Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.
Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.
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DOI：
10.1371/journal.pone.0137159
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Oliver S
中科院分区：
文献类型：
--
作者：
Akl EA;El-Jardali F;Bou Karroum L;El-Eid J;Brax H;Akik C;Osman M;Hassan G;Itani M;Farha A;Pottie K;Oliver S
需要在人道主义危机中提供或资助卫生服务的组织、机构和机构之间进行有效协调，以确保服务的效率、避免重复和改善公平。这次审查的目的是评估在人道主义危机期间和之后，提供或资助保健服务的组织、机构和机构之间的不同协调机制和模式在获得保健服务和保健成果方面的比较情况。我们在PROSPERO2014号为PROSPERO2014：CRD42014009267的PROSPERO国际系统评价前瞻性登记中登记了该评价的方案。符合条件的研究包括随机化和非随机化设计、过程评估和定性方法。我们检索了Medline、PubMed、EMBASE、Cochrane中央对照试验注册中心、CINAHL、SqucINFO和WHO全球健康图书馆以及相关组织的网站。我们遵循标准的系统评价方法进行选择、数据提取和偏倚风险评估。我们使用分级方法来评估证据的质量。在来自数据库和组织网站的14,309条确定的引文中，我们确定了4项符合条件的研究。两项研究使用了混合方法，一项使用了定量方法，一项使用了定性方法。现有证据表明，在人道主义危机情况下提供保健服务的机构之间的信息协调可能有效地改善保健系统的投入。还有其他证据表明，管理/指令协调，如分组模式，除了可获得保健服务外，还可改善保健系统的投入。所有纳入的研究均未评估通过共同代表制和框架协调进行的协调。证据被认为质量很低。这一系统审查提供了证据，证明在人道主义危机中提供或资助卫生服务的组织、机构和机构之间的信息协调和管理/指令协调可能有效。我们的研究结果可以为研究议程提供信息，并强调需要改进这一领域研究的进行和报告。
Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field.