Lessons learned in using realist evaluation to assess maternal and newborn health programming in rural Bangladesh.

Abstract:

:Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the three MNH programmes under consideration employed different implementation models to deliver similar services and meet similar MNH goals. Programme targets included adoption of recommended antenatal, post-natal and essential newborn care practices; health systems strengthening through improved referral, accountability and administrative systems, and increased community knowledge. Drawing on focused examples from this research, seven steps for operationalizing the realist evaluation approach are offered, while emphasizing the need to iterate and innovate in terms of methods and analysis strategies. The paper concludes by reflecting on lessons learned in applying realist evaluation, and the unique insights it yields regarding implementation strategies for successful MNH programming.

journal_name

Health Policy Plan

authors

Adams A,Sedalia S,McNab S,Sarker M

doi

10.1093/heapol/czv053

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

267-75

issue

2

eissn

0268-1080

issn

1460-2237

pii

czv053

journal_volume

31

pub_type

杂志文章
  • An integrated method for evaluating community-based safe water programmes and an application in rural Mexico.

    abstract::The burden of diarrhoeal disease remains high in the developing world. Community-based safe drinking water programmes are being promoted as cost-effective interventions that will help reduce this illness burden. However, the effectiveness of these programmes remains under-investigated. The primary argument of this pap...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czn017

    authors: deWilde CK,Milman A,Flores Y,Salmerón J,Ray I

    更新日期:2008-11-01 00:00:00

  • The effect of Integrated Management of Childhood Illness on observed quality of care of under-fives in rural Tanzania.

    abstract::Integrated Management of Childhood Illness (IMCI) has been adopted by over 80 countries as a strategy for reducing child mortality and improving child health and development. It includes complementary interventions designed to address the major causes of child mortality at community, health facility, and health system...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czh001

    authors: Armstrong Schellenberg J,Bryce J,de Savigny D,Lambrechts T,Mbuya C,Mgalula L,Wilczynska K,Tanzania IMCI Multi-Country Evaluation Health Facility Survey Study Group.

    更新日期:2004-01-01 00:00:00

  • Sub-national health care financing reforms in Indonesia.

    abstract::Indonesia has seen an emergence of local health care financing schemes over the last decade, implemented and operated by district governments. Often motivated by the local political context and characterized by a large degree of heterogeneity in scope and design, the common objective of the district schemes is to addr...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw101

    authors: Sparrow R,Budiyati S,Yumna A,Warda N,Suryahadi A,Bedi AS

    更新日期:2017-02-01 00:00:00

  • Public and private hospitals in Bangladesh: service quality and predictors of hospital choice.

    abstract::This study compares the quality of services provided by public and private hospitals in Bangladesh. The premise of the paper was that the quality of hospital services would be contingent on the incentive structure under which these institutions operate. Since private hospitals are not subsidized and depend on income f...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/15.1.95

    authors: Andaleeb SS

    更新日期:2000-03-01 00:00:00

  • Demand for private healthcare in a universal public healthcare system: empirical evidence from Sri Lanka.

    abstract::This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal pub...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx085

    authors: Pallegedara A,Grimm M

    更新日期:2017-11-01 00:00:00

  • The North American Free Trade Agreement (NAFTA) and Mexican nursing.

    abstract::In the context of nurse migration, experts view trade agreements as either vehicles for facilitating migration or as contributing to brain-drain phenomena. Using a case study design, this study explored the effects of the North American Free Trade Agreement (NAFTA) on the development of Mexican nursing. Drawing result...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czq024

    authors: Squires A

    更新日期:2011-03-01 00:00:00

  • Socioeconomic inequality in premiums for a community-based health insurance scheme in Rwanda.

    abstract::Community-based health insurance (CBHI) has gained popularity in many low- and middle-income countries, partly as a policy response to calls for low-cost, pro-poor health financing solutions. In Africa, Rwanda has successfully implemented two types of CBHI systems since 2005, one of which with a flat rate premium (200...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa135

    authors: Chirwa GC,Suhrcke M,Moreno-Serra R

    更新日期:2020-12-02 00:00:00

  • Cost-effectiveness of strategies to reduce mother-to-child HIV transmission in Mexico, a low-prevalence setting.

    abstract:OBJECTIVE:To estimate and compare the cost-effectiveness of selected interventions to reduce mother-to-child transmission (MTCT) of HIV in Mexico. METHODS:A spreadsheet-based model was used to examine five scenarios, each estimated using both zidovudine (ZDV) and nevirapine (NVP). Scenarios differ according to coverag...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czg035

    authors: Rely K,Bertozzi SM,Avila-Figueroa C,Guijarro MT

    更新日期:2003-09-01 00:00:00

  • Pneumonia's second wind? A case study of the global health network for childhood pneumonia.

