Journal of Education and Health Promotion

Nature of the private hospital services toward universal health coverage: A systematic scoping review of the developing countries evidence

. Razieh Fallah; . Mohammadreza Maleki

Volume 11, Issue 10 , November 2021, , Pages 1-15

Abstract

Private hospital services (PHS) with the undeniable effects on the Universal Health Coverage (UHC)goals have a considerable contribution to the health system of developing countries. ... Read More Private hospital services (PHS) with the undeniable effects on the Universal Health Coverage (UHC)goals have a considerable contribution to the health system of developing countries. The purpose ofthis systematic scoping review (ScR) was to identify and map the available evidence regarding thedeveloping countries to scrutinize the nature of the PHS toward UHC through providing graphical/tabular information of the records trends and types, sources of the records, frequent settings, driversof the PHS growth, range of the PHS, behaviors of the PHS, and opportunities for policy actions.This study was performed following the 2017 published methodological guidance of the JoannaBriggs Institute for the conduct of ScR. Furthermore, a narrative‑thematic synthesis integrated withthe systematic analysis applying approach to health system strengthening (HSS) through systemsthinking was employed. Thirty‑two included records in English that met the inclusion criteria werefound between 2011 and July 2020. There has been a sharp increase in the generation of the recordswith a 90.6% growth rate between 2015 and 2020. The most frequent records types were reviewarticle, and the lancet was the most specialized journal. India was the most frequent country. Nearhalf of the growth drivers of PHS have been originated from the governance. Besides, the range ofPHS was identified only about Mongolia, and the significant frequency of codes of the PHS behaviors(32.6%) was related to integrated people‑centered health service delivery. 47.8% of the identified HSSinterventions were recommended about governance. Governance plays a decisive role in the natureof the PHS in UHC. Concerning the dynamic architectures of interactions between health systemfunctions, probably the countries themselves have realized the importance of the governance role inthe HSS than other functions. Given the all of the recommended interventions were a combination offoundational and institutional, sustainable participation of PHS in the health system seems far andrequires a solid will of the governments. Future research is needed about the range of PHS and itsbehaviors in terms of consumables, revenue‑raising, and pooling of funds.

Force field analysis of driving and restraining factors affecting the evidence‑based decision‑making in health systems; comparing two approaches

. Tahereh Shafaghat; . Mohammad Kazem Rahimi Zarchi; . Mohammad Hasan Imani Nasab; . Zahra Kavosi; . Mahammad Amin Bahrami; . Peivand Bastani

Volume 11, Issue 10 , November 2021, , Pages 1-10

Abstract

BACKGROUND: All policies and decisions need evidence examined by scientific methods. Movingtoward evidence‑based decision‑making (EBDM) as a change in organizations, especially ... Read More BACKGROUND: All policies and decisions need evidence examined by scientific methods. Movingtoward evidence‑based decision‑making (EBDM) as a change in organizations, especially healthsystems (HSs), is inevitable. This study was conducted to identify the factors affecting EBDM in HSsfrom two approaches and to score them.MATERIALS AND METHODS: A mixed‑method study was carried out using the force field analysisregarding the change toward EBDM in HS in 2020. This study included six steps to identify andscore the key driving forces (DFs) and restraining forces (RFs) to change toward the EBDM inHS: first, finding forces from literature; second, selecting key DFs and RFs through focus groupdiscussion; third, scoring the first group of DFs and RFs by the experts through electronic forms;fourth, determining key DFs and RFs from the managers’ perspective using qualitative interviews;fifth, scoring the second group of DFs and RFs by the experts; and sixth, comparison between forcesresulted from two approaches.RESULTS: According to the literature and experts’ opinions, “relevant, reliable, interpretable, andunderstandable evidence” and “interaction between researchers and decision‑makers” were thestrongest forces to change, and “lack of organizational commitment and support” and “lack of relevant/high‑quality evidence” were the strongest forces against the change toward EBDM in HS. Further,based on managers’ perspective and scores by the experts, “suitable supervision and control” and“reforming the planning and decision‑making system” were the strongest forces to change, and“inadequate knowledge of the managers and staff about the principles and contents of EBDM” and“issues beyond the authorities of managers” were the strongest forces against the change towardEBDM in HS.CONCLUSIONS: Based on the findings, HSs’ managers can focus to reduce RFs and promote DFsfor implementing EBDM strategies, so they can provide better services by making more efficientdecisions.

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Keywords = Policy‑making

Nature of the private hospital services toward universal health coverage: A systematic scoping review of the developing countries evidence

Abstract

Force field analysis of driving and restraining factors affecting the evidence‑based decision‑making in health systems; comparing two approaches

Abstract