Health Research Policy and Systems最新文献

{"title":"The determinants of evidence use by Australian clinical networks as agents and stewards of safety and quality: a conceptual framework.","authors":"Jade Hart, Lucio Naccarella, Helen Dickinson","doi":"10.1186/s12961-025-01364-2","DOIUrl":"10.1186/s12961-025-01364-2","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems are increasingly complex given devolution of powers, decentralization of decision-making, and escalating fragmentation of effort. This indicates a role for governments in how they can bring this together, oversee and improve across the system. Goals pertaining to the safety and quality of clinical care are advanced by governments using stewardship and agent-based strategies that increasingly place reliance on being evidence based. In Australia, clinical networks are a safety and quality stewardship model that convenes multidisciplinary and intersectoral actors to define evidence-based expectations for clinical practice, management and policy. Yet understandings of the role that evidence is intended to play within clinical networks remain under investigated. Despite vast literature examining the contribution of stewardship, networks and evidence use in healthcare, research on these topics have occurred in relative isolation. There lacks an integrative approach to these concepts to advance stewardship research and practice.</p><p><strong>Methods: </strong>By employing a theory generating approach, this research outlines the determinants of evidence use by Australian clinical networks as safety and quality stewards. A conceptual framework is developed, informed by examination of the theoretical and empirical literature, findings from mixed methods research involving interviews, documentary analysis and Q-methodology, and validation of findings with research partners.</p><p><strong>Results: </strong>The Clinical Network Safety and Quality Stewardship Conceptual Framework situates the determinants of evidence use by networks within understandings of safety and quality stewardship. It encompasses three layers: (i) the model of health system coordination and governance, (ii) network inputs and understandings of evidence, and (iii) points of influence. Within each layer, several attributes are identified that are explained with reference to agency and stewardship theory. We describe the interactions within and between the layers incorporated in the framework that are of importance in order to explain how evidence can shape the decisions that contribute to safety and quality.</p><p><strong>Conclusions: </strong>Theoretical contributions offer greater conceptual clarity with regard to the role of evidence within the context of networked stewardship models and systems where foundations are in agent-based approaches of coordination and governance. The conceptual framework seeks to advance scholarly research and practice. Merits, limitations and considerations for further testing of the framework are outlined.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"119"},"PeriodicalIF":3.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of environmental impact assessments in hospital care: Healthcare professionals' views on research and implementation priorities.","authors":"L H J A Kouwenberg, A M Wijnhoven, E S Cohen, W J K Hehenkamp, N H Sperna Weiland, D S Kringos","doi":"10.1186/s12961-025-01386-w","DOIUrl":"10.1186/s12961-025-01386-w","url":null,"abstract":"<p><strong>Background: </strong>The crossing of planetary boundaries, such as climate change and biosphere integrity, threatens human health, while healthcare systems paradoxically contribute substantially to these environmental challenges. Although research on the environmental impact of care activities and pathways is expanding, it remains unclear how this information is used in clinical practice. This study explores healthcare professionals' views on the environmental impact of hospital care, the role of environmental impact data and research and implementation priorities to support sustainability in clinical practice.</p><p><strong>Methods: </strong>Semi-structured focus groups and interviews were conducted between April and July 2024 with 31 Dutch healthcare professionals working across 12 medical (hospital) specialities with the highest care volumes and expenditures. Participants were selected on the basis of their involvement or interest in green healthcare initiatives. Focus groups and interviews were transcribed verbatim and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants have a general sense of environmentally impactful care activities, including surgical procedures, medication and outpatient visits. However, they reported a lack of quantitative environmental impact data at the clinical level, limiting their ability to make informed, sustainable choices. While participants recognized multiple uses for environmental impact data and supported integrating sustainability considerations into healthcare decision-making, they emphasized the need to balance these factors with other priorities, such as clinical effectiveness, patient safety and costs. Several research gaps were identified, including the need for comparative pathway analyses and standardized metrics. Additionally, implementation priorities, such as focusing on high-volume care, leveraging healthcare co-benefits and driving systemic changes to overcome barriers in the sustainability transition, were defined.