting sustainable development.
A major contribution of the report is the introduction of the 4Fs Framework—Functions, Form, Field, and Flows—which provides an analytical lens for understanding how health systems generate effective and equitable outcomes. The framework emphasizes that successful health systems depend not only on infrastructure and resources but also on how knowledge, power, information, and relationships circulate among governments, healthcare providers, universities, research institutions, businesses, and communities. These interactions determine whether innovation can effectively improve health and wellbeing.
The review also highlights the importance of social innovation. While technological innovation remains valuable, the authors argue that many of the greatest improvements in healthcare arise from new organizational practices, governance models, partnerships, and community-based initiatives. Such innovations strengthen the connections among the different components of health systems, allowing them to adapt to changing needs and respond more effectively to complex health challenges in low- and middle-income countries.
Drawing on research from the Globelics community and examples from countries including Kenya and India, the report demonstrates how innovation systems thinking can inform more effective health policies. It encourages governments and development organizations to move beyond fragmented interventions and instead build integrated health and wellbeing systems that support continuous learning, institutional development, and collaboration across sectors. This approach aligns health policy with broader goals of inclusive economic and social development.
The review expands the innovation systems framework into the health sector by demonstrating that sustainable improvements in healthcare depend on knowledge sharing, institutional learning, and social innovation as much as technological progress. It remains an important reference for researchers and policymakers seeking to strengthen health systems through systemic, inclusive, and development-oriented approaches.