    abstract::Advocacy, policy, research and intervention efforts against childhood pneumonia have lagged behind other health issues, including malaria, measles and tuberculosis. Accelerating progress on the issue began in 2008, following decades of efforts by individuals and organizations to address the leading cause of childhood ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv070

    authors: Berlan D

    更新日期:2016-04-01 00:00:00

  • A home visit-based early childhood stimulation programme in Brazil-a randomized controlled trial.

    abstract::Home visiting programmes are increasingly recognized as one of the most effective interventions to improve child health and development in low-income settings. However, the best platforms to deliver such programmes remain unclear. We conducted a randomized controlled trial to test the relative effectiveness of child d...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa195

    authors: Brentani A,Walker S,Chang-Lopez S,Grisi S,Powell C,Fink G

    更新日期:2021-01-26 00:00:00

  • Review of corruption in the health sector: theory, methods and interventions.

    abstract::There is increasing interest among health policymakers, planners and donors in how corruption affects health care access and outcomes, and what can be done to combat corruption in the health sector. Efforts to explain the risk of abuse of entrusted power for private gain have examined the links between corruption and ...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czm048

    authors: Vian T

    更新日期:2008-03-01 00:00:00

  • Expenditure tracking and review of reproductive maternal, newborn and child health policy in Pakistan.

    abstract::Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx021

    authors: Malik MA,Nahyoun AS,Rizvi A,Bhatti ZA,Bhutta ZA

    更新日期:2017-07-01 00:00:00

  • Critical interactions between Global Fund-supported programmes and health systems: a case study in Papua New Guinea.

    abstract::In Papua New Guinea, investment by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) has played an important role in scaling up the response to HIV and tuberculosis (TB). As part of a series of case studies on how Global Fund-supported programmes interact with national health systems, we assess...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czq058

    authors: Rudge JW,Phuanakoonon S,Nema KH,Mounier-Jack S,Coker R

    更新日期:2010-11-01 00:00:00

  • The quality of risk factor screening during antenatal consultations in Niger.

    abstract::A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health prog...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/15.1.11

    authors: Prual A,Toure A,Huguet D,Laurent Y

    更新日期:2000-03-01 00:00:00

  • Cost of school-based drug treatment in Tanzania. The Partnership for Child Development.

    abstract::It has been argued that targeting delivery of anthelmintics to school-children by taking advantage of the existing education infrastructure and administrative system can be one of the most cost-effective approaches in minimizing the intensity of infections with both schistosomiasis and major intestinal nematodes in ma...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/13.4.384

    authors:

    更新日期:1998-12-01 00:00:00

  • Policymaking 'under the radar': a case study of pesticide regulation to prevent intentional poisoning in Sri Lanka.

    abstract:BACKGROUND:Suicide in Sri Lanka is a major public health problem and in 1995 the country had one of the highest rates of suicide worldwide. Since then reductions in overall suicide rates have been largely attributed to efforts to regulate a range of pesticides. The evolution, context, events and implementation of the k...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czt096

    authors: Pearson M,Zwi AB,Buckley NA,Manuweera G,Fernando R,Dawson AH,McDuie-Ra D

    更新日期:2015-02-01 00:00:00

  • Income elasticity of health expenditures in Iran.

    abstract::Because of its policy implications, the income elasticity of health care expenditures is a subject of much debate. Governments may have an interest in subsidizing the care of those with low income. Using more than two decades of data from the Iran Household Expenditure and Income Survey, this article investigates the ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs106

    authors: Zare H,Trujillo AJ,Leidman E,Buttorff C

    更新日期:2013-09-01 00:00:00

  • Health care utilization and health outcomes: a population study of Taiwan.

    abstract::Facing escalating health care expenditures, the governments of countries with national health insurance programs are trying to control or even to reduce health care utilization. Little research has examined the effects of decreased health care utilization on health outcomes. Applying a natural experiment design to the...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr080

    authors: Wang SY,Chen LK,Hsu SH,Wang SC

    更新日期:2012-10-01 00:00:00

  • The financing gaps framework: using need, potential spending and expected spending to allocate development assistance for health.

