Chandra-Mouli Venkatraman, Lenz Cosima, Adebayo Emmanuel, Lang Lundgren Iliana, Gomez Garbero Lucia, Chatteriee Subidita
a Department of Reproductive Health and Research, Human Reproduction Programme , World Health Organization , Geneva , Switzerland.
b UCLA Fielding School of Public Health , Los Angeles , USA.
Glob Health Action. 2018;11(1):1536412. doi: 10.1080/16549716.2018.1536412.
Mystery client methodology is a form of participatory research that provides a unique opportunity to monitor and evaluate the performance of health care providers or health facilities from the perspective of the service user. However, there are no systematic reviews that analyse the use of mystery clients in adolescent sexual and reproductive health (ASRH) research and monitoring and evaluation of programmes.
To assess the use of adolescent mystery clients in examining health care provider and facility performance in providing ASRH services in high, middle, and low-income countries.
We carried out a systematic review of published journal articles and reports from the grey literature on this topic from 2000 to 2017 (inclusive). Thirty research evaluations/studies were identified and included in the analysis. We identified common themes through thematic analysis.
The findings reveal that researchers and evaluators used mystery client methodology to observe client-provider relationships, and to reduce observation bias, in government or private health facilities, NGOs, and pharmacies. The mystery clients in the evaluations/studies were young people who played varying roles; in most cases, they were trained for these roles. Most reported good experiences and friendly providers; however, some reported lack of privacy and confidentiality, lack of sufficient written/verbal information, and unfavourable experiences such as sexual harassment and judgmental comments. Female mystery clients were more likely than males to report unfavourable experiences. Generally, the methodology was considered useful in monitoring and evaluating the attitudes of health service providers and ASRH service provision.
The research evaluations/studies in this review highlight the usefulness of mystery clients as a method to gain insight, from an adolescent perspective, on the quality of ASRH services for research and monitoring and evaluation of programmes.
神秘顾客方法是一种参与式研究形式，它提供了一个独特的机会，从服务使用者的角度监测和评估医疗服务提供者或医疗机构的表现。然而，尚无系统评价分析神秘顾客方法在青少年性与生殖健康（ASRH）研究以及项目监测与评价中的应用。
评估在高收入、中等收入和低收入国家，使用青少年神秘顾客来检查医疗服务提供者及机构在提供ASRH服务方面的表现。
我们对2000年至2017年（含）期间关于该主题的已发表期刊文章和灰色文献报告进行了系统评价。共识别出30项研究评价/研究并纳入分析。我们通过主题分析确定了共同主题。
研究结果显示，研究人员和评价人员使用神秘顾客方法来观察医患关系，并减少观察偏差，涉及政府或私立医疗机构、非政府组织和药店。评价/研究中的神秘顾客是扮演不同角色的年轻人；在大多数情况下，他们为此类角色接受了培训。大多数人报告了良好的体验和友善的提供者；然而，一些人报告存在隐私和保密问题、缺乏足够的书面/口头信息，以及诸如性骚扰和评判性评论等不良体验。女性神秘顾客比男性更有可能报告不良体验。总体而言，该方法被认为在监测和评价医疗服务提供者的态度以及ASRH服务提供方面是有用的。
本评价中的研究评价/研究突出了神秘顾客作为一种方法的有用性，即从青少年的角度深入了解ASRH服务质量，以用于研究以及项目的监测与评价。