</p><p><strong>Conclusions: </strong>Healthcare professionals lack the quantitative data needed for sustainable healthcare decision-making. Targeted research and implementation efforts should focus on high-impact, modifiable care. These findings may support better alignment between environmental research and clinical priorities, thereby informing evidence-based sustainability efforts in hospital care.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"116"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to the institutionalization and sustainability of knowledge translation platforms in the eastern Mediterranean: a scoping review.","authors":"Zakaria Belrhiti, Houda El Kirat, Djibrine Diallo, Selmi Abdellah, Kaoutar Dib, Saad Zbiri, Sanaa Belabbes, Mehrnaz Kheirandish, Aku Kwamie, Radouane Belouali","doi":"10.1186/s12961-025-01363-3","DOIUrl":"10.1186/s12961-025-01363-3","url":null,"abstract":"<p><strong>Background: </strong>Knowledge translation platforms (KTP) are partnerships comprising policy-makers, national researchers, and civil society, serving as organizational knowledge brokers to foster the use and uptake of evidence in evidence-informed policy-making (EIPM) processes. Recent evidence suggested that KTP institutionalization requires leadership, commitment, political engagement, shared ownership, monitoring and evaluation, participatory approaches and multi-institutional collaboration within a policy-stable context. However, limited evidence from the Eastern Mediterranean region (EMR) has confirmed, disconfirmed or refuted these theoretical assumptions. In this review, we set out to refine, confirm or disconfirm these theoretical assumptions and explore the barriers and facilitators to institutionalizing and sustaining (KTPs) in the EMR.</p><p><strong>Methods: </strong>We followed the scoping review methodological guidance. We searched three databases (Scopus, Web of Science and PubMed) for articles published in French, English or Arabic addressing knowledge translation platforms (KTP) in healthcare in countries from the Eastern Mediterranean region published between 2010 and 2022.</p><p><strong>Results: </strong>A total of 55 studies were included out of 2585. Most studies reported KTP initiatives from Pakistan (n = 11), Iran (n = 9), Jordan (n = 8), Lebanon (n = 9) and Egypt (n = 16), whilst North African countries were underrepresented. Review findings suggest that stakeholder, community engagement and political commitment are key underlying social mechanisms for translating evidence into action. Our review highlights contextual barriers such as rigid hierarchical structures, inadequate protected research time, delayed financial disbursements and cultural resistance to evidence use.</p><p><strong>Conclusions: </strong>Researchers might explore the political and structural barriers, such as overarching political forces, and the sensitivity of research findings that impede the uptake of evidence into policy in the region. Our findings underscore the need for multilayered interventions to address these challenges and support the need for systemic capacity-building interventions to promote the institutionalization of KTPs in the Eastern Mediterranean region.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"114"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial-intelligence-driven governance: addressing emerging risks with a comprehensive risk-prevention-centred model for public health crisis management.","authors":"Ching-Hung Lee, Zhichao Wang, Dianni Wang, Shupeng Lyu, Chun-Hsien Chen","doi":"10.1186/s12961-025-01390-0","DOIUrl":"10.1186/s12961-025-01390-0","url":null,"abstract":"<p><strong>Background: </strong>In response to the coronavirus disease 2019 (COVID-19) pandemic, an emerging public health crisis with global impact, various artificial intelligence (AI)-enabled devices for pandemic-prevention emerged, highlighting the urgent need to understand public leverage of AI-enabled digital technologies.</p><p><strong>Methods: </strong>This study constructs a comprehensive model, the Risk Prevention-centred and AI-enabled Anti-pandemic Technology Acceptance Model (RPAA-TAM), to elucidate public adoption of anti-pandemic digital tools, contributing to innovative governance. Integrating TAM, social influence theory and risk perception theory, RPAA-TAM analyses technology development and explores factors influencing public acceptance of AI in pandemic prevention.</p><p><strong>Results: </strong>The study identifies seven key factors impacting public acceptance, including external variables, public trust, perceived benefit, perceived risk, attitude toward use, behavioural intention to use and system usage, offering insights into the integration of AI in managing emerging public health crises. The study offers seven novel propositions derived from a literature review on the basis of the RPAA-TAM.</p><p><strong>Conclusions: </strong>The Risk Prevention-centred and AI-enabled Anti-pandemic Technology Acceptance Model (RPAA-TAM) offers a comprehensive framework for understanding public acceptance of AI in pandemic prevention. Identifying seven key factors impacting acceptance, our study provides novel propositions on the basis of literature review. RPAA-TAM contributes to innovative governance strategies, guiding the ethical and socially acceptable integration of AI in managing public health crises.