Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol.
<h4>Background</h4>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 sha...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245755&type=printable |
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| author | Tolib Mirzoev Ana Manzano Bui Thi Thu Ha Irene Akua Agyepong Do Thi Hanh Trang Anthony Danso-Appiah Le Minh Thi Mary Eyram Ashinyo Le Thi Vui Leveana Gyimah Nguyen Thai Quynh Chi Lucy Yevoo Doan Thi Thuy Duong Elizabeth Awini Joseph Paul Hicks Anna Cronin de Chavez Sumit Kane |
| author_facet | Tolib Mirzoev Ana Manzano Bui Thi Thu Ha Irene Akua Agyepong Do Thi Hanh Trang Anthony Danso-Appiah Le Minh Thi Mary Eyram Ashinyo Le Thi Vui Leveana Gyimah Nguyen Thai Quynh Chi Lucy Yevoo Doan Thi Thuy Duong Elizabeth Awini Joseph Paul Hicks Anna Cronin de Chavez Sumit Kane |
| author_sort | Tolib Mirzoev |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Discussion</h4>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. |
| format | Article |
| id | doaj-art-278b79c42e654e35b9de715206850a9f |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
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| spelling | doaj-art-278b79c42e654e35b9de715206850a9f2025-08-20T03:44:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024575510.1371/journal.pone.0245755Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol.Tolib MirzoevAna ManzanoBui Thi Thu HaIrene Akua AgyepongDo Thi Hanh TrangAnthony Danso-AppiahLe Minh ThiMary Eyram AshinyoLe Thi VuiLeveana GyimahNguyen Thai Quynh ChiLucy YevooDoan Thi Thuy DuongElizabeth AwiniJoseph Paul HicksAnna Cronin de ChavezSumit Kane<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Discussion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245755&type=printable |
| spellingShingle | Tolib Mirzoev Ana Manzano Bui Thi Thu Ha Irene Akua Agyepong Do Thi Hanh Trang Anthony Danso-Appiah Le Minh Thi Mary Eyram Ashinyo Le Thi Vui Leveana Gyimah Nguyen Thai Quynh Chi Lucy Yevoo Doan Thi Thuy Duong Elizabeth Awini Joseph Paul Hicks Anna Cronin de Chavez Sumit Kane Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. PLoS ONE |
| title | Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. |
| title_full | Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. |
| title_fullStr | Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. |
| title_full_unstemmed | Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. |
| title_short | Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. |
| title_sort | realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in ghana and vietnam study protocol |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245755&type=printable |
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