Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME)
| dc.contributor.author | Breuer, Erica | |
| dc.contributor.author | De Silva, Mary J | |
| dc.contributor.author | Fekadu, Abebaw | |
| dc.contributor.author | Luitel, Nagendra P | |
| dc.contributor.author | Murhar, Vaibhav | |
| dc.contributor.author | Nakku, Juliet | |
| dc.contributor.author | Petersen, Inge | |
| dc.contributor.author | Lund, Crick | |
| dc.date.accessioned | 2015-07-30T03:49:44Z | |
| dc.date.available | 2015-07-30T03:49:44Z | |
| dc.date.issued | 2014-04-30 | |
| dc.date.updated | 2015-01-15T17:57:20Z | |
| dc.description.abstract | Abstract Background The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way in high income countries. Little is known about its use to develop mental health care plans in low and middle income countries where mental health services remain inadequate. Aims ToC workshops were held as part of formative phase of the Programme for Improving Mental Health Care (PRIME) in order 1) to develop a structured logical and evidence-based ToC map as a basis for a mental health care plan in each district; (2) to contextualise the plans; and (3) to obtain stakeholder buy-in in Ethiopia, India, Nepal, South Africa and Uganda. This study describes the structure and facilitator’s experiences of ToC workshops. Methods The facilitators of the ToC workshops were interviewed and the interviews were recorded, transcribed and analysed together with process documentation from the workshops using a framework analysis approach. Results Thirteen workshops were held in the five PRIME countries at different levels of the health system. The ToC workshops achieved their stated goals with the contributions of different stakeholders. District health planners, mental health specialists, and researchers contributed the most to the development of the ToC while service providers provided detailed contextual information. Buy-in was achieved from all stakeholders but valued more from those in control of resources. Conclusions ToC workshops are a useful approach for developing ToCs as a basis for mental health care plans because they facilitate logical, evidence based and contextualised plans, while promoting stakeholder buy in. Because of the existing hierarchies within some health systems, strategies such as limiting the types of participants and stratifying the workshops can be used to ensure productive workshops. | |
| dc.identifier.apacitation | Breuer, E., De Silva, M. J., Fekadu, A., Luitel, N. P., Murhar, V., Nakku, J., ... Lund, C. (2014). Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME). <i>International Journal of Mental Health Systems</i>, http://hdl.handle.net/11427/13575 | en_ZA |
| dc.identifier.chicagocitation | Breuer, Erica, Mary J De Silva, Abebaw Fekadu, Nagendra P Luitel, Vaibhav Murhar, Juliet Nakku, Inge Petersen, and Crick Lund "Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME)." <i>International Journal of Mental Health Systems</i> (2014) http://hdl.handle.net/11427/13575 | en_ZA |
| dc.identifier.citation | Breuer, E., De Silva, M., Fekadu, A., Luitel, N. P., Murhar, V., Nakku, J., ... & Lund, C. (2014). Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME). International journal of mental health systems, 8(1), 15. | |
| dc.identifier.ris | TY - Journal Article AU - Breuer, Erica AU - De Silva, Mary J AU - Fekadu, Abebaw AU - Luitel, Nagendra P AU - Murhar, Vaibhav AU - Nakku, Juliet AU - Petersen, Inge AU - Lund, Crick AB - Abstract Background The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way in high income countries. Little is known about its use to develop mental health care plans in low and middle income countries where mental health services remain inadequate. Aims ToC workshops were held as part of formative phase of the Programme for Improving Mental Health Care (PRIME) in order 1) to develop a structured logical and evidence-based ToC map as a basis for a mental health care plan in each district; (2) to contextualise the plans; and (3) to obtain stakeholder buy-in in Ethiopia, India, Nepal, South Africa and Uganda. This study describes the structure and facilitator’s experiences of ToC workshops. Methods The facilitators of the ToC workshops were interviewed and the interviews were recorded, transcribed and analysed together with process documentation from the workshops using a framework analysis approach. Results Thirteen workshops were held in the five PRIME countries at different levels of the health system. The ToC workshops achieved their stated goals with the contributions of different stakeholders. District health planners, mental health specialists, and researchers contributed the most to the development of the ToC while service providers provided detailed contextual information. Buy-in was achieved from all stakeholders but valued more from those in control of resources. Conclusions ToC workshops are a useful approach for developing ToCs as a basis for mental health care plans because they facilitate logical, evidence based and contextualised plans, while promoting stakeholder buy in. Because of the existing hierarchies within some health systems, strategies such as limiting the types of participants and stratifying the workshops can be used to ensure productive workshops. DA - 2014-04-30 DB - OpenUCT DO - 10.1186/1752-4458-8-15 DP - University of Cape Town J1 - International Journal of Mental Health Systems LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME) TI - Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME) UR - http://hdl.handle.net/11427/13575 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/13575 | |
| dc.identifier.uri | http://dx.doi.org/10.1186/1752-4458-8-15 | |
| dc.identifier.vancouvercitation | Breuer E, De Silva MJ, Fekadu A, Luitel NP, Murhar V, Nakku J, et al. Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME). International Journal of Mental Health Systems. 2014; http://hdl.handle.net/11427/13575. | en_ZA |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Centre for Public Mental Health | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights | This is an open access article distributed under the terms of the Creative Commons Attribution License | * |
| dc.rights.holder | Breuer et al.; licensee BioMed Central Ltd. | |
| dc.rights.uri | http://creativecommons.org/licenses/by/2.0 | * |
| dc.source | International Journal of Mental Health Systems | en_ZA |
| dc.source.uri | http://www.ijmhs.com/ | |
| dc.subject.other | Theory of change | en_ZA |
| dc.subject.other | Programme evaluation | en_ZA |
| dc.subject.other | Programme design | en_ZA |
| dc.subject.other | Health planning | en_ZA |
| dc.subject.other | Mental health | en_ZA |
| dc.title | Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME) | |
| dc.type | Journal Article | en_ZA |
| uct.type.filetype | ||
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |