Health systems strengthening interventions in low-income and middle-income countries
Citation: Adam T, Hsu J, De Savigny D, et al. Evaluating health systems strengthening interventions in low-income and middle-income countries: are we asking the right questions? Health Policy and Planning. 2012;27(suppl_4):iv9-19.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: Alliance for Health Policy and Systems Research, World Health Organization.
What is this? Information on interventions intended to strength health systems in low- and middle-income countries might help policy makers seeking to provide health systems in these settings.
In this systematic review, the authors searched for studies of the effects and outcomes of health system interventions in low- and middle-income countries. They did not restrict their searches by language and searched for articles published in 2009 or 2010. They included articles that reported on a total of 106 evaluations, 91 of which were system-level interventions, targeting one or more of the health system building blocks; and 15 were evaluations of the large scale-up of disease-specific interventions.
What was found: Only a few comprehensive interventions had considered the complexity of healthcare systems, but these only addressed a limited number of conditions or illnesses.
Several barriers to comprehensive evaluations included limited capacity, inadequate funding and timeframe, lack of demand and difficulty in pursuing this type of research and analysis.
Implications: The authors concluded that there is a need for more comprehensive evaluations of the wider range of the intervention’s effects and that the full range of barriers to more comprehensive evaluations be examined and, where appropriate, addressed.
Other considerations: The authors of the review did not discuss their findings in the context of issues relating to health equity.
This summary was prepared by Yasmeen Saeed and finalized by Mike Clarke.