How to evaluate the implementation of complex health programmes in low-income settings: the approach of the Gavi Full Country Evaluations.
How to evaluate the implementation of complex health programmes in low-income settings: the approach of the Gavi Full Country Evaluations.
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DOI：
10.1093/heapol/czaa127
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发表时间：
2020-11-01
影响因子：
3.2
通讯作者：
Lim SS
中科院分区：
文献类型：
--
作者：
Soi C;Shearer JC;Budden A;Carnahan E;Salisbury N;Asiimwe G;Chilundo B;Sarma H;Gimbel S;Simuyemba M;Uddin J;Masiye F;Kamya M;Hozumi D;Rajaratnam JK;Lim SS
与大多数其他公共卫生服务一样，疫苗接种依赖于一整套复杂的干预措施、运作良好的系统和坚定的行为者，以实现全民覆盖。尽管对免疫方案进行了大量投资，但全国覆盖率的趋势已经放缓，公平差距已经扩大。本文介绍了全球免疫联盟全面国家评价的设计和实施情况，这是一种多国、前瞻性、混合方法的方法，其目标是监测和评价孟加拉国、莫桑比克、乌干达和赞比亚免疫规划的进程、投入、产出和成果。我们于2013年至2018年实施了全面国家评估，目标是确定免疫计划改进的驱动因素，以支持计划实施并提高公平的免疫覆盖率。该框架支持方法和范式的灵活性，以应对全球、国家和跨国各级的广泛评价和执行研究问题，但其主要基础是侧重于评价进程和查明执行失败的根本原因。过程评价是由全球疫苗免疫倡议的每一个资金流（如加强卫生系统）或活动的变化理论驱动的，从全球政策制定到地区一级的方案执行。随着时间的推移，随着我们学会将多种方法构建到越来越多的定制评估问题中，混合方法的相关性和严格性也在增加。国家研究所的评价小组越来越多地加强了与免疫方案的密切联系，因为随着时间的推移，重点逐渐转移到更注重利用方案学习和调整的结果。根据我们实施这一方法的经验，我们建议将其用于评价其他复杂的干预措施、卫生方案或发展援助。
Vaccination, like most other public health services, relies on a complex package of intervention components, functioning systems and committed actors to achieve universal coverage. Despite significant investment in immunization programmes, national coverage trends have slowed and equity gaps have grown. This paper describes the design and implementation of the Gavi Full Country Evaluations, a multi-country, prospective, mixed-methods approach whose goal was to monitor and evaluate processes, inputs, outputs and outcomes of immunization programmes in Bangladesh, Mozambique, Uganda and Zambia. We implemented the Full Country Evaluations from 2013 to 2018 with the goal of identifying the drivers of immunization programme improvement to support programme implementation and increase equitable immunization coverage. The framework supported methodological and paradigmatic flexibility to respond to a broad range of evaluation and implementation research questions at global, national and cross-country levels, but was primarily underpinned by a focus on evaluating processes and identifying the root causes of implementation breakdowns. Process evaluation was driven by theories of change for each Gavi funding stream (e.g. Health Systems Strengthening) or activity, ranging from global policy development to district-level programme implementation. Mixing of methods increased in relevance and rigour over time as we learned to build multiple methods into increasingly tailored evaluation questions. Evaluation teams in country-based research institutes increasingly strengthened their level of embeddedness with immunization programmes as the emphasis shifted over time to focus more heavily on the use of findings for programme learning and adaptation. Based on our experiences implementing this approach, we recommend it for the evaluation of other complex interventions, health programmes or development assistance.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.1136/bmj.h1258
发表时间：
2015-03-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moore GF;Audrey S;Barker M;Bond L;Bonell C;Hardeman W;Moore L;O'Cathain A;Tinati T;Wight D;Baird J
通讯作者：
Baird J
影响因子：
5.5
作者：
Phillips, David E.;Dieleman, Joseph L.;Lim, Stephen S.
通讯作者：
Lim, Stephen S.
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
DOI：
10.9745/ghsp-d-20-00126
发表时间：
2020-12-23
期刊：
Global health, science and practice
影响因子：
--
作者：
Carnahan E;Gurley N;Asiimwe G;Chilundo B;Duber HC;Faye A;Kamya C;Mpanya G;Nagasha S;Phillips D;Salisbury N;Shearer J;Shelley K;Gavi Full Country Evaluations Consortium; and Global Fund Prospective Country Evaluation Consortium
通讯作者：
Gavi Full Country Evaluations Consortium; and Global Fund Prospective Country Evaluation Consortium