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"115"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring impacts: a scoping review of healthcare impact evaluations.","authors":"L R Correia, J C Martins, E T Rother, P C de Soárez","doi":"10.1186/s12961-025-01324-w","DOIUrl":"10.1186/s12961-025-01324-w","url":null,"abstract":"<p><strong>Background: </strong>With the increasing use of the term \"impact evaluation\" in healthcare and the absence of an exhaustive review on this general theme, this research aims to map available evidence and methods associated with impact evaluations in healthcare by conducting a scoping review.</p><p><strong>Methods: </strong>This exhaustive review included peer-reviewed studies of healthcare interventions with no restrictions on language or time of publication.</p><p><strong>Results: </strong>In total, 324 studies met the inclusion criteria from 4372 single registries retrieved from Medline, Embase, Scopus, WoS and Econlit in August 2024, with no time restriction. Only ex-post studies were identified; as expected from guidelines, most studies used counterfactuals (58%) and only 7% did not use any comparison. Furthermore, natural experiments or quasi-experiments were the most applied designs (37%), followed by observational (26%) and experimental (17%) designs.</p><p><strong>Conclusions: </strong>Impact evaluations of healthcare interventions seem to be predominantly associated with methods of strong comparison (counterfactuals) designs as seen in guidelines; however, there are exceptions.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"113"},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact upfront: novel format for Novo Nordisk Foundation funding.","authors":"Gert Vilhelm Balling, Henrik Barslund Fosse, Katrine Zander Iversen, Stephen Robert Hanney","doi":"10.1186/s12961-025-01385-x","DOIUrl":"10.1186/s12961-025-01385-x","url":null,"abstract":"<p><p>Many retrospective assessments of the wider, societal impacts from health research funding use the Payback Framework or other frameworks. Much of this experience was collated in the 2018 Statement by the International School on Research Impact Assessment (ISRIA). Despite increased interest, especially in engaged research and a wider range of evaluation approaches, rarely do health and other research funders take a prospective approach and analyse the potential impact from a proposal to inform an impact management approach aimed at boosting impact. In this paper, experts from the Novo Nordisk Foundation, a leading philanthropic funder of research, describe how they are developing and applying such a pioneering approach. The five steps form a continuum from project inception to data collation and assessment. The first step entails preparing the project's narrative in alignment with the project's vision. The second, building the logic model, includes defining success factors and effect chains. The third is an early assessment of the initiative's potential impact, conducted on a case basis. The fourth is implementing the data model by integrating specific indicators. The fifth focuses on monitoring, impact management and creating impact products, including developing a comprehensive plan for data reporting and assessment, with scope for adjustments based on experience. This approach aligns with ISRIA guidelines, but further steps are needed. Whilst the Foundation is driving innovation in impact assessment by successfully introducing a new approach that uses prospective impact analysis to inform impact management to enhance the levels of impact achieved, further progress is needed on stakeholder engagement expanding towards a more inclusive stakeholder involvement.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"110"},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation context and stakeholder perspectives on routine immunization data among lower-level private for-profit providers in an urban setting: experiences from Kampala, Uganda.","authors":"Eric Ssegujja, Paul Kiggundu, Sarah Zalwango Karen, Elizeus Rutebemberwa","doi":"10.1186/s12961-025-01351-7","DOIUrl":"10.1186/s12961-025-01351-7","url":null,"abstract":"<p><strong>Background: </strong>Lower-level private for-profit health service providers form part of the pluralistic health systems delivering immunization services in urban areas of sub-Saharan Africa. However, their operational context is less documented since the conventional national Expanded Programme on Immunization (EPI) programmes tend to support delivery through public structures. Yet, private providers contribute greatly to immunization service coverage in urban settings. This paper explores the operational level context and stakeholders' perspectives regarding immunization data among lower-level private for-profit service providers in the city of Kampala, Uganda. The objective of this baseline assessment was to document the current implementation context of immunization data among urban lower-level private for-profit immunization service providers to inform implementation research to improve immunization data in Kampala, Uganda.</p><p><strong>Methods: </strong>The study adopted an exploratory qualitative design where key informant interviews and in-depth interviews were conducted. Analysis was guided by the health systems building-block framework, which informed the design of the codebook with coding done in Atlas.ti, a qualitative data management software.