Assessing the impacts of governance reforms on health services delivery: a quasi-experimental, multi-method, and participatory approach
Assessing the impacts of governance reforms on health services delivery: a quasi-experimental, multi-method, and participatory approach
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评估治理改革对卫生服务提供的影响：准实验性、多方法和参与性方法
DOI：
10.1007/s10742-019-00201-8
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发表时间：
2019
影响因子：
1.5
通讯作者：
Tara Grillos
中科院分区：
文献类型：
--
作者：
Alan Zarychta;Krister P. Andersson;E. Root;J. Menken;Tara Grillos
尽管在开发新的、更复杂的影响评估方法和工具包方面取得了相当大的进展，但政策研究在实现评估三重奏方面仍然面临持续的挑战：确定影响、隔离机制和影响政策。例如，由于政策改革的内生性和选择效应，评估研究经常受到建立有效反事实的问题的阻碍。此外，稳健的评估研究通常必须应对治疗的异质性、错开的时间和吸收的变化。最后，出于实际考虑，研究人员经常努力让政策制定者和从业者参与整个研究过程，以产生政策影响所需的信任类型。虽然很难在不同背景下概括出适当的评估方法，但诸如改善卫生服务提供的治理改革等突出的政策干预措施仍然需要严格而全面的评估策略，以产生有效的结果并吸引决策者参与。借鉴我们对洪都拉斯卫生部门权力下放的研究的例证，在本文中，我们提出了一种准实验性、多方法和参与性的方法，以解决政策评估中这些持续存在的挑战。
Despite considerable advances in developing new and more sophisticated impact evaluation methodologies and toolkits, policy research continues to suffer from persistent challenges in achieving the evaluation trifecta: identifying effects, isolating mechanisms, and influencing policy. For example, evaluation studies are routinely hampered by problems of establishing valid counterfactuals due to endogeneity and selection effects with respect to policy reform. Additionally, robust evaluation studies often must contend with heterogeneity in treatment, staggered timing, and variation in uptake. And finally, on practical grounds, researchers frequently struggle to involve policymakers and practitioners throughout the research process in order to engender the type of trust needed for policy influence. While it can be difficult to generalize about appropriate evaluation methodologies across contexts, prominent policy interventions like governance reforms for improving health services delivery nonetheless demand rigorous and comprehensive evaluation strategies that can produce valid results and engage policymakers. Drawing on illustrations from our research on health sector decentralization in Honduras, in this paper we present a quasi-experimental, multi-method, and participatory approach that addresses these persistent challenges to policy evaluation.