Refocusing upstream: Operational Research for population health

This paper examines the potential for the application of OR methods to ‘upstream’ problems in health sector planning. These address the underlying causes of ill health, and stand in contrast to ‘downstream’ health service planning which addresses the consequences of ill health. The paper reviews the emergence, globally and locally, of recognition of the importance of upstream planning and policy formation for the health sectors of both developed and developing countries. It presents examples of the use of OR techniques in upstream health planning, with particular illustrations taken from the area of health impact assessment. It argues for a fuller appreciation of the potential contribution of OR in this and in other areas of upstream health sector planning.