Browsing by Author "King, Maylene Shung"

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    Open Access
    An assessment of the ‘PHC Facility Governance Structures Trainer-of-Facilitator Learning Programme’ in Nkangala District, Mpumalanga Province
    (2018) Esau, Natasha; King, Maylene Shung; English, René
    Background In South Africa, as part of specified governance requirements, clinic committees were established to provide management oversight at Primary Health Care facilities. In order for them to better understand their roles they needed training. Facilitators in the district were selected to participate in the 'PHC Facility Governance Structures Trainer-of-Facilitator (ToF) Learning Programme’ in order to train the clinic committees. This study assessed the training of facilitators. Methods This retrospective single case study used qualitative methods and was guided by the Illuminative Evaluation Framework. It assessed whether the aims, objectives and methodology of the training programme was clearly conveyed by the trainers, whether this was understood by the participants and whether the participants were able to transfer the training programme as intended to the clinic committees. Qualitative data were collected through key informant interviews and focus group discussions, face to face and telephonically. These were complimented by a document and literature review. Study participants were purposively selected based on their involvement in the development, facilitation or training of the programme. Interviews were conducted in English, with semi-structured open ended questions pertaining to participants’ perceptions and understanding of the training, and whether the ToF Learning Programme was delivered to the clinic committees. After participants signed consent forms interviews were audio recorded and transcribed verbatim. Data analysis was done manually and guided by the methodology presented by Ritchie and Lewis. Results A total of 13 participants participated in the study and 23 (national, provincial and partner) documents were reviewed. Despite the different perceptions and understandings of the ToF Learning Programme its overall goal was achieved. Participants’ capacity was strengthened and they trained the clinic committees. The document review showed inconsistency across legislations with regards to clinic committees. Conclusion The ToF Learning Programme has reached its overall goal despite the deviation in the process of delivery and can be recommended for implementation
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    Open Access
    The role of document reviews in health policy analysis among low and middle-income countries: a systematic review
    (2018) Kayesa, Naomi Karen; King, Maylene Shung
    Background: Health policy analysis (HPA) is a central component of health systems research (HSR) and contributes significantly to the understanding of health systems reforms including their successes and failures. In most HPA studies, document reviews feature as one of the widely used data collecting methods, especially in retrospective policy analyses. Literature indicates that a substantial number of HPA studies conducted in low and middle-income countries (LMICs) are informed by interactive data collection methods such as interviews, focus group discussions (FGDs), and observations as well as non-interactive methods such as document reviews. While efforts have been made to look into the methodologies that inform health policy analyses for LMICs in the recent years, there is a dearth in knowledge specific to document reviews and how they fit into the framework for doing health policy analysis. This paper provides findings from a qualitative systematic review of peer reviewed policy analysis studies indicating the role of document reviews; why it is employed and how this methodology is positioned and motivated for in the LMICs. Methods: Nine electronic databases were explored in search of articles with adequate information relating to the use of document reviews in HPA studies conducted in LMICs. All 28 articles included in this review were conducted in LMICs between the years 2008-2016. Articles were in English with free full text accessibility. Data extraction focused on the aims of the HPA, and the methodology and results sections in order to identify why and how document reviews were employed in HPA. Results: Twenty-eight articles from LMICs that met the inclusion criteria and examined against a quality appraisal tool were included for thematic synthesis and analysis. Reasons as to why and how health policy analysts use document reviews was directly linked to accessibility and clarity of the document and the perceived contribution of a document to the HPA process. The more accessible the documents are, the more they are likely to be used in a policy analysis. Inductively, the author also considered ‘personal contact with policy makers’ in the identification of documents as another facilitator of document use in health policy analysis studies. Besides access, it is essential that the documents are clear and do not contain conflicting information so that at all phases, intentions of the policy and outcomes are clear to the document user. Apart from validating information obtained from other data collection methods, documents have also been noted to act as advocacy instruments in the health policymaking arena. However, the results have failed to explain as to why policy analysts using document reviews fail to fully describe, quantify or properly display the data obtained from documents used. Conclusion: To the best of the author’s knowledge, this is the first systematic review that has looked into a specific data collection method adapted by many health policy analysts in the LMICs. HPA researchers will always draw on documents. This review has provided a structured way of thinking of documents and document reviews as a data collection method in HPA studies. It elaborates which documents are suitable, for what purposes and how to think of document quality and utility. It is evident from this review that document reviews are a laudable, scientifically sound methodology and that it has a significant role of contributing to the conclusions made about particular policies in evaluating their processes and gauging their current state within a given timeframe. HPA researchers should not underestimate the extent of skill required to adequately analyse documents and draw conclusions from these analyses. Documents are helpful to the policy analysis process and policy analysts should equip themselves accordingly for this kind of methodology and when they do embark on documentary reviews.