Article type
Year
Abstract
Background: The health systems cover three types of arrangements, that is, governance arrangements, financial arrangements, and delivery arrangements, and the implementation considerations for supporting these arrangements. Some evidence showed that weak health systems could hinder the implementation of effective interventions. As an important input, health system guidance (HSG) could help address the challenges of weak health systems (i.e. strengthen health systems) and provide evidence to support policymaking about health systems. However, there is no framework or tool for HSG implementation.
Objectives: To develop a theoretical framework about the facilitators to, barriers to, and strategies of HSG implementation at different levels (individual, organizational, community and system), further to develop HSG implementation tool, then to assist the use and uptake of global HSG at national or sub-national levels.
Methods: A critical interpretive synthesis (CIS) approach will be conducted to develop a theoretical framework, which aims to identify the facilitating factors and barriers during HSG implementation at the four levels, and the corresponding strategies, and their relationships and connections. We will identify the related literature by searching four types of data sources: electronic databases, organizational websites and conference abstracts, the reference of included studies, and contacting experts. Two reviewers will independently assess eligibility for relevance and conduct the quality appraisal. There are no restrictions in the time frame, context, study design or language. We will extract and synthesize key findings using frameworks related to policy development and implementation, health system contextual factors and behavioral changes to develop a framework about HSG implementation. Lastly, we will use the framework to mock support the use of several HSG developed by the World Health Organization.
Results: The HSG implementation framework will cover facilitators, barriers, and strategies at four different levels, i.e. system (including political and health system), organizational, community and individual. For example, the financial incentives might be the strategy to promote the HSG implementation at the organizational level. Based on the mock results, we will summarize the strengths and weaknesses, to refine the HSG implementation framework. We will present the initial results at the conference.
Conclusions:The theoretical framework will help HSG users (such as policymakers) to better understand facilitating factors, barriers and strategies about HSG implementation processes at the individual, organizational, community and system level. Also, the HSG implementation framework will be used to further guide the development of implementation tool.
Patient or healthcare consumer involvement: One of the expected components of the HSG implementation framework will involve the facilitators, barriers, and strategies at the individual level, which will include the consumer (i.e. patients and public).
Objectives: To develop a theoretical framework about the facilitators to, barriers to, and strategies of HSG implementation at different levels (individual, organizational, community and system), further to develop HSG implementation tool, then to assist the use and uptake of global HSG at national or sub-national levels.
Methods: A critical interpretive synthesis (CIS) approach will be conducted to develop a theoretical framework, which aims to identify the facilitating factors and barriers during HSG implementation at the four levels, and the corresponding strategies, and their relationships and connections. We will identify the related literature by searching four types of data sources: electronic databases, organizational websites and conference abstracts, the reference of included studies, and contacting experts. Two reviewers will independently assess eligibility for relevance and conduct the quality appraisal. There are no restrictions in the time frame, context, study design or language. We will extract and synthesize key findings using frameworks related to policy development and implementation, health system contextual factors and behavioral changes to develop a framework about HSG implementation. Lastly, we will use the framework to mock support the use of several HSG developed by the World Health Organization.
Results: The HSG implementation framework will cover facilitators, barriers, and strategies at four different levels, i.e. system (including political and health system), organizational, community and individual. For example, the financial incentives might be the strategy to promote the HSG implementation at the organizational level. Based on the mock results, we will summarize the strengths and weaknesses, to refine the HSG implementation framework. We will present the initial results at the conference.
Conclusions:The theoretical framework will help HSG users (such as policymakers) to better understand facilitating factors, barriers and strategies about HSG implementation processes at the individual, organizational, community and system level. Also, the HSG implementation framework will be used to further guide the development of implementation tool.
Patient or healthcare consumer involvement: One of the expected components of the HSG implementation framework will involve the facilitators, barriers, and strategies at the individual level, which will include the consumer (i.e. patients and public).