Blanchet Karl, Girois Susan
International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene and Tropical Medicine, United Kingdom.
Eval Program Plann. 2013 Jun;38:28-32. doi: 10.1016/j.evalprogplan.2012.11.003. Epub 2012 Dec 3.
Sustainability evaluation has become a key component of international health. However, evaluators have faced a number of challenges linked to the lack of consensus on the meaning of the concept of "sustainability". This paper aims to describe a methodology, the Sustainability Analysis Process, based on several conceptual frameworks and tested in five different countries in the physical rehabilitation sector. The methodology consists of five successive steps: (i) overview of the context; (ii) system boundary; (iii) consensus vision of sustainability, and derivation of stakeholder perspectives; (iv) selection of sustainability indicators and characterization and analysis of local system sustainability; and (v) verification and modification. The paper also discusses the place of the evaluator and researcher in the process: the methodology aims to help evaluators objectively measure the level of sustainability of a health system with the challenge of dealing with a subjective notion, the concept of sustainability, and a diversity of actors. The Sustainability Analysis Process also aims to capture the dynamics of systems by repeating the process on a regular basis. The methodology highlights the need for evaluators build consensus amongst stakeholders on a common vision of the future of a health system.
可持续性评估已成为国际卫生领域的一个关键组成部分。然而，评估者面临着一些挑战，这些挑战与对“可持续性”概念含义缺乏共识有关。本文旨在描述一种基于若干概念框架并在物理康复领域的五个不同国家进行过测试的方法，即可持续性分析过程。该方法包括五个连续步骤：（i）背景概述；（ii）系统边界；（iii）可持续性的共识愿景以及利益相关者观点的推导；（iv）可持续性指标的选择以及地方系统可持续性的特征描述与分析；（v）验证与修改。本文还讨论了评估者和研究者在这一过程中的作用：该方法旨在帮助评估者客观衡量卫生系统的可持续性水平，同时应对一个主观概念——可持续性概念以及行为主体多样性带来的挑战。可持续性分析过程还旨在通过定期重复该过程来把握系统的动态变化。该方法强调评估者需要在利益相关者之间就卫生系统未来的共同愿景达成共识。
