CALL FOR PAPERS – Health Policy and Planning supplment: Changing Health Systems: Advancing Justice and Sustainability through Research, Policy and Practice

Health systems are undergoing rapid and often unpredictable transformations. These changes are driven by technological advancements, shifting demographic patterns, climate change, and geopolitical tensions. The COVID-19 pandemic, for example, exposed the fragility of many health systems while simultaneously demonstrating remarkable adaptability in others. The interplay of competing interests—between public health goals, economic priorities, and political imperatives—although a long-standing challenge in many settings, has become increasingly stark in recent times, highlighting the tensions at the heart of health system governance and reform.

In this climate of rapid change, new and under-explored pathways are emerging in which justice and sustainability are being advanced within health systems. These may take the form of innovative financing mechanisms that prioritize equity, governance reforms that enhance participation and accountability, or climate-sensitive health policies that integrate environmental sustainability. Understanding these efforts, learning from them, and amplifying their impact is critical for shaping future health systems that are both just and sustainable.

Health Policy and Systems Research (HPSR) is a transdisciplinary field that brings together diverse perspectives, methods, and analytical lenses. Given its orientation toward complexity, power, and social change, HPSR is well-positioned to both analyze and contribute to health system transformations. This special issue seeks to explore how HPSR can actively engage with—and even drive—efforts to promote justice and sustainability in health systems globally.

Rationale

There are significant and growing challenges to justice and sustainability in health systems. Economic inequalities, political instability, climate-related health threats, and structural power imbalances continue to shape health system functioning in ways that often undermine fairness and long-term resilience. While these challenges are well-documented, less attention has been given to understanding instances where positive change has been realized and the strategies that have enabled it.

To address this gap, this special issue, jointly organized by Health Policy and Planning and Health Systems Global, aims to advance scholarship and practical understanding of justice and sustainability in health systems.  Drawing on contributions from the recent 8th Global Symposium for Health Systems Research held in Nagasaki, Japan, the issue will encourage critical engagement with real-world transformation, bridging academic inquiry with policy and practice. The thematic focus is particularly relevant in the current era of geopolitical shifts, environmental crises, and evolving health system governance, making it timely for both researchers and policymakers.

Thus, the special issue will focus on three core areas:

1. Analyzing how change in health systems and their broader contexts brings challenges for justice and sustainability
   • This involves an analytical focus on the ways in which policy shifts, governance structures, and political-economic transformations create new pressures or opportunities for justice and sustainability. For example, how do austerity policies impact equitable access to care; how do trade agreements shape national health priorities; and how can climate responsive and broader mitigation policies address health inequities?
2. Exploring strategies being used to stimulate and manage change and to advance justice and sustainability
   • A prospective and strategic lens is needed to document and assess interventions designed to foster justice and sustainability. This could include community-led health governance reforms, novel financing models, or global policy instruments that shape national health system responses. Different arenas of change—such as social movements, legal challenges, or multilateral agreements—may offer useful insights into mechanisms for positive transformation.
3. Examining how the HPSR field itself can help create change to tackle justice and sustainability challenges
   • The third area of focus is reflexive: how can HPSR scholars, practitioners, and policymakers contribute more effectively to the pursuit of justice and sustainability in health systems? This includes epistemological and methodological innovations that move beyond traditional modes of research toward more critical, participatory, engaged, and action-oriented approaches. For instance, co-produced research with Indigenous communities may reveal alternative models of health system governance that align with principles of justice and sustainability.

Framing

The framing of this special issue references several interrelated concepts and approaches including—theories of change, resilience, and learning health systems—each of which provide a potential lens through which to examine change and the pursuit of justice and sustainability in health systems.

Theories of Change are useful in that examining the conditions that enable or constrain transformative change within health systems can yield important insights into how justice and sustainability goals are advanced. Contributions that engage with theories of change could explore how structural, institutional, and political factors shape reform processes or how macro- and micro-level changes interact to produce intended and unintended consequences, for example.

Current debate around the nature of health system resilience runs hot. But the concept provides a useful way to understand how health systems respond to shocks, adapt to crises, and evolve in the face of uncertainty. While resilience has been widely discussed in the context of crisis management, this special issue is also interested in broader applications, such as how resilience-oriented governance strategies can reinforce commitments to, or conversely undermine, justice and sustainability. Contributions may critically examine whether resilience supports or undermines equitable health system change and explore approaches for balancing short-term responses with long-term transformation.

Finally, a learning health system perspective highlights the role of continuous reflection, adaptation and innovation, and self-reliance, in shaping health system evolution. Submissions might explore how feedback mechanisms, participatory governance models, or learning institutions contribute to more just and sustainable health systems. Studies that examine the role of different types of knowledge,—scientific, experiential, and Indigenous— and the value systems that underpin them in shaping health system policies and practices are welcomed.

Types of Contributions

This supplement will welcome a broad range of contributions, including:

• Empirical research articles utilising qualitative, quantitative, or mixed-methods approaches.
• System analyses documenting mechanisms and institutional reforms that advance justice and sustainability in complex geo-political and institutional environments
• Policy analyses that identify and amplify solutions for change.
• Innovation and practice reports that critically reflect on emerging trends and challenges, and present learning for change
• Methodological musings and ‘How to do (or not to do)…’ papers that advance conceptual understandings of justice and sustainability in health systems. Interdisciplinary perspectives will be particularly encouraged, as insights from political science, economics, sociology, and environmental studies can enrich the discourse within HPSR.

Criteria for Selection

Although this supplement will priorities work presented at HSR2024, we welcome all submissions. Abstracts, and invitations for full submission will ultimately be selected based on:

• Originality: Novel contributions to ongoing debates in HPSR, justice, and sustainability.
• Methodological rigour: Robust research design, analysis, and transparency in reporting findings.
• Theoretical innovation: Contributions that engage with and extend existing frameworks.
• Policy relevance: Implications for real-world health system governance and reform.
• Regional diversity: A balance of perspectives from different geographic and socio-political contexts.

Editorial Process and Timeline

The supplement will follow a structured editorial process, with key milestones including:

• Call for papers issued: [11 Mar 2025]
• Full manuscript submissions due: [23 May 2025]
• Peer review and revisions: [June 2025 - Feb 2026]
• Publication: [May 2026]