How does capacity building of health managers work? A realist evaluation study protocol.
How does capacity building of health managers work? A realist evaluation study protocol.
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DOI：
10.1136/bmjopen-2012-000882
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发表时间：
2012
期刊：
影响因子：
2.9
通讯作者：
Criel B
中科院分区：
文献类型：
--
作者：
Prashanth NS;Marchal B;Hoeree T;Devadasan N;Macq J;Kegels G;Criel B
人力资源管理干预措施在改善中低收入国家保健服务提供方面的作用受到了广泛关注。然而，由于对方案执行情况的研究有限，以及在对人力资源干预措施进行实验性研究方面存在方法上的困难，因此对这一问题的研究很少。作者提出了一个地区一级的能力建设干预的评价协议，以确定在管理职位的卫生工作者的业绩的决定因素，并了解如何改变（如果有的话）带来的。这项研究的目的是了解能力建设是如何工作的。作者将使用现实主义的评估，以评估在印度卡纳塔克邦的干预。干预措施是一项能力建设方案，旨在通过定期在课堂上授课和在工作场所提供辅导支持，提高区和分区一级卫生管理人员的管理能力。作者进行了访谈，并回顾了有关卫生能力建设的文献，以得出干预的方案理论。在此基础上，作者制定了将干预（计划和监督）的预期结果与输入（接触课程和指导）联系起来的假设路径。作者准备了一份问卷，以评估该计划的理论，组织文化，自我效能和监督的元素。作者将在卫生管理者中进行调查，并通过对参与者和非参与者的访谈收集定性数据，这些参与者和非参与者是根据他们的计划和监督绩效有目的地选择的。作者将从结果中构建以情境-机制-结果配置形式的解释。这将是迭代的，作者将使用一个现实主义的评估框架来完善基于研究结果的解释性理论，以解释和验证“什么对谁有效，在什么条件下有效”的改进理论。应用现实主义评价研究卫生人力资源管理干预措施的范围进行了讨论。尽管发展中国家十分重视卫生工作人员的能力建设，以改善卫生成果，但关于能力建设如何带来更好业绩的研究却很少。方法上的困难和卫生系统的复杂性限制了对人力资源管理干预措施的评价。卫生工作者的做法是由各种个人、机构和系统因素决定的复杂行为。有可能使用一种理论驱动的评价方法，如现实主义评价，以了解能力建设方案改善（或不改善）卫生工作者业绩的机制。这是第一次将现实主义评价应用于地方卫生系统干预措施（能力建设）。而不是"它是否工作？"，这项研究旨在了解"什么对谁和在什么条件下有效"。
There has been a lot of attention on the role of human resource management interventions to improve delivery of health services in low- and middle-income countries. However, studies on this subject are few due to limited research on implementation of programmes and methodological difficulties in conducting experimental studies on human resource interventions. The authors present the protocol of an evaluation of a district-level capacity-building intervention to identify the determinants of performance of health workers in managerial positions and to understand how changes (if any) are brought about. The aim of this study is to understand how capacity building works. The authors will use realist evaluation to evaluate an intervention in Karnataka, India. The intervention is a capacity-building programme that seeks to improve management capacities of health managers at district and subdistrict levels through periodic classroom-based teaching and mentoring support at the workplace. The authors conducted interviews and reviewed literature on capacity building in health to draw out the programme theory of the intervention. Based on this, the authors formulated hypothetical pathways connecting the expected outcomes of the intervention (planning and supervision) to the inputs (contact classes and mentoring). The authors prepared a questionnaire to assess elements of the programme theory—organisational culture, self-efficacy and supervision. The authors shall conduct a survey among health managers as well as collect qualitative data through interviews with participants and non-participants selected purposively based on their planning and supervision performance. The authors will construct explanations in the form of context–mechanism–outcome configurations from the results. This will be iterative and the authors will use a realist evaluation framework to refine the explanatory theories that are based on the findings to explain and validate an improved theory on ‘what works for whom and under what conditions’. The scope for applying realist evaluation to study human resource management interventions in health are discussed. Despite a lot of focus on capacity building of health workforce to improve health outcomes in developing countries, there are very few studies on how capacity building brings about better performance. Methodological difficulties and complexity of health systems impose restrictions on evaluating human resource management interventions. Health worker practices are complex behaviours that are determined by various individual, institutional and systemic factors. It is possible to use a theory-driven evaluation approach such as realist evaluation to understand the mechanisms through which capacity-building programmes improve (or do not improve) performance of health workers. This is the first application of realist evaluation to a local health system intervention (capacity building). Instead of ‘does it work or not?’, the study seeks to understand ‘what works for whom and under what conditions’.
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影响因子：
168.9
作者：
Hongoro, C;McPake, B
通讯作者：
McPake, B
影响因子：
5.4
作者：
KIM, KK;MOODY, PM
通讯作者：
MOODY, PM
DOI：
10.1111/j.1365-2753.2006.00790.x
发表时间：
2007-12-01
影响因子：
2.4
作者：
Connelly, James B.
通讯作者：
Connelly, James B.
影响因子：
4
作者：
Dieleman, Marjolein;Gerretsen, Barend;van der Wilt, Gert Jan
通讯作者：
van der Wilt, Gert Jan
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