Phillips James F, Awoonor-Williams John Koku, Bawah Ayaga A, Nimako Belinda Afriyie, Kanlisi Nicholas S, Sheff Mallory C, Asuming Patrick O, Kyei Pearl E, Biney Adriana, Jackson Elizabeth F
Mailman School of Public Health, Columbia University, 60 Haven Avenue B-2, New York, NY, 10032, USA.
Policy Planning Monitoring and Evaluation Division, Ghana Health Service, Private Mailbag, Accra, Ghana.
BMC Health Serv Res. 2018 Jun 22;18(1):484. doi: 10.1186/s12913-018-3250-3.
The completion of an implementation research project typically signals the end of research. In contrast, the Ghana Health Service has embraced a continuous process of evidence-based programming, wherein each research episode is followed by action and a new program of research that monitors and guides the utilization of lessons learned. This paper reviews the objectives and design of the most recent phase in this process, known as a National Program for Strengthening the Implementation of the Community-based Health Planning and Services (CHPS) Initiative in Ghana (CHPS+).
A mixed method evaluation strategy has been launched involving: i) baseline and endline randomized sample surveys with 247 clusters dispersed in 14 districts of the Northern and Volta Regions to assess the difference in difference effect of stepped wedge differential cluster exposure to CHPS+ activities on childhood survival, ii) a monitoring system to assess the association of changes in service system readiness with CHPS+ interventions, and iii) a program of qualitative systems appraisal to gauge stakeholder perceptions of systems problems, reactions to interventions, and perceptions of change. Integrated survey and monitoring data will permit multi-level longitudinal models of impact; longitudinal QSA data will provide data on the implementation process.
A process of exchanges, team interaction, and catalytic financing has accelerated the expansion of community-based primary health care in Ghana's Upper East Region (UER). Using two Northern and two Volta Region districts, the UER systems learning concept will be transferred to counterpart districts where a program of team-based peer training will be instituted. A mixed method research system will be used to assess the impact of this transfer of innovation in collaboration with national and regional program management. This arrangement will generate embedded science that optimizes prospects that results will contribute to national CHPS reform policies and action.
实施研究项目的完成通常标志着研究的结束。相比之下，加纳卫生服务局采用了基于证据的持续规划过程，其中每个研究阶段之后都会采取行动，并开展新的研究项目，以监测和指导所学经验教训的应用。本文回顾了这一过程中最新阶段的目标和设计，该阶段被称为加纳加强社区卫生规划与服务（CHPS）倡议实施的国家项目（CHPS+）。
已启动一种混合方法评估策略，包括：i）在北部和沃尔特地区的14个区分散选取247个群组进行基线和终线随机抽样调查，以评估逐步楔形差异群组接触CHPS+活动对儿童生存的差异影响；ii）一个监测系统，以评估服务系统准备情况的变化与CHPS+干预措施之间的关联；iii）一个定性系统评估项目，以衡量利益相关者对系统问题的看法、对干预措施的反应以及对变化的看法。综合调查和监测数据将允许建立多层次的纵向影响模型；纵向定性系统评估数据将提供有关实施过程的数据。
交流、团队互动和催化性融资的过程加速了加纳上东部地区基于社区的初级卫生保健的扩展。利用北部地区和沃尔特地区的两个区，上东部地区的系统学习概念将被传授给对应地区，并在这些地区开展基于团队的同伴培训项目。将使用混合方法研究系统，与国家和地区项目管理部门合作评估这一创新转移的影响。这种安排将产生嵌入式科学，优化研究结果有助于国家CHPS改革政策和行动的前景。
