School of Population and Global Health, Centre for Health Policy, The University of Melbourne, Level 4, 207 Bouverie St., Melbourne, VIC, 3010, Australia.
School of Population and Global Health, Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia.
Hum Resour Health. 2021 Feb 6;19(1):17. doi: 10.1186/s12960-021-00553-8.
The United Nations Children's Fund (UNICEF) published their Health Systems Strengthening (HSS) approach to meet its strategic goals of ending preventable maternal, newborn and child deaths and promoting the health and development of all children and reducing inequities in health in 2016. UNICEF commissioned the University of Melbourne's Nossal Institute for Global Health to develop and deliver a pilot blended HSS program, involving 60 hours of online learning and 2 weeks of face-to-face teaching over a 6-month period. To assess the extent to which the HSS program had built the first 83 UNICEF 2017 graduates' capabilities to apply HSS actions by 2017, UNICEF funded an independent evaluator from the University of Melbourne.
A mixed-methods assessment was conducted using: online surveys of graduates at: enrolment, completion, 6 months post-HSS program; nine focus groups with graduates at face-to-face workshops; and interviews with purposive samples of UNICEF graduates and graduate Senior Managers 12 months post-HSS program.
The HSS program content, structure and mode of delivery was positively received. Graduates reported increased confidence taking HSS actions and multiple changes in work practices (e.g., increased systems thinking and using of health system-based approaches). Graduates' Senior Manager interviews revealed mixed impressions of graduates applying HSS actions, partly explained by the fit between the HSS program learnings and UNICEF's workplace environment. Key contextual factors influencing graduates applying HSS actions included: workload; limited opportunities to apply HSS actions; limited HSS examples; and variable support to apply HSS actions. Graduate and Senior Manager suggestions to optimise applying HSS actions included: linking HSS program content with UNICEF priorities; increasing opportunities for graduates to apply HSS actions; increasing access to HSS support.
The paper concludes by presenting HSS program and assessment suggestions from the 2017 UNICEF Pilot HSS program assessment and actions taken for the 2018 UNICEF staff cohorts by HSS program developers, funders and beneficiaries.
联合国儿童基金会（UNICEF）于 2016 年发布了其卫生系统强化（HSS）方法，以实现其战略目标，即消除可预防的孕产妇、新生儿和儿童死亡，促进所有儿童的健康和发展，并减少卫生方面的不平等。UNICEF 委托墨尔本大学诺萨尔全球卫生研究所开发并提供一个试点混合 HSS 方案，涉及 60 小时的在线学习和 6 个月内为期 2 周的面对面教学。为了评估 HSS 方案在多大程度上增强了 2017 年第一批 83 名 UNICEF 毕业生应用 HSS 行动的能力，UNICEF 资助了墨尔本大学的一名独立评估人员。
使用混合方法评估，对毕业生进行了以下评估：入学时、完成时、HSS 方案结束后 6 个月时的在线调查；面对面研讨会期间的 9 个焦点小组；以及 HSS 方案结束后 12 个月时对 UNICEF 毕业生和毕业生高级管理人员的有针对性抽样访谈。
HSS 方案的内容、结构和交付模式得到了积极的反馈。毕业生报告说，他们在采取 HSS 行动方面的信心增强了，并且工作实践发生了多次变化（例如，增强了系统思维和使用基于卫生系统的方法）。毕业生的高级管理人员访谈显示，毕业生应用 HSS 行动的印象参差不齐，部分原因是 HSS 方案的学习内容与 UNICEF 的工作环境之间的契合度。影响毕业生应用 HSS 行动的关键背景因素包括：工作量；应用 HSS 行动的机会有限；HSS 示例有限；以及应用 HSS 行动的支持程度不同。为了优化应用 HSS 行动，毕业生和高级管理人员提出了以下建议：将 HSS 方案的内容与 UNICEF 的优先事项联系起来；增加毕业生应用 HSS 行动的机会；增加获得 HSS 支持的机会。
本文最后提出了 2017 年 UNICEF 试点 HSS 方案评估的 HSS 方案和评估建议，以及 HSS 方案开发人员、资助者和受益者为 2018 年 UNICEF 员工群体采取的行动。
