PDF(Pubmed)
Abstract：
UNASSIGNED: Based on the World Health Organization\'s health systems strengthening framework, the Health Systems Governance and Accountability (HSGA) intervention to strengthen public health leadership/management, service integration and outcomes was developed in the Free State.
UNASSIGNED: This study describes the process to implement and measure the effects of the HSGA intervention for system-wide improvement of leadership/management under routine conditions in a resource-constrained setting.
UNASSIGNED: Based on normalisation process theory, participatory discussions were held with health managers, staff and local stakeholders to attain buy-in. Evaluation of the implementation process considered progress in improving leadership/management through application of the Balanced Scorecard (BSC). All provincial reporting units were assessed during 2014/15 and again during 2015/16.
UNASSIGNED: The mean scores on three BSC perspectives improved statistically significantly from 2014/15 to 2015/16: customer (p=0.0085), internal business processes (p=0.0008) and finance (p=0.0001). Overall leadership/management also improved significantly (p=0.0007).
UNASSIGNED: Improvement in leadership/management resulting from implementation of the HSGA intervention was observed during the two years under study. From this experience, successful implementation of a health systems strengthening intervention hinges on a participatory design, appropriate use of theory, as well as application of an evaluation approach to assess the success of implementation.
UNASSIGNED: This study describes the process to implement and measure the effects of the HSGA intervention for system-wide improvement of leadership/management under routine conditions in a resource-constrained setting.
UNASSIGNED: Based on normalisation process theory, participatory discussions were held with health managers, staff and local stakeholders to attain buy-in. Evaluation of the implementation process considered progress in improving leadership/management through application of the Balanced Scorecard (BSC). All provincial reporting units were assessed during 2014/15 and again during 2015/16.
UNASSIGNED: The mean scores on three BSC perspectives improved statistically significantly from 2014/15 to 2015/16: customer (p=0.0085), internal business processes (p=0.0008) and finance (p=0.0001). Overall leadership/management also improved significantly (p=0.0007).
UNASSIGNED: Improvement in leadership/management resulting from implementation of the HSGA intervention was observed during the two years under study. From this experience, successful implementation of a health systems strengthening intervention hinges on a participatory design, appropriate use of theory, as well as application of an evaluation approach to assess the success of implementation.
摘要：
■基于世界卫生组织的卫生系统加强框架，卫生系统治理和问责制（HSGA）干预措施，以加强公共卫生领导/管理，服务整合和成果是在自由州发展起来的。
■本研究描述了在资源受限的环境下，在常规条件下实施和衡量HSGA干预措施以改善全系统领导/管理的效果的过程。
■基于规范化过程理论，与卫生管理人员进行了参与性讨论，员工和当地利益相关者实现收买。对实施过程的评估考虑了通过应用平衡计分卡（BSC）改善领导/管理的进展。所有省级报告单位都在2014/15年度和2015/16年度进行了评估。
■从2014/15到2015/16，三种BSC观点的平均得分在统计上显着提高：客户（p=0.0085），内部业务流程(p=0.0008)和财务(p=0.0001)。整体领导/管理也显著改善（p=0.0007）。
■在研究的两年中，观察到由于实施HSGA干预而导致的领导/管理改善。从这次经历中,卫生系统加强干预的成功实施取决于参与性设计，合理运用理论,以及应用评估方法来评估实施的成功。
■本研究描述了在资源受限的环境下，在常规条件下实施和衡量HSGA干预措施以改善全系统领导/管理的效果的过程。
■基于规范化过程理论，与卫生管理人员进行了参与性讨论，员工和当地利益相关者实现收买。对实施过程的评估考虑了通过应用平衡计分卡（BSC）改善领导/管理的进展。所有省级报告单位都在2014/15年度和2015/16年度进行了评估。
■从2014/15到2015/16，三种BSC观点的平均得分在统计上显着提高：客户（p=0.0085），内部业务流程(p=0.0008)和财务(p=0.0001)。整体领导/管理也显著改善（p=0.0007）。
■在研究的两年中，观察到由于实施HSGA干预而导致的领导/管理改善。从这次经历中,卫生系统加强干预的成功实施取决于参与性设计，合理运用理论,以及应用评估方法来评估实施的成功。
