Moving from formative research to co- creation of interventions: insights from a community health system project in Mozambique, Nepal and Peru
Moving from formative research to co- creation of interventions: insights from a community health system project in Mozambique, Nepal and Peru
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DOI：
10.1136/bmjgh-2018-001183
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发表时间：
2018-11-01
影响因子：
8.1
通讯作者：
Toyama, Mauricio
中科院分区：
文献类型：
--
作者：
Beran, David;Lazo-Porras, Maria;Toyama, Mauricio
需要采取不同的方法，对全球卫生的实施情况进行研究，重点是如何制定、实施和评价干预措施。在本文中，我们详细介绍了社区卫生系统创新（COHESION）项目，旨在加强莫桑比克，尼泊尔和秘鲁的卫生系统的全球卫生项目开发和实施的方法。该项目在政策、卫生系统和社区各级开展创新性的形成性研究，以非传染性疾病和被忽视的热带疾病为示踪条件，全面了解慢性病管理的障碍、促进因素、需求和经验教训。在形成性研究之后，COHESION在干预措施的规划中采用了共同创造的方法。该方法包括与每个国家的政策、卫生系统和社区一级的每类利益攸关方进行两次互动，旨在制定干预措施，改善示踪剂条件下的护理服务。使用了各种工具和方法，以便根据支助、资源和影响确定干预措施的优先次序。此外，评估可行性、可持续性和扩大规模的凝聚力评分被用来选择三种潜在的干预措施。COHESION项目的下一个步骤是进一步细化和制定通过这一过程提出的干预措施。除了提供一些有用的工具和方法外，这项工作还强调了从这种方法中吸取的挑战和经验教训。
Different methodological approaches for implementation research in global health focusing on how interventions are developed, implemented and evaluated are needed. In this paper, we detail the approach developed and implemented in the COmmunity HEalth System InnovatiON (COHESION) Project, a global health project aimed at strengthening health systems in Mozambique, Nepal and Peru. This project developed innovative formative research at policy, health system and community levels to gain a comprehensive understanding of the barriers, enablers, needs and lessons for the management of chronic disease using non-communicable and neglected tropical diseases as tracer conditions. After formative research, COHESION adopted a co-creation approach in the planning of interventions. The approach included two interactions with each type of stakeholder at policy, health system and community level in each country which aimed to develop interventions to improve the delivery of care of the tracer conditions. Diverse tools and methods were used in order to prioritise interventions based on support, resources and impact. Additionally, a COHESION score that assessed feasibility, sustainability and scaling up was used to select three potential interventions. Next steps for the COHESION Project are to further detail and develop the interventions propositioned through this process. Besides providing some useful tools and methods, this work also highlights the challenges and lessons learned from such an approach.