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Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis

Identifieur interne : 001886 ( Main/Exploration ); précédent : 001885; suivant : 001887

Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis

Auteurs : Joanne Mcveigh [Irlande (pays)] ; Malcolm Maclachlan [Irlande (pays), Afrique du Sud] ; Brynne Gilmore [Irlande (pays)] ; Chiedza Mcclean [Irlande (pays)] ; Arne H. Eide [Norvège, Afrique du Sud] ; Hasheem Mannan [Irlande (pays)] ; Priscille Geiser [France] ; Antony Duttine [États-Unis] ; Gubela Mji [Afrique du Sud] ; Eilish Mcauliffe [Irlande (pays)] ; Beth Sprunt [Australie] ; Mutamad Amin [Soudan] ; Charles Normand [Irlande (pays)]

Source :

RBID : PMC:4997679

Abstract

Background

Good governance may result in strengthened performance of a health system. Coherent policies are essential for good health system governance. The overall aim of this research is to provide the best available scientific evidence on principles of good policy related leadership and governance of health related rehabilitation services in less resourced settings. This research was also conducted to support development of the World Health Organization’s (WHO) Guidelines on health related rehabilitation.

Methods

An innovative study design was used, comprising two methods: a systematic search and realist synthesis of literature, and a Delphi survey of expert stakeholders to refine and triangulate findings from the realist synthesis. In accordance with Pawson and Tilley’s approach to realist synthesis, we identified context mechanism outcome pattern configurations (CMOCs) from the literature. Subsequently, these CMOCs were developed into statements for the Delphi survey, whereby 18 expert stakeholders refined these statements to achieve consensus on recommendations for policy related governance of health related rehabilitation.

Results

Several broad principles emerged throughout formulation of recommendations: participation of persons with disabilities in policy processes to improve programme responsiveness, efficiency, effectiveness, and sustainability, and to strengthen service-user self-determination and satisfaction; collection of disaggregated disability statistics to support political momentum, decision-making of policymakers, evaluation, accountability, and equitable allocation of resources; explicit promotion in policies of access to services for all subgroups of persons with disabilities and service-users to support equitable and accessible services; robust inter-sectoral coordination to cultivate coherent mandates across governmental departments regarding service provision; and ‘institutionalizing’ programmes by aligning them with preexisting Ministerial models of healthcare to support programme sustainability.

Conclusions

Alongside national policymakers, our policy recommendations are relevant for several stakeholders, including service providers and service-users. This research aims to provide broad policy recommendations, rather than a strict formula, in acknowledgement of contextual diversity and complexity. Accordingly, our study proposes general principles regarding optimal policy related governance of health related rehabilitation in less resourced settings, which may be valuable across diverse health systems and contexts.


Url:
DOI: 10.1186/s12992-016-0182-8
PubMed: 27558240
PubMed Central: 4997679


Affiliations:


Links toward previous steps (curation, corpus...)


