TY - JOUR
T1 - Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam
T2 - Study protocol
AU - Mirzoev, Tolib
AU - Manzano, Ana
AU - Ha, Bui Thi Thu
AU - Agyepong, Irene Akua
AU - Trang, Do Thi Hanh
AU - Danso-Appiah, Anthony
AU - Thi, Le Minh
AU - Ashinyo, Mary Eyram
AU - Vui, Le Thi
AU - Gyimah, Leveana
AU - Chi, Nguyen Thai Quynh
AU - Yevoo, Lucy
AU - Duong, Doan Thi Thuy
AU - Awini, Elizabeth
AU - Hicks, Joseph Paul
AU - De Chavez, Anna Cronin
AU - Kane, Sumit
N1 - Publisher Copyright:
© 2021 Mirzoev et al.
PY - 2021/1
Y1 - 2021/1
N2 - Background 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. Methods 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 contextsensitive 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. Discussion 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.
AB - Background 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. Methods 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 contextsensitive 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. Discussion 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.
UR - http://www.scopus.com/inward/record.url?scp=85100026599&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0245755
DO - 10.1371/journal.pone.0245755
M3 - Article
C2 - 33481929
AN - SCOPUS:85100026599
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 1 January
M1 - e0245755
ER -