Mapping the Multiple Health System Responsiveness Mechanisms in One Local Health System: A Scoping Review of the Western Cape Provincial Health System of South Africa.
Mapping the Multiple Health System Responsiveness Mechanisms in One Local Health System: A Scoping Review of the Western Cape Provincial Health System of South Africa.
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DOI：
10.34172/ijhpm.2021.85
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发表时间：
2022-01-01
影响因子：
3.5
通讯作者：
Olivier, Jill
中科院分区：
文献类型：
--
作者：
Sutherns, Tammy;Olivier, Jill
背景资料：尽管各国政府努力建立反应灵敏的卫生系统，并实施各种机制，以促进更好的公民反馈，加强问责制和管理，但这些机制并不总是以有效、公平或高效的方式运作。也有有限的证据表明，映射不同的反应机制连贯地在一个特定的卫生系统，特别是在低收入和中等收入国家（LMIC）的情况。 研究方法：这种范围审查提出了一个横截面的“地图”类型的卫生系统响应机制;监管环境;和现有的证据，这些;并评估了什么是已知的功能，在一个特定的当地南非卫生系统;西开普省（WC）。多种形式的索引和灰色文献进行了合成，以提供当前的“正式”的响应机制，在国家和省级政策和指导方针（n = 379）的背景下的理解。对定量和定性数据进行了各种形式的二次分析，包括专题和时间序列分析。作为检查分析和结论准确性的最后一步，由三名当地实地专家进行了专家检查。 结果如下：国家、省和地区政策规定了卫生系统的反应能力，包括旨在促进公众反馈的各种机制。然而，虽然有些机制已证明在发挥作用和有效，但所有机制都面临重大障碍，如资源和能力限制，作用和责任不明确。大多数机制都是孤立存在的，未能纳入提高应对能力的总体战略。 结论：各机制之间缺乏协同作用，或对各种形式的反馈缺乏分析，是错失了一个机会。决策者无法看到反馈流中的趋势或差距，无法检查是否听到了所有的声音，也无法充分了解是否/如何作出系统性反应。紧急卫生系统的工作在于研究宏观“整体”系统的反应性（水平，发展，趋势）。
Background: Despite governments striving for responsive health systems and the implementation of mechanisms to foster better citizen feedback and strengthen accountability and stewardship, these mechanisms do not always function in effective, equitable, or efficient ways. There is also limited evidence that maps the diverse array of responsiveness mechanisms coherently across a particular health system, especially in low- and middle-income country (LMIC) contexts. Methods: This scoping review presents a cross-sectional ‘map’ of types of health system responsiveness mechanisms; the regulatory environment; and evidence available about these; and assesses what is known about their functionality in a particular local South African health system; the Western Cape (WC) province. Multiple forms of indexed and grey literature were synthesized to provide a contextualized understanding of current ‘formal’ responsiveness mechanisms mandated in national and provincial policies and guidelines (n = 379). Various forms of secondary analysis were applied across quantitative and qualitative data, including thematic and time-series analyses. An expert checking process was conducted, with three local field experts, as a final step to check the veracity of the analytics and conclusions made. Results: National, provincial and district policies make provision for health system responsiveness, including varied mechanisms intended to foster public feedback. However, while some are shown to be functioning and effective, there are major barriers faced by all, such as resource and capacity constraints, and a lack of clarity about roles and responsibilities. Most mechanisms exist in isolation, failing to feed into an overarching strategy for improved responsiveness. Conclusion: The lack of synergy between mechanisms or analysis of varied forms of feedback is a missed opportunity. Decision-makers are unable to see trends or gaps in the flow of feedback, check whether all voices are heard or fully understand whether/how systemic response occurs. Urgent health system work lies in the research of macro ‘whole’ systems responsiveness (levels, development, trends).
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DOI：
10.11604/pamj.2014.18.172.4084
发表时间：
2014
期刊：
The Pan African medical journal
影响因子：
--
作者：
Jacobsen KH;Hasumi T
通讯作者：
Hasumi T
DOI：
10.1111/j.1759-5436.2004.tb00116.x
发表时间：
2004-04-01
影响因子：
0.7
作者：
Mahmud, S
通讯作者：
Mahmud, S
影响因子：
2.9
作者：
Gugsa, Frey;Karmarkar, Ellora;Yamey, Gavin
通讯作者：
Yamey, Gavin
影响因子：
4
作者：
Akintola, Olagoke;Lavis, John N.;Hoskins, Ryan
通讯作者：
Hoskins, Ryan
影响因子：
9.7
作者：
Hawn, Carleen
通讯作者：
Hawn, Carleen