School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
BMJ Open. 2020 Dec 2;10(12):e032820. doi: 10.1136/bmjopen-2019-032820.
Disparities in health outcomes and access to maternal neonatal and child health (MNCH) are apparent among urban poor compared with national, rural or urban averages. A fundamental first step in addressing inequities in MNCH services is knowing what services exist in urban areas, where these are located, who provides them and who uses them. This study aims to institutionalise the Urban Health Atlas (UHA)-a novel information and communications technology (ICT) tool-to strengthen health service delivery and oversight and generate critical evidence to inform health policy and planning in urban Bangladesh.
This mixed-method implementation research will be conducted in four purposively selected urban sites representing larger and smaller cities. Research activities will include an assessment of information needs and task review analysis of information users, stakeholder mapping and cost estimation. To document stakeholder perceptions and experiences, key informant interviews and in-depth interviews will be conducted along with desk reviews to understand MNCH planning and referral decisions. The UHA will be refined to increase responsiveness to user needs and capacities, and hands-on training will be provided to health managers. Cost estimation will be conducted to assess the financial implications of UHA uptake and scale-up. Systematic documentation of the implementation process will be undertaken. Policy decision-making and ICT health policy process flowcharts will be prepared using desk reviews and qualitative interviews. Thematic analysis of qualitative data will involve both emergent and a priori coding guided by WHO PATH toolkit and Policy Engagement Framework. Stakeholder analysis will apply standard techniques and measurement scales. Descriptive analysis of quantitative data and cost estimation analysis will also be performed.
The study has been approved by the Institutional Review Board of icddr,b (# PR-16057). Study findings will be disseminated through national and international workshops, conferences, policy briefs and peer-reviewed publications.
与全国、农村或城市平均水平相比，城市贫困人口在母婴和儿童健康（MNCH）的健康结果和获得方面存在明显差距。解决母婴保健服务不公平问题的基本第一步是了解城市地区存在哪些服务、这些服务的位置、谁提供这些服务以及谁使用这些服务。本研究旨在使城市健康地图集（UHA）这一新颖的信息和通信技术（ICT）工具制度化，以加强卫生服务的提供和监督，并生成关键证据，为城市孟加拉国的卫生政策和规划提供信息。
这项混合方法实施研究将在四个有目的选择的城市地点进行，这些地点代表了较大和较小的城市。研究活动将包括评估信息需求和信息用户的任务审查分析、利益相关者绘图和成本估算。为了记录利益相关者的看法和经验，将进行关键知情人访谈和深入访谈，并进行桌面审查，以了解母婴保健规划和转诊决策。将对 UHA 进行改进，以增加对用户需求和能力的响应能力，并为卫生管理人员提供实践培训。将进行成本估算，以评估 UHA 采用和扩大规模的财务影响。将系统地记录实施过程。将使用桌面审查和定性访谈编制政策决策和 ICT 卫生政策流程图。对定性数据的主题分析将包括基于世卫组织 PATH 工具包和政策参与框架的新兴和先验编码。利益相关者分析将应用标准技术和测量量表。还将对定量数据进行描述性分析和成本估算分析。
该研究已获得 icddr,b 机构审查委员会的批准（# PR-16057）。研究结果将通过国家和国际研讨会、会议、政策简报和同行评审出版物进行传播。