    abstract::As growth in development assistance for health levels off, development assistance partners must make allocation decisions within tighter budget constraints. Furthermore, with the advent of comprehensive and comparable burden of disease and health financing estimates, empirical evidence can increasingly be used to dire...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx165

    authors: Haakenstad A,Templin T,Lim S,Bump JB,Dieleman J

    更新日期:2018-02-01 00:00:00

  • Developing more participatory and accountable institutions for health: identifying health system research priorities for the Sustainable Development Goal-era.

    abstract::Health policy and systems research (HPSR) is vital to guiding global institutions, funders, policymakers, activists and implementers in developing and enacting strategies to achieve the Sustainable Development Goals. We undertook a multi-stage participatory process to identify priority research questions relevant to i...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czy079

    authors: Scott K,Jessani N,Qiu M,Bennett S

    更新日期:2018-11-01 00:00:00

  • Social franchising of TB care through private GPs in Myanmar: an assessment of treatment results, access, equity and financial protection.

    abstract::This article assesses whether social franchising of tuberculosis (TB) services in Myanmar has succeeded in providing quality treatment while ensuring equity in access and financial protection for poor patients. Newly diagnosed TB patients receiving treatment from private general practitioners (GPs) belonging to the fr...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czm007

    authors: Lönnroth K,Aung T,Maung W,Kluge H,Uplekar M

    更新日期:2007-05-01 00:00:00

  • Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter?

    abstract:OBJECTIVE:We examine socio-economic status (SES) and geographic differences in willingness of respondents to pay for community-based health insurance (CBHI). METHODS:The study took place in Anambra and Enugu states, south-east Nigeria. It involved a rural, an urban and a semi-urban community in each of the two states....

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp046

    authors: Onwujekwe O,Okereke E,Onoka C,Uzochukwu B,Kirigia J,Petu A

    更新日期:2010-03-01 00:00:00

  • The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion.

    abstract::Zambia has one of the most liberal abortion laws in sub-Saharan Africa. However, rates of unsafe abortion remain high with negative health and economic consequences. Little is known about the economic burden on women of abortion care-seeking in low income countries. The majority of studies focus on direct costs (e.g. ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv138

    authors: Leone T,Coast E,Parmar D,Vwalika B

    更新日期:2016-09-01 00:00:00

  • The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique.

    abstract:OBJECTIVE:To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001. METHODS:A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi006

    authors: Griffiths UK,Hutton G,Das Dores Pascoal E

    更新日期:2005-01-01 00:00:00

  • Determinants of patient choice of medical provider: a case study in rural China.

    abstract::This study examines the factors that influence patient choice of medical provider in the three-tier health care system in rural China: village health posts, township health centres, and county (and higher level) hospitals. The model is estimated using a multinomial logit approach applied to a sample of 1877 cases of o...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/13.3.311

    authors: Yip WC,Wang H,Liu Y

    更新日期:1998-09-01 00:00:00

  • Financing mental health services in low- and middle-income countries.

    abstract::Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries und...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czl004

    authors: Dixon A,McDaid D,Knapp M,Curran C

    更新日期:2006-05-01 00:00:00

  • Supporting mental health in South African HIV-affected communities: primary health care professionals' understandings and responses.

    abstract::How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients' distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoni...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu092

    authors: Burgess RA

    更新日期:2015-09-01 00:00:00

  • The evolution, etiology and eventualities of the global health security regime.

    abstract:BACKGROUND:Attention to global health security governance is more important now than ever before. Scientists predict that a possible influenza pandemic could affect 1.5 billion people, cause up to 150 million deaths and leave US$3 trillion in economic damages. A public health emergency in one country is now only hours ...

    journal_title:Health policy and planning

    pub_type: 历史文章,杂志文章

    doi:10.1093/heapol/czq037

    authors: Hoffman SJ

    更新日期:2010-11-01 00:00:00

  • Bypassing districts? Implications of sector-wide approaches and decentralization for integrating gender equity in Uganda and Kenya.

    abstract::While the concept of gender mainstreaming has gained acceptance among many national and international development organizations, many obstacles are faced in translating the concept into tangible improvements in the health and well-being of women and men. This paper presents two qualitative case studies, one from Kenya...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi017

    authors: Elsey H,Kilonzo N,Tolhurst R,Molyneux C

    更新日期:2005-05-01 00:00:00

  • Equity in coverage of maternal and newborn care in India: evidence from a nationally representative survey.

    abstract::Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa020

    authors: Krishnamoorthy Y,Majella MG,Rajaa S

    更新日期:2020-06-01 00:00:00