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Cui C, Meng K. Development of an index system for evaluating the organisational capabilities of primary medical institutions: a modified Delphi study in China. BMJ Open 2021; 11:e055422. [PMID: 34921088 PMCID: PMC8689195 DOI: 10.1136/bmjopen-2021-055422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The low performance of primary medical institutions (PMIs) in China is a significant issue. The WHO proposed that the main reason for the failure of the healthcare system in developing countries is poor organisational capabilities. However, there is no international tool for evaluating the organisational capabilities of PMIs. Therefore, this study aimed to develop an index system for evaluating the organisational capabilities of PMIs. DESIGN We searched the literature (English and Chinese) published before June 2020 in the PubMed, China National Knowledge Infrastructure and Wanfang databases to conduct a literature review and develop a preliminary indicator pool. Then, two rounds of Delphi expert consultations were conducted by email from June to September 2020, followed by screening, revision and supplementation of the indicators using the boundary value method. Finally, the analytic hierarchy process was used to determine the weight of the indicators. SETTING The Delphi consultation questionnaire was distributed to the leaders of PMIs in districts D, F and S in Beijing, China. PARTICIPANTS Nineteen leaders of PMIs who had a profound understanding of PMI operations and management and were able to participate in Delphi research from a professional and comprehensive perspective were included in this study. RESULTS The Cr values were 0.76 (first-level indicators) and 0.78 (second-level indicators), indicating that the expert consultation results were accurate and reliable. The result of the expert coordination coefficient test was significant at the p<0.01 level, suggesting that the experts' views were consistent. The organisational capability index system includes 3 first-level indicators, 9 second-level indicators and 37 third-level indicators. CONCLUSIONS An index system for the organisational capabilities of PMIs was developed. This index system is a scoring system that focuses on basic service capabilities, management capabilities and sustainable development capabilities, and it can determine the priority of improvement areas for PMIs.
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Affiliation(s)
- Chengsen Cui
- School of Public Health, Capital Medical University, Beijing, China
| | - Kai Meng
- School of Public Health, Capital Medical University, Beijing, China
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Ezenwaka U, Onwujekwe O. Getting Evidence From Health Policy and Systems Research Into Policy and Practice for Controlling Endemic Tropical Diseases in Nigeria: Assessing Knowledge, Capacity, and Use. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.735990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundGetting evidence from Health Policy and Systems Research (HPSR) into policy and practice for effective control of neglected tropical diseases (NTDs) is essential for providing better service delivery because evidence-informed decision-making improves the effectiveness of a health system and health outcomes. The paper provides new knowledge on the policy-/decision-makers’ level of knowledge, capacity to use, and how evidence from HPSR has been used in decision-making for the control of endemic tropical diseases (ETDs), especially the NTDs and malaria in Nigeria.MethodsA cross-sectional qualitative study of decision-makers was undertaken in Anambra and Enugu states, southeast Nigeria. Data was collected through in-depth interviews (n=22) of purposively selected decision-makers to assess how HPSR evidence is translated into policy and practice for controlling ETDs. The respondents were selected based on their job description, roles, and involvement in the control of ETDs. Data were analyzed using the thematic content approach.ResultsThere is a considerable level of knowledge on HPSR and its relationship with evidence-informed policy- and decision-making towards control of ETDs and health system strengthening. Organizational capacity to use HPSR evidence in decision-making was found to be weak due to various reasons such as no embedded structure for translating research evidence to policy and practice, lack of decision-making autonomy by individuals, and politically driven decisions. Few respondents have either ever used or are currently using HPRS evidence for developing/reviewing and implementing strategies for ETDs programs. Majority of the respondents reported that their main source of evidence was routine data from health information management system, which they found useful due to its representativeness and completeness. Main enabler for using HPSR evidence for decision-making is existing collaborations between researchers and policy-/decision-makers.ConclusionThere is a high level of awareness about evidence from HPSR and the usefulness of such evidence in decision-making. However, this awareness does not translate to optimal use of evidence for decision-making due to weak organizational capacity and other constraints. There is the need to invest in capacity-building activities to develop a critical mass of users of evidence (policy-/decision-makers) to facilitate enhanced uptake of high-quality evidence into policy decisions for better control of ETDs.