</p><p><strong>Results: </strong>Overall, private for-profit immunization service providers reflected a context consisting of both barriers and opportunities underlying immunization data management practices. The barriers identified included: high staff turnover; data overload and manipulation tendencies; a transient population that access immunization services from different service providers without data linkage systems; computation of catchment populations, which affects utilization coverage data; financial barriers to the collection of community-level data; and inadequate facilitation leading to lean human resources at EPI departments managing immunization data from private providers. Nonetheless, opportunities to improve immunization data included the ability to widen data coverage through their services, enhanced public-private-partnership through data sharing arrangements, linkage of urban data among providers, improved recording of urban surveillance data, additional human resource to record data, widened scope for capturing adverse events data, improved community data linkages, and transitioning from paper-based to electronic data capture.</p><p><strong>Conclusions: </strong>Opportunities to improve urban immunization data management through private for-profit providers exist amidst numerous barriers. This calls for innovative strategies by the programme managers to design interventions with specific emphasis on addressing barriers inherent among urban lower-level private for-profit service providers if immunization data management among these entities is to be improved.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"112"},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ideas matter: An analysis of the effects of framing on health system strengthening in Zimbabwe.","authors":"Alison T Mhazo, Charles C Maponga","doi":"10.1186/s12961-025-01327-7","DOIUrl":"10.1186/s12961-025-01327-7","url":null,"abstract":"<p><strong>Background: </strong>Health system strengthening (HSS) has been a well-endorsed concept globally since the 2000s. However, few studies have utilized theory to examine its evolution at the country level and potential implications for policy. This study used framing theory to examine changes in the portrayal of HSS in Zimbabwe from the mid-2000s to the period post-2020.</p><p><strong>Methods: </strong>We employed a framing analysis methodology encompassing documentary review and key informant interviews.</p><p><strong>Results: </strong>Four main frames were identified, namely HSS as (i) a donor imperative, (ii) a pathway to resolve crisis, (iii) a strategy for achieving long-term stability and (iv) a foundational investment for a resilient health system. HSS as a remedy for a crisis frame has been the most influential, but the greater involvement of donors in crisis response may have entrenched the mis-framings of HSS as a donor imperative. Donors have shifted from outlining strategies to assigning responsibility for HSS, with framing for more governmental funding. The government's response to those framing shifts has been more symbolic rather than substantive, undermining health system performance. Recently, donors have started to reduce their funding to align with framing towards more governmental responsibility, resulting in health system shocks in critical areas such as human resources.</p><p><strong>Conclusions: </strong>The vulnerability and emotional frames that attracted donor funding during peak crisis have lost potency over time. Shifts in framing require proactive action, as policy underreaction can lead to exacerbated problems, missed opportunities for improvement and a loss of public trust in government effectiveness and responsiveness. Nascent, overly futuristic framings such as \"resilience\" need to be interpreted with caution, as they may cloud the reality that HSS is simply sufficient investment in basic functions. HSS needs to be reframed as a routine, country-owned strategy aimed at improving health system performance rather than a crisis response shaped by donor interventions. Zimbabwe has a rich history of effectively framing events to design and implement pragmatic, domestic -led policies towards HSS, and such latent potential should be tapped into to steer progressive reforms.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"111"},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge translation platforms: Broker, intermediary or more? A scoping review of definitions, functions and characteristics.","authors":"B Schmidt, C Mulopo, L Mayieka, S Cooper, A Jaca, C Späth, J Oliver, N S Jessani","doi":"10.1186/s12961-025-01383-z","DOIUrl":"10.1186/s12961-025-01383-z","url":null,"abstract":"<p><strong>Background: </strong>Knowledge translation platforms (KTPs), also referred to as intermediaries, play a key role in supporting evidence-informed decision-making. Numerous KTPs exist globally, striving to translate evidence into policy. However, these platforms are described in varying ways, and some KTPs do not explicitly identify themselves as such. This makes identification, recognition and leveraging of KTPs suboptimal. It also hinders opportunities for learning, adapting and scaling of such platforms.