SD.20.012 – ADaptation of health systems research through a JUSTice and equity lens: the ADJUST study

Route: Sustainable development goals for inclusive global development

Cluster question: 044 Can globalisation and development be reinvented in a way that, in time, will mitigate differences in prosperity between world regions?

Well-functioning health systems are crucial to achieve health-related Sustainable Development Goals (SDGs). However, the world is off-track to achieve the Sustainable Development Goal target of universal health coverage for all by 2030. Although health systems research (HSR) is a rapidly growing multidisciplinary field that tries to strengthen the performance of health systems, a firm moral basis for HSR beyond avoiding exploitation is lacking. This renders the field somewhat heterogeneous in its objectives and approach and decreases the potential of this field to meaningfully impact the achievement of SDGs.
In this project, we will study how social justice and equity as a basis for HSR may speed up, enrich and enhance the impact of HSR on the SDGs, in particular 3 (Good health and well-being), 10 (Reduced inequalities), 16 (Peace, justice and strong institutions) and 17 (Partnerships for the goals). Health systems research will be used as a case example for other disciplines. We hypothesize that a social justice and equity lens towards health systems will contribute to more equitable priority-setting, a more responsive global research agenda, sustainable long-term partnerships, strengthened capacity for research, and more engaged communities. We will use an empirical ethics approach. By means of the empirical reflective equilibrium method we will go back and forth between theory and practice building towards a coherent moral framework for HSR to promote SDGs. Conceptual, theoretical work on foundations, power dynamics and governance is needed in order to build the framework. Case descriptions from Low-resource settings (domestic, European and global) will be used to refine the theories. Once the framework has been built, it will be translated into a dashboard to monitor achievements on SDGs. Accordingly, we will test the dashboard at the domestic, European and global level and embed it in international policy structures to ensure sustainability


capacity building, equality, equity, global challenges, global health, Governance, health policy, health systems, health systems research, justice, research ethics

Other organisations

KEMRI Wellcome Trust (Kenya), Ministry of Foreign Affairs, Netherlands), University of Melbourne (Australia), University of Oxford (England), University of Sydney (Australia), Utrecht University (UU)


Organisation University Medical Center Utrecht (UMCU)
Name Dr. R. (Rieke) van der Graaf