TY - JOUR
T1 - HeAlth System StrEngThening in four sub-Saharan African countries (ASSET) to achieve high-quality, evidence-informed surgical, maternal and newborn, and primary care
T2 - protocol for pre-implementation phase studies
AU - Seward, Nadine
AU - Hanlon, Charlotte
AU - Abdella, Ahmed
AU - Abrahams, Zulfa
AU - Alem, Atalay
AU - Araya, Ricardo
AU - Bachmann, Max
AU - Bekele, Alemayehu
AU - Bogale, Birke
AU - Brima, Nataliya
AU - Chibanda, Dixon
AU - Curran, Robyn
AU - Davies, Justine
AU - Beyene, Andualem
AU - Fairall, Lara
AU - Farrant, Lindsay
AU - Frissa, Souci
AU - Gallagher, Jennifer
AU - Gao, Wei
AU - Gwyther, Liz
AU - Harding, Richard
AU - Kartha, Muralikrishnan R.
AU - Leather, Andrew
AU - Lund, Crick
AU - Marx, Maggie
AU - Nkhoma, Kennedy
AU - Murdoch, Jamie
AU - Petersen, Inge
AU - Petrus, Ruwayda
AU - van Rensburg, André
AU - Sandall, Jane
AU - Sevdalis, Nick
AU - Sheenan, Andrew
AU - Tadesse, Amezene
AU - Thornicroft, Graham
AU - Verhey, Ruth
AU - Willott, Chris
AU - Prince, Martin
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - To achieve universal health coverage, health system strengthening (HSS) is required to support the of delivery of high-quality care. The aim of the National Institute for Health Research Global Research Unit on HeAlth System StrEngThening in Sub-Saharan Africa (ASSET) is to address this need in a four-year programme, with three healthcare platforms involving eight work-packages. Key to effective health system strengthening (HSS) is the pre-implementation phase of research where efforts focus on applying participatory methods to embed the research programme within the existing health system. To conceptualise the approach, we provide an overview of the key methods applied across work-package to address this important phase of research conducted between 2017 and 2021. Work-packages are being undertaken in publicly funded health systems in rural and urban areas in Ethiopia, Sierra Leone, South Africa, and Zimbabwe. Stakeholders including patients and their caregivers, community representatives, clinicians, managers, administrators, and policymakers are the main research participants. In each work-package, initial activities engage stakeholders and build relationships to ensure co-production and ownership of HSSIs. A mixed-methods approach is then applied to understand and address determinants of high-quality care delivery. Methods such as situation analysis, cross-sectional surveys, interviews and focus group discussions are adopted to each work-package aim and context. At the end of the pre-implementation phase, findings are disseminated using focus group discussions and participatory Theory of Change workshops where stakeholders from each work package use findings to select HSSIs and develop a programme theory. ASSET places a strong emphasis of the pre-implementation phase in order to provide an in-depth and systematic diagnosis of the existing heath system functioning, needs for strengthening and stakeholder engagement. This common approach will inform the design and evaluation of the HSSIs to increase effectiveness across work packages and contexts, to better understand what works, for whom, and how.
AB - To achieve universal health coverage, health system strengthening (HSS) is required to support the of delivery of high-quality care. The aim of the National Institute for Health Research Global Research Unit on HeAlth System StrEngThening in Sub-Saharan Africa (ASSET) is to address this need in a four-year programme, with three healthcare platforms involving eight work-packages. Key to effective health system strengthening (HSS) is the pre-implementation phase of research where efforts focus on applying participatory methods to embed the research programme within the existing health system. To conceptualise the approach, we provide an overview of the key methods applied across work-package to address this important phase of research conducted between 2017 and 2021. Work-packages are being undertaken in publicly funded health systems in rural and urban areas in Ethiopia, Sierra Leone, South Africa, and Zimbabwe. Stakeholders including patients and their caregivers, community representatives, clinicians, managers, administrators, and policymakers are the main research participants. In each work-package, initial activities engage stakeholders and build relationships to ensure co-production and ownership of HSSIs. A mixed-methods approach is then applied to understand and address determinants of high-quality care delivery. Methods such as situation analysis, cross-sectional surveys, interviews and focus group discussions are adopted to each work-package aim and context. At the end of the pre-implementation phase, findings are disseminated using focus group discussions and participatory Theory of Change workshops where stakeholders from each work package use findings to select HSSIs and develop a programme theory. ASSET places a strong emphasis of the pre-implementation phase in order to provide an in-depth and systematic diagnosis of the existing heath system functioning, needs for strengthening and stakeholder engagement. This common approach will inform the design and evaluation of the HSSIs to increase effectiveness across work packages and contexts, to better understand what works, for whom, and how.
KW - global health
KW - health systems strengthening
KW - Implementation research
KW - implementation science
KW - Sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85123367048&partnerID=8YFLogxK
U2 - 10.1080/16549716.2021.1987044
DO - 10.1080/16549716.2021.1987044
M3 - Article
C2 - 35037844
AN - SCOPUS:85123367048
SN - 1654-9716
VL - 15
JO - Global Health Action
JF - Global Health Action
IS - 1
M1 - 1987044
ER -
