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Systematic Reviews
Published in: Systematic Reviews 1/2016

Open Access 01-12-2016 | Protocol

To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocol

Authors: Zakaria Belrhiti, Andrew Booth, Bruno Marchal, Roosmarijn Verstraeten

Published in: Systematic Reviews | Issue 1/2016

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Abstract

Background

District health managers play a key role in the effectiveness of decentralized health systems in low- and middle-income countries. Inadequate management and leadership skills often hamper their ability to improve quality of care and effectiveness of health service delivery. Nevertheless, significant investments have been made in capacity-building programmes based on site-based training, mentoring, and operational research. This systematic review aims to review the effectiveness of site-based training, mentoring, and operational research (or action research) on the improvement of district health system management and leadership. Our secondary objectives are to assess whether variations in composition or intensity of the intervention influence its effectiveness and to identify enabling and constraining contexts and underlying mechanisms.

Methods

We will search the following databases: MEDLINE, PsycInfo, Cochrane Library, CRD database (DARE), Cochrane Effective Practice and Organisation of Care (EPOC) group, ISI Web of Science, Health Evidence.org, PDQ-Evidence, ERIC, EMBASE, and TRIP. Complementary search will be performed (hand-searching journals and citation and reference tracking).
Studies that meet the following PICO (Population, Intervention, Comparison, Outcome) criteria will be included: P: professionals working at district health management level; I: site-based training with or without mentoring, or operational research; C: normal institutional arrangements; and O: district health management functions. We will include cluster randomized controlled trials, controlled before-and-after studies, interrupted time series analysis, quasi-experimental designs, and cohort and longitudinal studies. Qualitative research will be included to contextualize findings and identify barriers and facilitators.
Primary outcomes that will be reported are district health management and leadership functions. We will assess risk of bias with the Cochrane Collaboration’s tools for randomized controlled trials (RCT) and non RCT studies and Critical Appraisal Skills Programme checklists for qualitative studies. We will assess strength of recommendations with the GRADE tool for quantitative studies, and the CERQual approach for qualitative studies. Synthesis of quantitative studies will be performed through meta-analysis when appropriate. Best fit framework synthesis will be used to synthesize qualitative studies.

Discussion

This protocol paper describes a systematic review assessing the effectiveness of site-based training (with or without mentoring programmes or operational research) on the improvement of district health system management and leadership.

Systematic review registration

Appendix
Available only for authorised users
Footnotes
1
Site-based training is also called on-the-job training, hands-on training, and continuing education, which means training that takes place in workplace settings.
 
2
Nurse practitioners: nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician
 
3
Clinical officer (formerly called medical assistant) is a medical separate healthcare provider who has clinical duties (diagnosis, treatment of patients in primary healthcare, assessment, management, and transfer of surgical patients) and administrative duties at respective health centres.
 
4
Community members who connect healthcare beneficiaries with providers in order to promote access to health
 
5
Prof. Bart Criel, Dr. Geneviève Michaux, and Prof. Bruno Marchal from the Institute of Tropical Medicine, Antwerp
 
6
Members of the RIPSEC consortium. RIPSEC is an EU-funded programme that aims at implementing a site-based training intervention, mentoring, and operational research in four health districts in the Democratic Republic of Congo.
 
7
Zakaria Belrhiti, National School of Public Health, PhD student at Institute of Tropical Medicine
 
8
Issam Bennis, National School of Public Health, PhD student at Institute of Tropical Medicine
 
9
Andrew Booth, University of Sheffield, and Roos Verstraeten, Institute of Tropical Medicine, Antwerp
 
10
Ibid
 
11
Theory, theories, theoretical
 
12
Concept, concepts, and conceptual
 
13
Framework, frameworks
 
14
Model, models
 
15
Critical Appraisal Skills Programme (CASP). Qualitative Research Checklist. 2013 available at http://​www.​casp-uk.​net/​#!checklists/​cb36
 
16
University of Sheffield
 
17
Institute of tropical medicine, Antwerp, Belgium
 
18
List of LMIC is based on 2016 fiscal report, World Bank, “http://​data.​worldbank.​org/​about/​country-and-lending-groups#Lower_​middle_​income. I added nationality adjectives for irregular forms.
 
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Metadata
Title
To what extent do site-based training, mentoring, and operational research improve district health system management and leadership in low- and middle-income countries: a systematic review protocol
Authors
Zakaria Belrhiti
Andrew Booth
Bruno Marchal
Roosmarijn Verstraeten
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2016
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-016-0239-z

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