Strengthening the quality of paediatric primary care: protocol for the process evaluation of a health systems intervention in South Africa.
Strengthening the quality of paediatric primary care: protocol for the process evaluation of a health systems intervention in South Africa.
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DOI：
10.1136/bmjgh-2018-000945
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发表时间：
2018
影响因子：
8.1
通讯作者：
Fairall L
中科院分区：
文献类型：
--
作者：
Murdoch J;Curran R;Bachmann M;Bateman E;Cornick RV;Doherty T;Picken SC;Simelane ML;Fairall L
尽管死亡率大幅下降，但可预防和可治疗的疾病仍然是南非五岁以下儿童死亡的主要原因。世卫组织的儿童疾病综合管理方案已得到广泛实施，以解决五岁以下儿童死亡的最常见原因。虽然有效，但在儿童疾病综合管理的范围和遵守方面也出现了限制。开发了实用的护理工具包(PACK)儿童指南，以扩展IMCI并解决这些限制。它的目的是作为卫生工作者的临床决策支持工具，并增加加强系统的组成部分，包括积极实施和培训战略，以解决阻碍儿童护理质量的背景和组织因素。实施是复杂的，需要全面的试点和进程评估。Pack Child试点和可行性研究将对西开普省的10个初级保健设施进行抽样。工作人员将接受培训，以便将Pack儿童指南纳入日常实践。进程评价将调查执行情况和卫生系统组成部分，以确定如何优化交付，加强儿童疾病综合管理原则和因素，以支持有效和持续地将其纳入日常实践。混合法过程评价。定性数据包括对管理人员、工作人员、护理人员和政策制定者的访谈；对培训、咨询和诊所流程的观察。量化数据包括培训日志和工作人员问卷。将结合定量和定性分析来描述研究地点，并为执行情况的变化制定解释。在进行更大规模的务实试验或扩大规模之前，进程评价将提供记录执行情况和完善方案的机会。
Despite significant reductions in mortality, preventable and treatable conditions remain the leading causes of death in children under five within South Africa. The WHO’s Integrated Management of Childhood Illness (IMCI) programme has been widely implemented to address the most common causes of mortality in children under five. Although effective, limitations in IMCI scope and adherence have emerged. The Practical Approach to Care Kit (PACK) Child guide has been developed to expand on IMCI and address these limitations. It is intended as a clinical decision support tool for health workers with additional systems strengthening components, including active implementation and training strategy to address contextual and organisational factors hindering quality of care for children. Implementation is complex, requiring comprehensive pilot and process evaluation. The PACK Child pilot and feasibility study will sample 10 primary care facilities in the Western Cape Province. Staff will be trained to integrate the PACK Child guide into routine practice. The process evaluation will investigate implementation and health systems components to establish how to optimise delivery, strengthen IMCI principles and factors required to support effective and sustained uptake into everyday practice. Mixed method process evaluation. Qualitative data include interviews with managers, staff, caregivers and policymakers; observations of training, consultations and clinic flow. Quantitative data include training logs and staff questionnaires. Quantitative and qualitative analysis will be integrated to describe study sites and develop explanations for implementation variation. The process evaluation will provide the opportunity to document implementation and refine the programme prior to a larger pragmatic trial or scale-up.
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影响因子：
3.1
作者：
Hawe, Penelope;Shiell, Alan;Riley, Therese
通讯作者：
Riley, Therese
影响因子：
3.7
作者：
Horwood C;Vermaak K;Rollins N;Haskins L;Nkosi P;Qazi S
通讯作者：
Qazi S
影响因子：
8.1
作者：
Cornick, Ruth;Picken, Sandy;Fairall, Lara
通讯作者：
Fairall, Lara
影响因子：
16.4
作者：
BRONFENBRENNER, U
通讯作者：
BRONFENBRENNER, U
制定和评估复杂的干预措施：新的医学研究委员会指南。
DOI：
10.1136/bmj.a1655
发表时间：
2008-09-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Craig P;Dieppe P;Macintyre S;Michie S;Nazareth I;Petticrew M;Medical Research Council Guidance
通讯作者：
Medical Research Council Guidance