HSR is undertaken primarily to provide information to support decision-making that can improve the functioning of the health system. It is evident that many issues in health are interrelated and interact with issues in other sectors, such as education, environment, health facilities and societal factors. In order to be effective, health systems research should be participatory in nature. Involvement of those directly concerned with a particular health or health care problem including policymakers, managers from the health and other public services, health care providers and the community is critical if research is to be relevant and appropriate.