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<orgName type="university">Université de Melbourne</orgName>
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<settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Amin, Mutamad" sort="Amin, Mutamad" uniqKey="Amin M" first="Mutamad" last="Amin">Mutamad Amin</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff10">Ahfad University for Women, P.O. Box 167, Omdurman, Sudan</nlm:aff>
<country xml:lang="fr">Soudan</country>
<wicri:regionArea>Ahfad University for Women, P.O. Box 167, Omdurman</wicri:regionArea>
<wicri:noRegion>Omdurman</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Normand, Charles" sort="Normand, Charles" uniqKey="Normand C" first="Charles" last="Normand">Charles Normand</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff11">Health Policy & Management, Trinity College Dublin, Room 0.21, 3-4 Foster Place, College Green, Dublin 2, Ireland</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Health Policy & Management, Trinity College Dublin, Room 0.21, 3-4 Foster Place, College Green, Dublin 2</wicri:regionArea>
<wicri:noRegion>Dublin 2</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="Aff1">Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2</wicri:regionArea>
<wicri:noRegion>Dublin 2</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Globalization and Health</title>
<idno type="eISSN">1744-8603</idno>
<imprint>
<date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p>Good governance may result in strengthened performance of a health system. Coherent policies are essential for good health system governance. The overall aim of this research is to provide the best available scientific evidence on principles of good policy related leadership and governance of health related rehabilitation services in less resourced settings. This research was also conducted to support development of the World Health Organization’s (WHO) Guidelines on health related rehabilitation.</p>
</sec>
<sec>
<title>Methods</title>
<p>An innovative study design was used, comprising two methods: a systematic search and realist synthesis of literature, and a Delphi survey of expert stakeholders to refine and triangulate findings from the realist synthesis. In accordance with Pawson and Tilley’s approach to realist synthesis, we identified context mechanism outcome pattern configurations (CMOCs) from the literature. Subsequently, these CMOCs were developed into statements for the Delphi survey, whereby 18 expert stakeholders refined these statements to achieve consensus on recommendations for policy related governance of health related rehabilitation.</p>
</sec>
<sec>
<title>Results</title>
<p>Several broad principles emerged throughout formulation of recommendations: participation of persons with disabilities in policy processes to improve programme responsiveness, efficiency, effectiveness, and sustainability, and to strengthen service-user self-determination and satisfaction; collection of disaggregated disability statistics to support political momentum, decision-making of policymakers, evaluation, accountability, and equitable allocation of resources; explicit promotion in policies of access to services for all subgroups of persons with disabilities and service-users to support equitable and accessible services; robust inter-sectoral coordination to cultivate coherent mandates across governmental departments regarding service provision; and ‘institutionalizing’ programmes by aligning them with preexisting Ministerial models of healthcare to support programme sustainability.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>Alongside national policymakers, our policy recommendations are relevant for several stakeholders, including service providers and service-users. This research aims to provide broad policy recommendations, rather than a strict formula, in acknowledgement of contextual diversity and complexity. Accordingly, our study proposes general principles regarding optimal policy related governance of health related rehabilitation in less resourced settings, which may be valuable across diverse health systems and contexts.</p>
</sec>
</div>
</front>
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<name sortKey="Hoy, Dg" uniqKey="Hoy D">DG Hoy</name>
</author>
<author>
<name sortKey="Rickart, Kt" uniqKey="Rickart K">KT Rickart</name>
</author>
<author>
<name sortKey="Durham, J" uniqKey="Durham J">J Durham</name>
</author>
<author>
