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      Realist evaluation of the role of the Universal Health Coverage Partnership in strengthening policy dialogue for health planning and financing: a protocol

      protocol

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          Abstract

          Introduction

          In 2011, WHO, the European Union and Luxembourg entered into a collaborative agreement to support policy dialogue for health planning and financing; these were acknowledged as core areas in need of targeted support in countries’ quest towards universal health coverage (UHC). Entitled ‘Universal Health Coverage Partnership’, this intervention is intended to strengthen countries’ capacity to develop, negotiate, implement, monitor and evaluate robust and integrated national health policies oriented towards UHC. It is a complex intervention involving a multitude of actors working on a significant number of remarkably diverse activities in different countries.

          Methods and analysis

          The researchers will conduct a realist evaluation to answer the following question: How, in what contexts, and triggering what mechanisms, does the Partnership support policy dialogue for health planning and financing towards UHC? A qualitative multiple case study will be undertaken in Togo, Liberia, Democratic Republic of Congo, Cape Verde, Burkina Faso and Niger. Three steps will be implemented: (1) formulating context–mechanism–outcome explanatory propositions to guide data collection, based on expert knowledge and theoretical literature; (2) collecting empirical data through semistructured interviews with key informants and observations of key events, and analysing data; (3) specifying the intervention theory.

          Ethics and dissemination

          The primary target audiences are WHO and its partner countries; international and national stakeholders involved in or supporting policy dialogues in the health sector, especially in low-income countries; and researchers with interest in UHC, policy dialogue, evaluation research and/or realist evaluation.

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          Most cited references24

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          Stakeholder analysis: a review.

          R. Brugha (2000)
          The growing popularity of stakeholder analysis reflects an increasing recognition of how the characteristics of stakeholders--individuals, groups and organizations--influence decision-making processes. This paper reviews the origins and uses of stakeholder analysis, as described in the policy, health care management and development literature. Its roots are in the political and policy sciences, and in management theory where it has evolved into a systematic tool with clearly defined steps and applications for scanning the current and future organizational environment. Stakeholder analysis can be used to generate knowledge about the relevant actors so as to understand their behaviour, intentions, interrelations, agendas, interests, and the influence or resources they have brought--or could bring--to bear on decision-making processes. This information can then be used to develop strategies for managing these stakeholders, to facilitate the implementation of specific decisions or organizational objectives, or to understand the policy context and assess the feasibility of future policy directions. Policy development is a complex process which frequently takes place in an unstable and rapidly changing context, subject to unpredictable internal and external factors. As a cross-sectional view of an evolving picture, the utility of stakeholder analysis for predicting and managing the future is time-limited and it should be complemented by other policy analysis approaches.
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            Partnership Synergy: A Practical Framework for Studying and Strengthening the Collaborative Advantage

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              • Record: found
              • Abstract: found
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              Exploring the relationship between synergy and partnership functioning factors in health promotion partnerships.

              Intersectoral partnerships have been identified as a useful mechanism for addressing the health challenges that face society. In theory, partnerships achieve synergistic outcomes that amount to more than can be achieved by individual partners working on their own. This study aimed to identify key factors that influence health promotion partnership synergy. Data were collected from 337 partners in 40 health promotion partnerships using a postal survey. The questionnaire incorporated a number of multidimensional scales designed to assess the contribution of factors that influence partnership synergy. New validated scales were developed for synergy, trust, mistrust and power. Pearson's correlations and multiple regression analysis were used to identify the significance of each factor to partnership synergy. Trust, leadership and efficiency were shown to be the most important predictors of partnership synergy. Synergy is predicated on trust and leadership. Trust-building mechanisms need to be built into the partnership forming stage and this trust needs to be sustained throughout the collaborative process. We need to develop systems where the best leaders are put forward for intersectoral partnerships. This should be consistent across all sectors and organizations.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                17 January 2019
                : 9
                : 1
                : bmjopen-2018-022345
                Affiliations
                [1 ] departmentTraining and Research Transcultural Team , Research Institute of the McGill University Health Centre , Montreal, Quebec, Canada
                [2 ] Centre Population et Développement , Paris, Île-de-France, France
                [3 ] departmentInstitut de recherche en santé publique , Université de Montréal , Montreal, Quebec, Canada
                [4 ] departmentDepartment of Health Systems Governance and Financing , World Health Organization , Geneva, Switzerland
                [5 ] departmentInter-Country Support Team , World Health Organization , Ouagadougou, Burkina Faso
                [6 ] departmentCountry Office , World Health Organization , Lomé, Togo
                Author notes
                [Correspondence to ] Dr Emilie Robert; emilie.robert2@ 123456mail.mcgill.ca
                Author information
                http://orcid.org/0000-0001-9299-8266
                Article
                bmjopen-2018-022345
                10.1136/bmjopen-2018-022345
                6340476
                30782678
                fd51fe31-9a21-44f7-80c3-87e577187355
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

                History
                : 07 March 2018
                : 08 October 2018
                : 19 October 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004423, World Health Organization;
                Categories
                Global Health
                Protocol
                1506
                1699
                Custom metadata
                unlocked

                Medicine
                realist evaluation,policy dialogue,universal health coverage,health planning,health financing

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