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Member Research & Reports

Member Research & Reports

GW: Study Finds Measurement, Management Strategies Put in Place Without Sufficient Evidence

Dr. Wolfgang Munar, an associate professor of global health systems at the George Washington University Milken Institute School of Public Health (Milken Institute SPH), and his colleagues set out to map available evidence on performance measurement and management strategies in primary health care systems.

This work was conducted because in 2015, the United Nations created a set of Sustainable Development Goals, including one to achieve good health and well-being for all, by the year 2030. An effective primary health care system is crucial to the achievement of those goals, especially for low and middle-income countries. Yet the study by Dr. Munar and his colleagues suggests that attempts to transform or redesign primary health care systems often deploy unproven strategies that often lack the underlying scientific evidence of effectiveness. The team conducted a literature search and looked at 38,088 publications – selecting 155 studies that met the inclusion criteria for the final analysis.

Dr. Munar and his colleagues found that two-thirds of the studies done on this topic were conducted in sub-Saharan Africa and South Asia. The researchers found that studies typically focused on two types of strategies: implementation strategies such as in-service training of health care professionals or continuing education, and performance-based financing.

“Our study suggests that most performance and management strategies are implemented without sufficient knowledge of their impact,” Dr. Munar said. “Future efforts to redesign primary health care systems must be undertaken armed with the knowledge of what works and what doesn’t.”

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