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Koon AD, Windmeyer L, Bigdeli M, Charles J, El Jardali F, Uneke J, Bennett S. A scoping review of the uses and institutionalisation of knowledge for health policy in low- and middle-income countries. Health Res Policy Syst 2020; 18:7. [PMID: 31959208 PMCID: PMC6971874 DOI: 10.1186/s12961-019-0522-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/20/2019] [Indexed: 12/21/2022] Open
Abstract
There is growing interest in how different forms of knowledge can strengthen policy-making in low- and middle-income country (LMIC) health systems. Additionally, health policy and systems researchers are increasingly aware of the need to design effective institutions for supporting knowledge utilisation in LMICs. To address these interwoven agendas, this scoping review uses the Arskey and O’Malley framework to review the literature on knowledge utilisation in LMIC health systems, using eight public health and social science databases. Articles that described the process for how knowledge was used in policy-making, specified the type of knowledge used, identified actors involved (individual, organisation or professional), and were set in specific LMICs were included. A total of 53 articles, from 1999 to 2016 and representing 56 countries, were identified. The majority of articles in this review presented knowledge utilisation as utilisation of research findings, and to a lesser extent routine health system data, survey data and technical advice. Most of the articles centered on domestic public sector employees and their interactions with civil society representatives, international stakeholders or academics in utilising epistemic knowledge for policy-making in LMICs. Furthermore, nearly all of the articles identified normative dimensions of institutionalisation. While there is some evidence of how different uses and institutionalisation of knowledge can strengthen health systems, the evidence on how these processes can ultimately improve health outcomes remains unclear. Further research on the ways in which knowledge can be effectively utilised and institutionalised is needed to advance the collective understanding of health systems strengthening and enhance evidence-informed policy formulation.
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Affiliation(s)
- Adam D Koon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States of America. .,International Development Division, Abt Associates Inc, Rockville, MD, United States of America.
| | - Lauren Windmeyer
- Upstream USA, Oakland, CA, United States of America.,John F Kennedy School of Government, Harvard University, Cambridge, MA, United States of America
| | | | - Jodi Charles
- Office of Health Systems, United States Agency for International Development, Washington, D.C, United States of America
| | | | | | - Sara Bennett
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States of America
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Uneke CJ, Sombie I, Keita N, Lokossou V, Johnson E, Ongolo-Zogo P, Uro-Chukwu HC. Assessment of policy makers' individual and organizational capacity to acquire, assess, adapt and apply research evidence for maternal and child health policy making in Nigeria: a cross-sectional quantitative survey. Afr Health Sci 2017; 17:700-711. [PMID: 29085397 PMCID: PMC5656188 DOI: 10.4314/ahs.v17i3.12] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Throughout the world, there is increasing awareness and acknowledgement of the value of research evidence in the development of effective health policy and in quality health care practice and administration. Among the major challenges associated with the lack of uptake of research evidence into policy and practice in Nigeria is the capacity constraints of policymakers to use research evidence in policy making. Objective To assess the capacity of maternal and child health policy makers to acquire, access, adapt and apply available research evidence. Methods This cross-sectional quantitative survey was conducted at a national maternal, newborn and child health (MNCH) stakeholders' engagement event. An evidence to policy self-assessment questionnaire was used to assess the capacity of forty MNCH policy makers to acquire, assess, adapt and apply research evidence for policy making. Results Low mean ratings were observed ranging from 2.68–3.53 on a scale of 5 for knowledge about initiating/conducting research and capacity to assess authenticity, validity, reliability, relevance and applicability of research evidence and for organizational capacity for promoting and using of research for policy making. Conclusion There is need to institute policy makers' capacity development programmes to improve evidence-informed policymaking.