</p><p><strong>Objective: </strong>This scoping review aimed to synthesize the literature on the variety of definitions, functions and characteristics of a KTP with a view to harmonize these aspects of KTPs and offer a revised framework of functions.</p><p><strong>Methods: </strong>This review was conducted using recommended methods and reporting guidelines. Searches were performed in PubMed, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) using a predetermined search strategy, without date or geographical restrictions. Included studies were analysed and synthesized in ATLAS.ti, following Braun and Clarke's six steps of thematic analysis.</p><p><strong>Findings: </strong>With one exception, all KTPs did not identify themselves as such in their names. Five common elements emerged across the KTP definitions: (i) a physical or virtual platform (ii) that engages with and convenes different stakeholders (iii) through a set of knowledge translation activities and outputs (iv) to contribute to health decision-making. We identified KTP activities that aligned with the core functions described in the Valmeekanathan et al. (Valmeekanathan et al. in Tert Educ Manag 27:227-256, 2021) framework - namely knowledge exchange, dialogue and capacity - but also additional activities, including engaging funders, planning for sustainability and scalability, providing training grants and initiating innovative knowledge translation processes that integrate knowledge across projects and sectors to maximize impact.</p><p><strong>Conclusion: </strong>This review provides a synthesized definition of KTPs while expanding on the three core functions described in the Valmeekanathan et al. (Valmeekanathan et al. in Tert Educ Manag 27:227-256, 2021) framework. To maximize their impact, sustained investment, stronger institutional support and integration into national policy ecosystems are essential.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"107"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic community health information system in Ethiopia: current maturity status, opportunities and improvement pathways.","authors":"Dawit Wolde Daka, Asaye Birhanu Senay, Ketema Lemma Abdi, Tesfahun Melese Yilma, Asefa Adimasu Taddese, Adane Letta Mamuye, Berhanu Fikadie Endehabtu, Loko Abraham, Rabeal Tadesse, Gemechis Melkamu, Naod Wendrad, Oli Kaba, Mesoud Mohammed, Matebu Gezahegn Jebessa, Chaluma Kumala, Eyerusalem Kebede, Muluemebet Abera Wordofa, Yibeltal Kiflie Alemayehu","doi":"10.1186/s12961-025-01355-3","DOIUrl":"10.1186/s12961-025-01355-3","url":null,"abstract":"<p><strong>Background: </strong>Assessing the maturity level of digital solutions and the ability of digital systems to meet the changing needs and demands related to their purposes is essential. Despite Ethiopia's significant efforts in expanding the electronic Community Health Information System (eCHIS), the results have been below expectations, varying by location and hindered by several issues. This research aimed to evaluate the current maturity status, identify implementation gaps and propose future directions for improving eCHIS in Ethiopia.</p><p><strong>Methods: </strong>Through a consultative workshop, a collaborative assessment was carried out with the participation of key stakeholders and experts. The Stages of Continuous Improvement (SOCI) tool was used to measure maturity levels in 39 subcomponents, 13 components and 5 core domains. The evaluation focussed on the leadership and governance of the digital health system, human resources, information and communication technology (ICT) infrastructure, interoperability and data quality and use. The measurement scales used were Emerging, Repeatable, Defined, Managed and Optimized.</p><p><strong>Results: </strong>The current maturity status of eCHIS is rated as repeatable (2.24/5) and aims to improve to the defined state (3.75/5) by 2025. Comparatively, the leadership and governance domain had the highest level of maturity (2.67/5), followed by the standards and interoperability domain (2.47/5) and the data quality and use domain (2.28/5). The ICT infrastructure (1.67/5) and management and workforce (2.09/5) domains have the lowest level of maturity. Strengths include the presence of a comprehensive HIS strategic plan, updated standard guidelines and operational manuals, a defined organizational structure and processes for eCHIS, defined data management, reporting and use procedures, monitoring and evaluation (M&E) mechanisms for eCHIS and central eCHIS infrastructure capacity. Areas of improvement in the digital solution included the absence of certain aspects such as a standard eCHIS training curriculum (both pre-service and in-service), reliable power supply and connectivity at health facilities, robust business continuity plans, a multiyear budget and a skilled workforce. Furthermore, weaknesses were also found in the enforcement of existing laws, regulations and policies, as well as leadership and coordination within the eCHIS program at lower levels.</p><p><strong>Conclusions: </strong>The implementation status of eCHIS in Ethiopia was at the repeatable stage, with the ICT infrastructure domain having the lowest level of maturity compared with the other four domains. By 2025, the current maturity status was planned to advance to the defined stage by addressing the identified gaps. To achieve this maturity level, various action points are suggested.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"109"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}