Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries
Introduction Health systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiali...
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2021-06-01
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Series: | BMJ Open |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tolib Mirzoev Joseph Paul Hicks Sumit Kane Judy M Wright Anna Cronin De Chavez Ana Manzano Anthony Danso-Appiah Mary Eyram Ashinyo Leveana Gyimah Lucy Yevoo Elizabeth Awini Bui Thi Thu Ha Trang Do Thi Hanh Quynh-Chi Thai Nguyen Thi Minh Le Vui Thi Le |
spellingShingle |
Tolib Mirzoev Joseph Paul Hicks Sumit Kane Judy M Wright Anna Cronin De Chavez Ana Manzano Anthony Danso-Appiah Mary Eyram Ashinyo Leveana Gyimah Lucy Yevoo Elizabeth Awini Bui Thi Thu Ha Trang Do Thi Hanh Quynh-Chi Thai Nguyen Thi Minh Le Vui Thi Le Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries BMJ Open |
author_facet |
Tolib Mirzoev Joseph Paul Hicks Sumit Kane Judy M Wright Anna Cronin De Chavez Ana Manzano Anthony Danso-Appiah Mary Eyram Ashinyo Leveana Gyimah Lucy Yevoo Elizabeth Awini Bui Thi Thu Ha Trang Do Thi Hanh Quynh-Chi Thai Nguyen Thi Minh Le Vui Thi Le |
author_sort |
Tolib Mirzoev |
title |
Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries |
title_short |
Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries |
title_full |
Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries |
title_fullStr |
Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries |
title_full_unstemmed |
Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries |
title_sort |
protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries |
publisher |
BMJ Publishing Group |
series |
BMJ Open |
issn |
2044-6055 |
publishDate |
2021-06-01 |
description |
Introduction Health systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiality. Little is known, however, about underlying theories of health systems responsiveness, and the mechanisms through which responsiveness works. This realist synthesis contributes to bridging these two knowledge gaps.Methods and analysis In this realist synthesis, we will use a four-step process, comprising: mapping of theoretical bases, formulation of programme theories, theory refinement and testing of programme theories using literature and empirical data from Ghana and Vietnam. We will include theoretical and conceptual pieces, reviews, empirical studies and grey literature, alongside the primary data. We will explore responsiveness as entailing external and internal interactions within health systems. The search strategy will be purposive and iterative, with continuous screening and refinement of theories. Data extraction will be combined with quality appraisal, using appropriate tools. Each fragment of evidence will be appraised as it is being extracted, for its relevance to the emerging programme theories and methodological rigour. The extracted data pertaining to contexts, mechanisms and outcomes will be synthesised to identify patterns and contradictions. Results will be reported using narrative explanations, following established guidance on realist syntheses.Ethics and dissemination Ethics approvals for the wider RESPONSE (Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) study, of which this review is one part, were obtained from the ethics committees of the following institutions: London School of Hygiene and Tropical Medicine (ref: 22981), University of Leeds, School of Medicine (ref: MREC19-051), Ghana Health Service (ref: GHS-ERC 012/03/20) and Hanoi University of Public Health (ref: 020-149/DD-YTCC).We will disseminate results through academic papers, conference presentations and stakeholder workshops in Ghana and Vietnam.PROSPERO registration number CRD42020200353. Full record: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200353. |
url |
https://bmjopen.bmj.com/content/11/6/e046992.full |
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doaj-9754dc995a634bcd972729609738663b2021-08-07T17:01:17ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-046992Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countriesTolib Mirzoev0Joseph Paul Hicks1Sumit Kane2Judy M Wright3Anna Cronin De Chavez4Ana Manzano5Anthony Danso-Appiah6Mary Eyram Ashinyo7Leveana Gyimah8Lucy Yevoo9Elizabeth Awini10Bui Thi Thu Ha11Trang Do Thi Hanh12Quynh-Chi Thai Nguyen13Thi Minh Le14Vui Thi Le15Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKNuffield Centre for International Health and Development, University of Leeds, Leeds, UKNossal Institute for Global Health, University of Melbourne Queen's College, Parkville, Victoria, AustraliaLeeds Institute of Health Sciences, University of Leeds, Leeds, UKGlobal Health and Development, London School of Hygiene & Tropical Medicine, London, UKSchool of Sociology and Social Policy, University of Leeds, Leeds, UKSchool of Public Health, University of Ghana, Accra-Legon, GhanaDepartment of Quality Assurance, Institutional Care Directorate, Ghana Health Service, Accra, GhanaPantang Hospital, Mental Health Authority, Accra, GhanaResearch and Development Division, Ghana Health Service, Accra, Greater Accra, GhanaResearch and Development Division, Ghana Health Service, Accra, Greater Accra, GhanaDepartment of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, VietnamDepartment of Environmental Health, Hanoi University of Public Health, Hanoi, Viet NamDepartment of Health Promotion, Hanoi University of Public Health, Hanoi, VietnamDepartment of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, VietnamDepartment of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, VietnamIntroduction Health systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiality. Little is known, however, about underlying theories of health systems responsiveness, and the mechanisms through which responsiveness works. This realist synthesis contributes to bridging these two knowledge gaps.Methods and analysis In this realist synthesis, we will use a four-step process, comprising: mapping of theoretical bases, formulation of programme theories, theory refinement and testing of programme theories using literature and empirical data from Ghana and Vietnam. We will include theoretical and conceptual pieces, reviews, empirical studies and grey literature, alongside the primary data. We will explore responsiveness as entailing external and internal interactions within health systems. The search strategy will be purposive and iterative, with continuous screening and refinement of theories. Data extraction will be combined with quality appraisal, using appropriate tools. Each fragment of evidence will be appraised as it is being extracted, for its relevance to the emerging programme theories and methodological rigour. The extracted data pertaining to contexts, mechanisms and outcomes will be synthesised to identify patterns and contradictions. Results will be reported using narrative explanations, following established guidance on realist syntheses.Ethics and dissemination Ethics approvals for the wider RESPONSE (Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) study, of which this review is one part, were obtained from the ethics committees of the following institutions: London School of Hygiene and Tropical Medicine (ref: 22981), University of Leeds, School of Medicine (ref: MREC19-051), Ghana Health Service (ref: GHS-ERC 012/03/20) and Hanoi University of Public Health (ref: 020-149/DD-YTCC).We will disseminate results through academic papers, conference presentations and stakeholder workshops in Ghana and Vietnam.PROSPERO registration number CRD42020200353. Full record: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200353.https://bmjopen.bmj.com/content/11/6/e046992.full |