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Affiliation(s)
- Chigozie Jesse Uneke
- African Institute for Health Policy & Health Systems, Ebonyi State University, PMB 053 Abakaliki Nigeria
| | - Issiaka Sombie
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Namoudou Keita
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Virgil Lokossou
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Ermel Johnson
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Pierre Ongolo-Zogo
- Hopital Central Yaounde, CDBPH Lawrence VERGNE Building 2nd Floor, Avenue Henry Dunant Messa Yaoundé, Cameroon
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Uneke CJ, Sombie I, Keita N, Lokossou V, Johnson E, Ongolo-Zogo P. An Assessment of National Maternal and Child Health Policy-Makers' Knowledge and Capacity for Evidence- Informed Policy-Making in Nigeria. Int J Health Policy Manag 2017; 6:309-316. [PMID: 28812823 PMCID: PMC5458792 DOI: 10.15171/ijhpm.2016.132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 09/25/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is increasing interest globally in the use of more rigorous processes to ensure that maternal, newborn, and child health (MNCH) care recommendations are informed by the best available research evidence use. The purpose of this study was to engage Nigerian MNCH policy-makers and other stakeholders to consider issues around research to policy and practice interface and to assess their existing knowledge and capacity on the use of research evidence for policy-making and practice. METHODS The study design is a cross-sectional evaluation of MNCH stakeholders' knowledge as it pertains different dimensions of research to practice. This was undertaken during a national MNCH stakeholders' engagement event convened under the auspices of the West African Health Organization (WAHO) and the Federal Ministry of Health (FMoH) in Abuja, Nigeria. A questionnaire was administered to participants, which was designed to assess participants' knowledge, capacity and organizational process of generation, synthesis and utilization of research evidence in policy-making regarding MNCH. RESULTS A total of 40 participants signed the informed consent form and completed the questionnaire. The mean ratings (MNRs) of participants' knowledge of electronic databases and capacity to identify and obtain relevant research evidence from electronic databases ranged from 3.62-3.68 on the scale of 5. The MNRs of participants' level of understanding of a policy brief, a policy dialogue and the role of researchers in policy-making ranged from 3.50-3.86. The MNRs of participants' level of understanding of evidence in policy-making context, types and sources of evidence, capacity to identify, select, adapt, and transform relevant evidence into policy ranged from 3.63-4.08. The MNRs of the participants' organization's capacity to cover their geographical areas of operation were generally low ranging from 3.32-3.38 in terms of manpower, logistics, facilities, and external support. The lowest MNR of 2.66 was recorded in funding. CONCLUSION The outcomes of this study suggest that a stakeholders' engagement event can serve as an important platform to assess policy-makers' knowledge and capacity for evidence-informed policy-making and for the promotion of evidence use in the policy process.
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Affiliation(s)
- Chigozie Jesse Uneke
- Knowledge Translation Platform, African Institute for Health Policy and Health Systems Studies, Ebonyi State University, Abakaliki, Nigeria
| | - Issiaka Sombie
- Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Namoudou Keita
- Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Virgil Lokossou
- Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Ermel Johnson
- Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
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Uneke CJ, Sombie I, Keita N, Lokossou V, Johnson E, Ongolo-Zogo P. An assessment of policymakers' engagement initiatives to promote evidence informed health policy making in Nigeria. Pan Afr Med J 2017; 27:57. [PMID: 28819479 PMCID: PMC5554684 DOI: 10.11604/pamj.2017.27.57.9844] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 11/30/2016] [Indexed: 11/11/2022] Open
Abstract
In most developing countries including Nigeria, one of the most challenging issues associated with evidence-to-policy link is the capacity constraints of policymakers to access, synthesize, adapt and utilize available research evidence. The purpose of this review is to assess the efforts and various initiatives that have been undertaken to deliberately engage policymakers and other stakeholders in the health sector in Nigeria for the promotion of evidence informed policymaking. A MEDLINE Entrez Pubmed search was performed and studies that investigated policy making process, evidence to policy link, research to policy mechanism, and researchers/policymakers interaction in Nigeria in relation to health policy were sought. Of the 132 publications found, 14(10.6%) fulfilled the study inclusion criteria and were selected and included in the review. Of the fourteen scientific publications identified, 11 of the studies targeted both researchers and policymakers and the principal tool of intervention was training workshops which focused on various aspects of evidence informed policymaking. All the studies indicated positive outcomes and impacts in relation to quantifiable improvement in policymakers' knowledge and competence in evidence to policy process. Capacity strengthening engagement mechanism is needed for both researchers to generate better evidence and for policymakers and health-care professionals to better use available evidence.
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Affiliation(s)
- Chigozie Jesse Uneke
- Knowledge Translation Platform, African Institute for Health Policy and Health Systems, Ebonyi State University, PMB 053 Abakaliki Nigeria
| | - Issiaka Sombie
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Namoudou Keita
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Virgil Lokossou
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Ermel Johnson
- Organisation Ouest Africaine de la Santé, 175, avenue Ouezzin Coulibaly, 01 BP 153 Bobo-Dioulasso 01, Burkina Faso
| | - Pierre Ongolo-Zogo
- Hopital Central Yaounde, CDBPH Lawrence VERGNE Building 2nd Floor, Avenue Henry Dunant Messa Yaoundé
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