Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption; Comment on “Barriers and Opportunities for WHO ‘Best Buys’ Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review”
1
Center for Commercial Determinant of Health, Institute of Public Health Bengaluru, Bengaluru, India
2
Centre for Health Systems, Institute of Public Health Bengaluru, Bengaluru, India
Abstract
There is a growing interest in complexity research. A recent systematic review by Loffreda et al attempted to study the barriers and opportunities for the adoption and implementation of the “best buys” for non-communicable diseases (NCDs) from a political economy perspective. In this commentary we take forward the discussion on the NCD best-buys by comparing the findings of the article with one of the risk factors of tobacco use and its control in India. We reflect on the challenges in actualizing the promise of research methods and approaches while studying such complex interventions like the NCD best buys. The balance of studying complexity while still keeping the findings translatable at country levels. Future research could potentially use a comparative lens focusing on either industry/ government or actor behaviour across the different risk factors to facilitate cross learning, anticipate and pre-empt adverse policy decisions and implementation outcomes.
Petticrew M, Knai C, Thomas J, et al. Implications of a complexity perspective for systematic reviews and guideline development in health decision making. BMJ Glob Health. 2019;4(Suppl 1):e000899. doi:1136/bmjgh-2018-000899
Greenhalgh T, Papoutsi C. Studying complexity in health services research. BMC Med. 2018;16(1):4-9.
Loffreda G, Arakelyan S, Bou-Orm I, et al. Barriers and opportunities for WHO “best buys” non-communicable disease policy adoption and implementation from a political economy perspective: a complexity systematic review. Int J Health Policy Manag. 2024;13:7989. doi:34172/ijhpm.2023.7989
World Health Organization. Tackling NCDs: Best Buys and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases. 2nd ed. Geneva: WHO; 2024.
Dsouza R, Bhojani U. Strategic and contested use of food laws to ban smokeless tobacco products in India: a qualitative analysis of litigation. Tob Control. 2023;32(3):275-279. doi:1136/tobaccocontrol-2020-056241
Varma A, Chilgod L, Bhojani U. Diverse and competing interests around tobacco: qualitative analysis of two decades of parliamentary questions in India. BMJ Glob Health. 2021;6(4):e004093. doi:1136/bmjgh-2020-004093
Dsouza V, Kembhavi PM, Rao S P, P K, Hebbar PB. How does Indian news media report smokeless tobacco control? A content analysis of the gutka ban enforcement. PLOS Glob Public Health. 2023;3(3):e0001724. doi:1371/journal.pgph.0001724
Hebbar PB, Bhojani U, van Schayck O, Babu G, Dsouza V, Nagelhout GE. Shifting the gaze on implementation: examining the association between the implementation of tobacco control laws and prevalence of tobacco using data from a nationally representative survey. BMC Public Health. 2023;23(1):1971. doi:1186/s12889-023-16780-8
Lencucha R, Neupane S. The use, misuse and overuse of the 'low-income and middle-income countries' category. BMJ Glob Health. 2022;7(6):e009067. doi:1136/bmjgh-2022-009067
Hebbar PB, Dsouza V, Nagelhout GE, et al. A realist evaluation of the implementation of a national tobacco control programme and policy in India. Health Policy Plan. 2025;40(2):140-152. doi:1093/heapol/czae081
Hebbar PB, Dsouza V, Bhojani U, et al. How do tobacco control policies work in low-income and middle-income countries? A realist synthesis. BMJ Glob Health. 2022;7(11):e008859. doi:1136/bmjgh-2022-008859
Maia EG, Stopa SR, de Oliveira Santos R, Claro RM. Trends in Prevalence of Cigarette Smoking in Brazil: 2006-2019. Am J Public Health. 2021;111(4):730-738. doi:2105/AJPH.2020.306102
Hebbar, P. B. , Bhojani, U. M. and Nuggehalli Srinivas, P. (2025). Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption; Comment on “Barriers and Opportunities for WHO ‘Best Buys’ Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review”. International Journal of Health Policy and Management, (), -.
MLA
Hebbar, P. B. , , Bhojani, U. M. , and Nuggehalli Srinivas, P. . "Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption; Comment on “Barriers and Opportunities for WHO ‘Best Buys’ Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review”", International Journal of Health Policy and Management, , , 2025, -.
HARVARD
Hebbar, P. B., Bhojani, U. M., Nuggehalli Srinivas, P. (2025). 'Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption; Comment on “Barriers and Opportunities for WHO ‘Best Buys’ Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review”', International Journal of Health Policy and Management, (), pp. -.
CHICAGO
P. B. Hebbar , U. M. Bhojani and P. Nuggehalli Srinivas, "Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption; Comment on “Barriers and Opportunities for WHO ‘Best Buys’ Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review”," International Journal of Health Policy and Management, (2025): -,
VANCOUVER
Hebbar, P. B., Bhojani, U. M., Nuggehalli Srinivas, P. Finding the Right Balance: Challenges in Optimising the Promise of Complexity Research for NCD Best-Buys Implementation and Adoption; Comment on “Barriers and Opportunities for WHO ‘Best Buys’ Non-communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review”. International Journal of Health Policy and Management, 2025; (): -.
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