A process evaluation of a family planning, livelihoods and conservation project in Rukiga, Western Uganda.

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Megan Beare, Richard Muhumuza, Gift Namanya, Susannah H Mayhew
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引用次数: 0

Abstract

Although Population-Health-Environment (PHE) approaches have been implemented and studied for several decades, there are limited data on whether, how and why they work. This study provides a process evaluation of the 'Healthy Wetlands for the Cranes and People of Rukiga, Uganda' project, implemented by an NGO-local hospital consortium. This programme involved a research design element, testing two delivery modalities to understand the added benefit of integrating conservation, livelihoods and human health interventions, compared to delivering sector support services separately (as is more usual). The process evaluation sought to understand how the programme was implemented, the mechanisms of impact, how it was shaped by the context in which it was delivered and whether there were discernable differences across the two delivery arms. Methods involved key informant interviews with implementing staff and community educators, a review of programme documents and secondary qualitative analysis of interviews and focus groups with community members. The findings include a statistically significant increase in the reach of the programme, in both service delivery and sensitization activities, when the sectors were fully integrated. It appears that this comparative advantage of integration is because of the improved acceptability and motivation among stakeholders, and increased initiative (and agency) taken by community-based peer educators and community members. We argue that the 'software' of the programme underpins these mechanisms of impact: trust-based relationships embedded in the system enabled coordinated leadership, supported local staff agency and encouraged motivation.

对乌干达西部鲁基加的计划生育、生计和保护项目进行过程评估。
尽管 "人口-健康-环境"(PHE)方法已经实施和研究了几十年,但关于这些方法是否有效、如何有效以及为什么有效的数据却很有限。本研究对由非政府组织和当地医院联合实施的 "乌干达鲁基加鹤类和人类健康湿地 "项目进行了过程评估。该计划包含一个研究设计元素,测试两种实施模式,以了解与单独提供部门支持服务(更常见的做法)相比,将保护、生计和人类健康干预措施整合在一起的额外益处。过程评估旨在了解计划的实施方式、影响机制、实施环境对计划的影响以及两种实施方式是否存在明显差异。评估方法包括与实施人员和社区教育工作者进行关键信息访谈,审查计划文件,以及对与社区成员的访谈和焦点小组进行二次定性分析。研究结果表明,当各部门充分整合时,该计划在服务提供和宣传活动方面的覆盖范围在统计上都有显著增加。整合后的比较优势似乎是由于利益相关者的接受度和积极性提高了,社区同伴教育者和社区成员的主动性(和能动性)增强了。我们认为,该计划的 "软件 "是这些影响机制的基础:系统中基于信任的关系促成了协调的领导、支持了当地工作人员的能动性并鼓励了积极性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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