HEALTH SYSTEMS STRENGTHENING TO IMPROVE HEALTH OUTCOMES: APPLYING IMPLEMENTATION

摘要 尽管全球卫生投资显著增加，而且可获得低成本、有效的 旨在减轻中低收入国家可预防疾病负担的干预措施 将这些科学进步转化为有效的交付战略是缓慢的、不均衡的和 不完整。卫生系统在缩小我们的科学知识和知识之间的差距方面发挥着重要作用 它们以足够的规模提供，以导致人口一级健康结果的改善。然而， 卫生系统的复杂性继续挑战实施研究人员及其确定 并克服卫生系统障碍，广泛应用这些经验教训。这项研究的目的是 该项目由多丽丝·杜克慈善基金会的非洲健康倡议资助，旨在改善健康 在莫桑比克索法拉省13个区通过加强卫生系统和提供 综合初级卫生保健。在具体目标1中，我们将评估卫生系统加强干预措施 包括改进数据系统，使用数据驱动的决策工具，以及加强领导和 地区卫生团队对卫生系统产出和成果的管理能力。在具体目标2中，我们将 评估卫生系统加强干预措施的一揽子措施的影响，包括改进的数据 系统，使用数据驱动的决策工具，以及加强对 地区卫生小组对人口一级的健康结果进行了评估。将采用准实验设计来 对特定目标作出响应，比较所选的产出、结果和影响措施的变化 提供服务和改善健康结果。这项实施研究的结果将产生 具有全球重要性的知识，以支持循证卫生服务和卫生系统规划。

ABSTRACT Despite significant increases in global health investment and the availability of low-cost, efficacious interventions designed to reduce the burden of preventable diseases in low and middle income countries, the translation of these scientific advances into effective delivery strategies has been slow, uneven and incomplete. Health systems play a fundamental role in closing this gap between our scientific knowledge and their delivery at sufficient scale to lead to population-level improvements in health outcomes. However, the complexity of health systems continues to challenge implementation researchers and their efforts to identify and overcome health system barriers, and broadly apply these lessons learned. This goal of this research project, funded through the Doris Duke Charitable Foundation's African Health Initiative, is to improve health outcomes in 13 districts in Sofala province, Mozambique, through strengthened health systems and delivery of integrated primary health care. In specific aim 1, we will assess health systems strengthening interventions including improved data systems, use of data driven decision-making tools, and strengthened leadership and management capacity of district health teams on health system outputs and outcomes. In specific aim 2 we will assess the impact of a package of health systems strengthening interventions including improved data systems, use of data driven decision-making tools, and strengthened leadership and management capacity of district health teams on population-level health outcomes. A quasi-experimental design will be employed to respond to the specific aims, comparing changes in output, outcome and impact measures selected to capture service delivery and health outcome improvements. The results of this implementation research will generate knowledge of global significance to support evidence-based health delivery and health systems planning.