Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol.
Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol.
复制标题
DOI：
10.1371/journal.pone.0245755
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Kane S
中科院分区：
文献类型：
--
作者：
Mirzoev T;Manzano A;Ha BTT;Agyepong IA;Trang DTH;Danso-Appiah A;Thi LM;Ashinyo ME;Vui LT;Gyimah L;Chi NTQ;Yevoo L;Duong DTT;Awini E;Hicks JP;Cronin de Chavez A;Kane S
许多低收入和中等收入国家的社会经济增长使人们能够获得更多的医疗保健服务，尽管这种服务的获得并不公平。这种增长也增加了公民对卫生系统更好地满足其需求的要求。本文分享了RESPONSE研究的协议，该研究旨在了解，共同制作，实施和评估环境敏感的干预措施，以提高加纳和越南弱势群体健康需求的卫生系统响应能力。我们将使用现实主义的混合方法理论驱动的案例研究设计，结合定量（家庭调查，设施数据的二次分析）和定性（深入访谈，焦点小组，观察和文件和文献综述）的方法。将对数据进行追溯性分析。研究将包括三个阶段。在第一阶段，我们将了解参与者对响应性卫生系统的期望，确定干预措施的关键优先事项，并使用来自现实主义综合的证据，我们将开发初始理论并生成基线数据。在第二阶段，我们将与关键行动者共同制定对具体情况有敏感认识的干预措施，以提高卫生系统的反应能力。干预措施将力求通过参与性讲习班改善内部（即系统内）和外部（即人与系统）的互动。在第三阶段，我们将通过比较预期设计和干预措施的实际表现来测试和完善我们的初始理论，从而实施和评估干预措施。该研究的主要成果将是：（1）提高卫生系统的响应能力，有助于改善加纳和越南的卫生服务，并最终改善健康结果;（2）建立一个基于实践和理论的复杂背景-机制-结果关系模型，以及可扩展性和普遍性的可转移最佳实践。各级决策者将自始至终参与。能力加强将以深入了解每个伙伴团队的能力需求和资产为基础，并旨在加强个人、组织和系统层面的能力。
Socio-economic growth in many low and middle-income countries has resulted in more available, though not equitably accessible, healthcare. Such growth has also increased demands from citizens for their health systems to be more responsive to their needs. This paper shares a protocol for the RESPONSE study which aims to understand, co-produce, implement and evaluate context-sensitive interventions to improve health systems responsiveness to health needs of vulnerable groups in Ghana and Vietnam. We will use a realist mixed-methods theory-driven case study design, combining quantitative (household survey, secondary analysis of facility data) and qualitative (in-depth interviews, focus groups, observations and document and literature review) methods. Data will be analysed retroductively. The study will comprise three Phases. In Phase 1, we will understand actors’ expectations of responsive health systems, identify key priorities for interventions, and using evidence from a realist synthesis we will develop an initial theory and generate a baseline data. In Phase 2, we will co-produce jointly with key actors, the context-sensitive interventions to improve health systems responsiveness. The interventions will seek to improve internal (i.e. intra-system) and external (i.e. people-systems) interactions through participatory workshops. In Phase 3, we will implement and evaluate the interventions by testing and refining our initial theory through comparing the intended design to the interventions’ actual performance. The study’s key outcomes will be: (1) improved health systems responsiveness, contributing to improved health services and ultimately health outcomes in Ghana and Vietnam and (2) an empirically-grounded and theoretically-informed model of complex contexts-mechanisms-outcomes relations, together with transferable best practices for scalability and generalisability. Decision-makers across different levels will be engaged throughout. Capacity strengthening will be underpinned by in-depth understanding of capacity needs and assets of each partner team, and will aim to strengthen individual, organisational and system level capacities.
登录
查看更多内容
影响因子：
2.3
作者：
Doan, Duong Thi Thuy;Bui, Ha Thi Thu;Mirzoev, Tolib
通讯作者：
Mirzoev, Tolib
影响因子：
--
作者：
Agyepong, I A;Anniah, K;Mirzoev, T
通讯作者：
Mirzoev, T
影响因子：
2.2
作者：
Den hollander, Geerte C.;Browne, Joyce L.;Klipstein-Grobusch, Kerstin
通讯作者：
Klipstein-Grobusch, Kerstin
影响因子：
2.6
作者：
Mirzoev T;Kane S
通讯作者：
Kane S
影响因子：
1.9
作者：
Fenny, Ama Pokuaa;Asuman, Derek;Odame, Doreen Nyarko Anyamesem
通讯作者：
Odame, Doreen Nyarko Anyamesem