Bennett Sara, Lagomarsino Gina, Knezovich Jeffrey, Lucas Henry
Johns Hopkins School of Public Health, Baltimore, MD, USA.
Global Health. 2014 Jun 24;10:54. doi: 10.1186/1744-8603-10-54.
Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets.
Notable challenges to learning in health markets include the difficulty of acquiring data from private health care providers, designing evaluations that capture the complex dynamics present within health markets and developing communities of practice that encompass the diverse actors present within health markets, and building trust and mutual understanding across these groups. The paper proposes experimentation with country-specific market data platforms that can integrate relevant evidence from different data sources, and simultaneously exploring strategies to secure better information on private providers and health markets. Possible approaches to adapting evaluation designs so that they are better able to take account of different and changing contexts as well as producing real time findings are discussed. Finally capturing informal knowledge about health markets is key. Communities of practice that bridge different health market actors can help to share such experience-based knowledge and in so doing, may help to formalize it. More geographically-focused communities of practice are needed, and such communities may be supported by innovation brokers and/or be built around member-based organizations.
Strategic investments in and support to learning about health markets can address some of the challenges experienced to-date, and accelerate learning that supports health markets that serve the poor.
鉴于卫生市场的快速演变，学习对于推动识别和采用能更好满足贫困人口需求的卫生市场政策及实践至关重要。然而，了解卫生市场存在重大挑战。我们讨论了学习所采取的不同形式，从编纂科学知识的发展，到基于经验的学习，所有这些都与卫生市场相关。
卫生市场学习面临的显著挑战包括难以从私立医疗服务提供者获取数据、设计能捕捉卫生市场复杂动态的评估、发展涵盖卫生市场中不同行为者的实践社区，以及在这些群体之间建立信任和相互理解。本文提议对特定国家的市场数据平台进行试验，该平台可整合来自不同数据源的相关证据，同时探索获取有关私立提供者和卫生市场更好信息的策略。讨论了调整评估设计的可能方法，以便它们能更好地考虑不同且不断变化的背景，并产生实时结果。最后，获取有关卫生市场的非正式知识至关重要。连接不同卫生市场行为者的实践社区有助于分享此类基于经验的知识，这样做可能有助于将其形式化。需要更多以地理为重点的实践社区，此类社区可能由创新中介提供支持和/或围绕会员制组织建立。
对卫生市场学习进行战略投资和支持可以应对迄今遇到的一些挑战，并加速有助于服务贫困人口的卫生市场的学习。