<name sortKey="Puntumetakul, R" uniqKey="Puntumetakul R">R Puntumetakul</name>
</author>
<author>
<name sortKey="Mansoor, Gf" uniqKey="Mansoor G">GF Mansoor</name>
</author>
<author>
<name sortKey="Muijlwijk, A" uniqKey="Muijlwijk A">A Muijlwijk</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Jacobson, E" uniqKey="Jacobson E">E Jacobson</name>
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</analytic>
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<analytic>
<author>
<name sortKey="Kiima, D" uniqKey="Kiima D">D Kiima</name>
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<author>
<name sortKey="Jenkins, R" uniqKey="Jenkins R">R Jenkins</name>
</author>
</analytic>
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<author>
<name sortKey="Kirchner, C" uniqKey="Kirchner C">C Kirchner</name>
</author>
</analytic>
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<analytic>
<author>
<name sortKey="Lazcano Ponce, E" uniqKey="Lazcano Ponce E">E Lazcano-Ponce</name>
</author>
<author>
<name sortKey="Katz, G" uniqKey="Katz G">G Katz</name>
</author>
<author>
<name sortKey="Allen Leigh, B" uniqKey="Allen Leigh B">B Allen-Leigh</name>
</author>
<author>
<name sortKey="Maga A Valladares, L" uniqKey="Maga A Valladares L">L Magaña Valladares</name>
</author>
<author>
<name sortKey="Rangel Eudave, G" uniqKey="Rangel Eudave G">G Rangel-Eudave</name>
</author>
<author>
<name sortKey="Minoletti, A" uniqKey="Minoletti A">A Minoletti</name>
</author>
</analytic>
</biblStruct>
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<analytic>
<author>
<name sortKey="Lord, Je" uniqKey="Lord J">JE Lord</name>
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<author>
<name sortKey="Suozzi, D" uniqKey="Suozzi D">D Suozzi</name>
</author>
<author>
<name sortKey="Taylor, Al" uniqKey="Taylor A">AL Taylor</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Mji, G" uniqKey="Mji G">G Mji</name>
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<author>
<name sortKey="Maclachlan, M" uniqKey="Maclachlan M">M MacLachlan</name>
</author>
<author>
<name sortKey="Melling Williams, N" uniqKey="Melling Williams N">N Melling-Williams</name>
</author>
<author>
<name sortKey="Gcaza, S" uniqKey="Gcaza S">S Gcaza</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Mmatli, To" uniqKey="Mmatli T">TO Mmatli</name>
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<author>
<name sortKey="Penny, N" uniqKey="Penny N">N Penny</name>
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<author>
<name sortKey="Zulianello, R" uniqKey="Zulianello R">R Zulianello</name>
</author>
<author>
<name sortKey="Dreise, M" uniqKey="Dreise M">M Dreise</name>
</author>
<author>
<name sortKey="Steenbeek, M" uniqKey="Steenbeek M">M Steenbeek</name>
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</analytic>
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<author>
<name sortKey="Stringfellow, Jw" uniqKey="Stringfellow J">JW Stringfellow</name>
</author>
<author>
<name sortKey="Muscari, Kd" uniqKey="Muscari K">KD Muscari</name>
</author>
</analytic>
</biblStruct>
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<analytic>
<author>
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<author>
<name sortKey="Durkin, Em" uniqKey="Durkin E">EM Durkin</name>
</author>
<author>
<name sortKey="Hammel, J" uniqKey="Hammel J">J Hammel</name>
</author>
<author>
<name sortKey="Murray, P" uniqKey="Murray P">P Murray</name>
</author>
<author>
<name sortKey="Whyte, J" uniqKey="Whyte J">J Whyte</name>
</author>
<author>
<name sortKey="Dijkers, M" uniqKey="Dijkers M">M Dijkers</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Maclachlan, M" uniqKey="Maclachlan M">M MacLachlan</name>
</author>
<author>
<name sortKey="Amin, M" uniqKey="Amin M">M Amin</name>
</author>
<author>
<name sortKey="Mannan, H" uniqKey="Mannan H">H Mannan</name>
</author>
<author>
<name sortKey="El Tayeb, S" uniqKey="El Tayeb S">S El Tayeb</name>
</author>
<author>
<name sortKey="Bedri, N" uniqKey="Bedri N">N Bedri</name>
</author>
<author>
<name sortKey="Swartz, L" uniqKey="Swartz L">L Swartz</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Emmett, T" uniqKey="Emmett T">T Emmett</name>
</author>
<author>
<name sortKey="Alant, E" uniqKey="Alant E">E Alant</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Walsh Danishmandi, A" uniqKey="Walsh Danishmandi A">A Walsh-Danishmandi</name>
</author>
<author>
