Health systems research and acute respiratory infections: essential focus on the health system

Health systems research is receiving increasing prominence in the developing world as an aid to decision-making. In acute respiratory infection (ARI), health systems research has focused on alternative means of educating mothers to recognize pneumonia and seek treatment and on improving the case management practices of health workers. While these interventions have demonstrated their effectiveness in reducing ARI mortality in the research setting, on a wider scale the management and control of ARI will depend on a well-functioning health system, with skilled workers, essential drugs and equipment, an operating referral system, adequate supervision and an active monitoring system. The essential focus for health systems research in the reduction of the impact of ARI on public health in Papua New Guinea should be on improving the effectiveness of the health care delivery system. Some potential areas for health systems research are outlined.