Delivery arrangements for health systems in low-income countries : an overview of systematic reviews

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dc.contributor.authorCiapponi, Agustinen_ZA
dc.contributor.authorLewin, Simonen_ZA
dc.contributor.authorHerrera, Cristian A.en_ZA
dc.contributor.authorOpiyo, Newtonen_ZA
dc.contributor.authorPantoja, Tomasen_ZA
dc.contributor.authorPaulsen, Elizabethen_ZA
dc.contributor.authorRada, Gabrielen_ZA
dc.contributor.authorWiysonge, Charles S.en_ZA
dc.contributor.authorBastias, Gabrielen_ZA
dc.contributor.authorDudley, Lilianen_ZA
dc.contributor.authorFlottorp, Signeen_ZA
dc.contributor.authorGagnon, Marie-Pierreen_ZA
dc.contributor.authorMarti, Sebastian Garciaen_ZA
dc.contributor.authorGlenton, Claireen_ZA
dc.contributor.authorOkwundu, Charles I.en_ZA
dc.contributor.authorPenaloza, Blancaen_ZA
dc.contributor.authorSuleman, Fatimaen_ZA
dc.contributor.authorOxman, Andrew D.en_ZA
dc.date.accessioned2018-08-08T09:34:38Z
dc.date.available2018-08-08T09:34:38Z
dc.date.issued2017
dc.descriptionCITATION: Ciapponi, A, et al. 2017. Delivery arrangements for health systems in low-income countries : an overview of systematic reviews. Cochrane Database of Systematic Reviews, 9:1-182, Art. CD011083, doi:10.1002/14651858.CD011083.pub2.
dc.descriptionThe original publication is available at https://www.cochranelibrary.com
dc.description.abstractBackground: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services. Objectives: To provide an overview of the available evidence from up‐to‐date systematic reviews about the effects of delivery arrangements for health systems in low‐income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on delivery arrangements and informing refinements of the framework for delivery arrangements outlined in the review. Methods: We searched Health Systems Evidence in November 2010 and PDQ‐Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well‐conducted systematic reviews of studies that assessed the effects of delivery arrangements on patient outcomes (health and health behaviours), the quality or utilisation of healthcare services, resource use, healthcare provider outcomes (such as sick leave), or social outcomes (such as poverty or employment) and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the findings. Two overview authors independently screened reviews, extracted data, and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence), and assessments of the relevance of findings to low‐income countries. Main results: We identified 7272 systematic reviews and included 51 of them in this overview. We judged 6 of the 51 reviews to have important methodological limitations and the other 45 to have only minor limitations. We grouped delivery arrangements into eight categories. Some reviews provided more than one comparison and were in more than one category. Across these categories, the following intervention were effective; that is, they have desirable effects on at least one outcome with moderate‐ or high‐certainty evidence and no moderate‐ or high‐certainty evidence of undesirable effects.en_ZA
dc.description.urihttps://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011083.pub2/full
dc.description.versionPublisher's version
dc.format.extent184 pages ; illustrations
dc.identifier.citationCiapponi, A, et al. 2017. Delivery arrangements for health systems in low-income countries : an overview of systematic reviews. Cochrane Database of Systematic Reviews, 9:1-182, Art. CD011083
dc.identifier.issn1469-493X (online)
dc.identifier.otherdoi:10.1002/14651858.CD011083.pub2
dc.identifier.urihttp://hdl.handle.net/10019.1/104242
dc.language.isoen_ZAen_ZA
dc.publisherJohn Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration
dc.rights.holderAuthors retain copyright
dc.subjectHealth services administration -- Developing countriesen_ZA
dc.subjectHealth services administration -- Researchen_ZA
dc.subjectSystematic reviews (Medical research)en_ZA
dc.titleDelivery arrangements for health systems in low-income countries : an overview of systematic reviewsen_ZA
dc.typeArticleen_ZA
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