Review of strategies to strengthen health services

John Ovretveit, Banafsheh Siadat, David H. Peters, Anil Thota, Sameh El-Saharty

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Objective: To evaluate the published literature on strategies to strengthen the delivery of health services in LMICs.

Methods: A modified systematic review was made of electronic databases on publication, literature reviews, and bibliographies by type of strategy, implementation characteristics, validity of findings, and strength of evidence.

Key messages:

The evidence base is weak for claiming success of any particular health services strengthening strategy across LMICs.

How a strategy is implemented is as important as the type of strategy implemented.

Strategies that are more effective in strengthening service delivery for the poor involve planning for benefits to reach the poor, ensuring regular measurement of impact on the poor, and providing oversight to ensure that the poor benefit.

Stakeholder involvement and consultation are necessary for effective implementation.

Successful implementation is linked to interventions to identify and minimize constraints.

There was no evidence that certain strategies are less dependent on the local environment and work in more countries than other strategies.

Mobilization of adequate resources is linked to successful strategy implementation.

The initial and continuous adaptation of the strategy to the local context is associated with more complete strategy implementation, and that adaptation is easier in small-scale interventions.

Multiple strategies are more effective than single strategies, but risk of failure is greater.

Moderate evidence suggests that strategies to strengthen disease-specific programs that are effective in one area can be successfully scaled up nationally.

The evidence is inconclusive as to whether disease-specific programs are an effective way to strengthen health services.

Original languageEnglish
Title of host publicationImproving health service delivery in developing countries
Subtitle of host publicationfrom evidence to action
EditorsDavid H. Peters, Sameh El-Saharty, Banafsheh Siadat, Marko Vujicic, Katja Janovsky
Place of PublicationWashington, DC
PublisherThe World Bank
Pages35-68
Number of pages34
ISBN (Electronic)9780821379431
ISBN (Print)9780821378885
DOIs
Publication statusPublished - 2009
Externally publishedYes

Publication series

NameDirections in Development
PublisherThe World Bank

Keywords

  • RANDOMIZED CONTROLLED-TRIAL
  • SEXUALLY-TRANSMITTED-DISEASES
  • FAMILY-PLANNING-SERVICES
  • TRADITIONAL BIRTH ATTENDANTS
  • INSECTICIDE-TREATED NETS
  • TUBERCULOSIS TREATMENT PROGRAM
  • PUBLIC-PRIVATE PARTNERSHIP
  • ORAL REHYDRATION THERAPY
  • CHILDHOOD ILLNESS IMCI
  • LOW-INCOME COUNTRIES

Cite this

Ovretveit, J., Siadat, B., Peters, D. H., Thota, A., & El-Saharty, S. (2009). Review of strategies to strengthen health services. In D. H. Peters, S. El-Saharty, B. Siadat, M. Vujicic, & K. Janovsky (Eds.), Improving health service delivery in developing countries: from evidence to action (pp. 35-68). (Directions in Development). Washington, DC: The World Bank. https://doi.org/10.1596/978-0-8213-7888-5