Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
Semel Institute, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California.
Ann N Y Acad Sci. 2018 May;1419(1):218-229. doi: 10.1111/nyas.13650.
Most low- and middle-income countries lack resources with which to implement public health programs. As such, there is a necessity to facilitate programing that judiciously makes use of what resources there are. However, despite evidence for the efficacy of many interventions, translating these into real-world effectiveness, and then into scalability, is complex and has often been neglected. We draw on a case study of Philani+ (a maternal and child health intervention implemented in South Africa) to distil eight features of health programing that aid intervention effectiveness. We argue that implementation science should turn its attention to the human resource "process" features of interventions. We describe the importance of staff selection (rigorous selection and hiring procedures); training (developing a set of common core pragmatic problem-solving skills); monitoring (feedback about quality); community and institutional support (rapport with intervention communities); the importance of stable leadership (consistent leadership focusing on how to optimize the potential of staff); the importance of implementing with sustainable, long-term change in mind; and, finally, we describe how cultivating consistency within an organization requires disciplined action and disciplined focus on the organization's vision.
大多数中低收入国家缺乏实施公共卫生项目的资源。因此，有必要促进明智地利用现有资源的项目规划。然而，尽管有许多干预措施的有效性证据，但将这些措施转化为实际效果，然后再转化为可扩展性，是复杂的，而且常常被忽视。我们借鉴了 Philani+（在南非实施的母婴健康干预措施）的案例研究，提炼出有助于干预措施有效性的八项健康规划特征。我们认为，实施科学应该将注意力转向干预措施的人力资源“过程”特征。我们描述了人员选择（严格的选拔和招聘程序）、培训（发展一套共同的核心实用问题解决技能）、监测（关于质量的反馈）、社区和机构支持（与干预社区的融洽关系）、稳定领导的重要性（一致的领导专注于如何优化员工的潜力）、以可持续的、长期的变革为导向的实施的重要性，最后，我们描述了如何在组织内部培养一致性，需要有纪律的行动和有纪律的关注组织的愿景。
