To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocolReport as inadecuate




To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocol - Download this document for free, or read online. Document in PDF available to download.

Systematic Reviews

, 5:70

First Online: 27 April 2016Received: 21 January 2016Accepted: 06 April 2016DOI: 10.1186-s13643-016-0239-z

Cite this article as: Belrhiti, Z., Booth, A., Marchal, B. et al. Syst Rev 2016 5: 70. doi:10.1186-s13643-016-0239-z

Abstract

BackgroundDistrict health managers play a key role in the effectiveness of decentralized health systems in low- and middle-income countries. Inadequate management and leadership skills often hamper their ability to improve quality of care and effectiveness of health service delivery. Nevertheless, significant investments have been made in capacity-building programmes based on site-based training, mentoring, and operational research. This systematic review aims to review the effectiveness of site-based training, mentoring, and operational research or action research on the improvement of district health system management and leadership. Our secondary objectives are to assess whether variations in composition or intensity of the intervention influence its effectiveness and to identify enabling and constraining contexts and underlying mechanisms.

MethodsWe will search the following databases: MEDLINE, PsycInfo, Cochrane Library, CRD database DARE, Cochrane Effective Practice and Organisation of Care EPOC group, ISI Web of Science, Health Evidence.org, PDQ-Evidence, ERIC, EMBASE, and TRIP. Complementary search will be performed hand-searching journals and citation and reference tracking.

Studies that meet the following PICO Population, Intervention, Comparison, Outcome criteria will be included: P: professionals working at district health management level; I: site-based training with or without mentoring, or operational research; C: normal institutional arrangements; and O: district health management functions. We will include cluster randomized controlled trials, controlled before-and-after studies, interrupted time series analysis, quasi-experimental designs, and cohort and longitudinal studies. Qualitative research will be included to contextualize findings and identify barriers and facilitators.

Primary outcomes that will be reported are district health management and leadership functions. We will assess risk of bias with the Cochrane Collaboration’s tools for randomized controlled trials RCT and non RCT studies and Critical Appraisal Skills Programme checklists for qualitative studies. We will assess strength of recommendations with the GRADE tool for quantitative studies, and the CERQual approach for qualitative studies. Synthesis of quantitative studies will be performed through meta-analysis when appropriate. Best fit framework synthesis will be used to synthesize qualitative studies.

DiscussionThis protocol paper describes a systematic review assessing the effectiveness of site-based training with or without mentoring programmes or operational research on the improvement of district health system management and leadership.

Systematic review registrationPROSPERO CRD42015032351

KeywordsSite-based training Mentoring Operational research Best fit framework synthesis District health Management Leadership Low- and middle-income countries AbbreviationsARaction research

BeHEMoThBehaviour of interest, Health context, Exclusions, Models or Theories

BFFbest fit framework

CBAControl before and after studies

CASPCritical Appraisal Skills Programme

DAREDatabase of

Abstracts of Reviews of Effects

DHMdistrict health managers

EPOCCochrane Effective Practice and Organisation of Care

ERICEducation Resources Information Center

EVIDENTEvidence Informed Decision-Making in Health and Nutrition

HICshigh-income countries

ITSInterrupted Time Series

LMICslow- and middle-income countries

PDQ-Evidence-Pretty Darn Quick- evidence

ORoperational research

PICOPopulation, Intervention, Comparison, Outcome

PICOCPopulation, Intervention, Comparison, Outcome, Context

RCTrandomized controlled trials

SBTsite-based training

WHOWorld Health Organization

Electronic supplementary materialThe online version of this article doi:10.1186-s13643-016-0239-z contains supplementary material, which is available to authorized users.

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Author: Zakaria Belrhiti - Andrew Booth - Bruno Marchal - Roosmarijn Verstraeten

Source: https://link.springer.com/







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