Health system evaluation in conflict-affected countries: a scoping review of approaches and methods.
Health system evaluation in conflict-affected countries: a scoping review of approaches and methods.
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DOI：
10.1186/s13031-023-00526-9
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发表时间：
2023-06-19
影响因子：
3.6
通讯作者：
Howard, Natasha
中科院分区：
文献类型：
--
作者：
Marzouk, Manar;Durrance-Bagale, Anna;Lam, Sze Tung;Nagashima-Hayashi, Michiko;Ung, Mengieng;Aribou, Zeenathnisa Mougammadou;Zaseela, Ayshath;Ibrahim, Nafeesah Mohamed;Agarwal, Sunanda;Omar, Maryam;Newaz, Sanjida;Mkhallalati, Hala;Howard, Natasha
加强受冲突影响地区的卫生系统已变得越来越专业化。然而，评估仍然具有挑战性，并且文献中往往没有充分记录。许多评估，特别是小规模的卫生系统评估，是由政府机构或非政府组织 (NGO) 进行的，但发布经验的能力有限。必须确定现有文献和主要研究结果，作为未来评估受冲突影响的卫生系统的能力和复原力的基线。因此，我们的目的是综合受冲突影响环境下卫生系统评估的同行评审文献中使用的方法论方法和方法的范围。我们使用阿克西和奥马利的方法进行了范围界定审查，并使用世卫组织卫生系统“构建模块”框架综合了研究结果。我们纳入了 2,355 个筛查项目中的 58 个合格来源，其中包括对 26 个受冲突影响国家的卫生系统或组成部分的检查，主要是南苏丹和阿富汗（各 7 个来源）、刚果民主共和国（6 个）和巴勒斯坦（5 个）。大多数来源 (86%) 由外国学术机构和国际捐助者主导，重点关注卫生服务提供 (78%)，其中定性设计占主导地位 (53%)。理论或概念基础极其有限，研究设计通常并不复杂，因为许多来源（43％）是对国际捐助者的非政府组织项目评估，并且依赖于简单且成本较低的方法。来源在地理（例如，美洲地区的覆盖范围有限）、组成部分（例如，对服务提供等特定组成部分的偏好）、性别（例如，妇女的有限参与）和殖民化（例如，受影响国家的作者和研究领导力有限）方面也受到限制。受冲突影响环境中的评估文献在范围和内容上仍然有限，倾向于简化研究设计和方法，包括国际上实施或资助的组成部分和项目。许多已确定的挑战和限制（例如，有限的创新/情境化、与当地参与者的互动不佳、性别和语言偏见）可以通过更严格和系统的评估方法来缓解。
Strengthening health systems in conflict-affected settings has become increasingly professionalised. However, evaluation remains challenging and often insufficiently documented in the literature. Many, particularly small-scale health system evaluations, are conducted by government bodies or non-governmental organisations (NGO) with limited capacity to publish their experiences. It is essential to identify the existing literature and main findings as a baseline for future efforts to evaluate the capacity and resilience of conflict-affected health systems. We thus aimed to synthesise the scope of methodological approaches and methods used in the peer-reviewed literature on health system evaluation in conflict-affected settings. We conducted a scoping review using Arksey and O’Malley’s method and synthesised findings using the WHO health system ‘building blocks’ framework. We included 58 eligible sources of 2,355 screened, which included examination of health systems or components in 26 conflict-affected countries, primarily South Sudan and Afghanistan (7 sources each), Democratic Republic of the Congo (6), and Palestine (5). Most sources (86%) were led by foreign academic institutes and international donors and focused on health services delivery (78%), with qualitative designs predominating (53%). Theoretical or conceptual grounding was extremely limited and study designs were not generally complex, as many sources (43%) were NGO project evaluations for international donors and relied on simple and lower-cost methods. Sources were also limited in terms of geography (e.g., limited coverage of the Americas region), by component (e.g., preferences for specific components such as service delivery), gendered (e.g., limited participation of women), and colonised (e.g., limited authorship and research leadership from affected countries). The evaluation literature in conflict-affected settings remains limited in scope and content, favouring simplified study designs and methods, and including those components and projects implemented or funded internationally. Many identified challenges and limitations (e.g., limited innovation/contextualisation, poor engagement with local actors, gender and language biases) could be mitigated with more rigorous and systematic evaluation approaches.
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影响因子：
2.6
作者：
Durrance-Bagale, Anna;Marzouk, Manar;Tung, Lam Sze;Agarwal, Sunanda;Aribou, Zeenathnisa Mougammadou;Ibrahim, Nafeesah Bte Mohamed;Mkhallalati, Hala;Newaz, Sanjida;Omar, Maryam;Ung, Mengieng;Zaseela, Ayshath;Nagashima-Hayashi, Michiko;Howard, Natasha
通讯作者：
Howard, Natasha
在反对派控制的叙利亚重建卫生系统治理的视角： 定性研究
DOI：
10.15171/ijhpm.2018.132
发表时间：
2019-04-01
影响因子：
3.5
作者：
Douedari, Yazan;Howard, Natasha
通讯作者：
Howard, Natasha
影响因子：
3.7
作者：
Bernasconi, Andrea;Crabbe, Francois;Rossi, Rodolfo
通讯作者：
Rossi, Rodolfo
影响因子：
3.6
作者：
Collier, Jane;Kienzler, Hanna
通讯作者：
Kienzler, Hanna
影响因子：
3.6
作者：
Anwari Z;Shukla M;Maseed BA;Wardak GF;Sardar S;Matin J;Rashed GS;Hamedi SA;Sahak H;Aziz AH;Boyd-Boffa M;Trasi R
通讯作者：
Trasi R