<name sortKey="Maclachlan, M" uniqKey="Maclachlan M">M MacLachlan</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Elkins, Mr" uniqKey="Elkins M">MR Elkins</name>
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<author>
<name sortKey="Herbert, Rd" uniqKey="Herbert R">RD Herbert</name>
</author>
<author>
<name sortKey="Moseley, Am" uniqKey="Moseley A">AM Moseley</name>
</author>
<author>
<name sortKey="Sherrington, C" uniqKey="Sherrington C">C Sherrington</name>
</author>
<author>
<name sortKey="Maher, C" uniqKey="Maher C">C Maher</name>
</author>
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</div1>
</back>
</TEI>
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<list>
<country>
<li>Afrique du Sud</li>
<li>Australie</li>
<li>France</li>
<li>Irlande (pays)</li>
<li>Norvège</li>
<li>Soudan</li>
<li>États-Unis</li>
</country>
<region>
<li>Auvergne-Rhône-Alpes</li>
<li>Maryland</li>
<li>Rhône-Alpes</li>
<li>Trøndelag</li>
<li>Victoria (État)</li>
<li>Østlandet</li>
</region>
<settlement>
<li>Lyon</li>
<li>Melbourne</li>
<li>Oslo</li>
<li>Trondheim</li>
</settlement>
<orgName>
<li>Université de Melbourne</li>
</orgName>
</list>
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<country name="Irlande (pays)">
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<name sortKey="Mcveigh, Joanne" sort="Mcveigh, Joanne" uniqKey="Mcveigh J" first="Joanne" last="Mcveigh">Joanne Mcveigh</name>
</noRegion>
<name sortKey="Gilmore, Brynne" sort="Gilmore, Brynne" uniqKey="Gilmore B" first="Brynne" last="Gilmore">Brynne Gilmore</name>
<name sortKey="Maclachlan, Malcolm" sort="Maclachlan, Malcolm" uniqKey="Maclachlan M" first="Malcolm" last="Maclachlan">Malcolm Maclachlan</name>
<name sortKey="Maclachlan, Malcolm" sort="Maclachlan, Malcolm" uniqKey="Maclachlan M" first="Malcolm" last="Maclachlan">Malcolm Maclachlan</name>
<name sortKey="Mannan, Hasheem" sort="Mannan, Hasheem" uniqKey="Mannan H" first="Hasheem" last="Mannan">Hasheem Mannan</name>
<name sortKey="Mcauliffe, Eilish" sort="Mcauliffe, Eilish" uniqKey="Mcauliffe E" first="Eilish" last="Mcauliffe">Eilish Mcauliffe</name>
<name sortKey="Mcclean, Chiedza" sort="Mcclean, Chiedza" uniqKey="Mcclean C" first="Chiedza" last="Mcclean">Chiedza Mcclean</name>
<name sortKey="Mcveigh, Joanne" sort="Mcveigh, Joanne" uniqKey="Mcveigh J" first="Joanne" last="Mcveigh">Joanne Mcveigh</name>
<name sortKey="Normand, Charles" sort="Normand, Charles" uniqKey="Normand C" first="Charles" last="Normand">Charles Normand</name>
<name sortKey="Normand, Charles" sort="Normand, Charles" uniqKey="Normand C" first="Charles" last="Normand">Charles Normand</name>
</country>
<country name="Afrique du Sud">
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<name sortKey="Maclachlan, Malcolm" sort="Maclachlan, Malcolm" uniqKey="Maclachlan M" first="Malcolm" last="Maclachlan">Malcolm Maclachlan</name>
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<name sortKey="Eide, Arne H" sort="Eide, Arne H" uniqKey="Eide A" first="Arne H." last="Eide">Arne H. Eide</name>
<name sortKey="Mji, Gubela" sort="Mji, Gubela" uniqKey="Mji G" first="Gubela" last="Mji">Gubela Mji</name>
</country>
<country name="Norvège">
<region name="Østlandet">
<name sortKey="Eide, Arne H" sort="Eide, Arne H" uniqKey="Eide A" first="Arne H." last="Eide">Arne H. Eide</name>
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<name sortKey="Eide, Arne H" sort="Eide, Arne H" uniqKey="Eide A" first="Arne H." last="Eide">Arne H. Eide</name>
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<country name="France">
<region name="Auvergne-Rhône-Alpes">
<name sortKey="Geiser, Priscille" sort="Geiser, Priscille" uniqKey="Geiser P" first="Priscille" last="Geiser">Priscille Geiser</name>
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</country>
<country name="États-Unis">
<region name="Maryland">
<name sortKey="Duttine, Antony" sort="Duttine, Antony" uniqKey="Duttine A" first="Antony" last="Duttine">Antony Duttine</name>
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</country>
<country name="Australie">
<region name="Victoria (État)">
<name sortKey="Sprunt, Beth" sort="Sprunt, Beth" uniqKey="Sprunt B" first="Beth" last="Sprunt">Beth Sprunt</name>
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</country>
<country name="Soudan">
<noRegion>
<name sortKey="Amin, Mutamad" sort="Amin, Mutamad" uniqKey="Amin M" first="Mutamad" last="Amin">Mutamad Amin</name>
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</tree>
</affiliations>
</record>

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