RESPONSE - Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam

Primary investigator: Dr Ana Manzano.

RESPONSE is collaborative study between researchers from Hanoi University of Public Health, Ghana Health Service, Mental Health Authority Ghana, University of Ghana, University of Melbourne, University of Leeds and LSHTM. It seeks to contribute to improving health systems responsiveness in low- and middle-income countries through case studies of addressing health needs of vulnerable groups in Ghana and Vietnam.

Project aims

Our core research question is: “In what way can health systems become more responsive to neglected health needs of vulnerable groups within the contexts of lower-middle-income countries?” The project objectives are to:

Conduct in-depth analyses of how health systems responsiveness is understood and enacted by key health systems actors, and to what degree the local health systems are responsive to these expectations using the case study of maternal mental health;

Co-produce, implement and evaluate context-sensitive interventions to improve health systems responsiveness to neglected health needs of vulnerable groups;

Develop an empirically based and theoretically grounded model of complex relations between the contexts, the mechanisms and the outcomes of the interventions to improve health systems responsiveness;

Develop transferable best practices for scalability and generalisability of the pilot-tested interventions;

Strengthen research capacity through extending existing collaborations into strong South-South and South-North exchange and learning within and between Ghana, Vietnam, Australia and the UK.

Impact

Decision-makers from facility, district, Health professionals in Ghana regional and national levels in both Ghana and Vietnam will be continuously engaged through embedding research into policy and practice.

Key study outcomes and impacts will be:

Improved health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam and;

An empirically-grounded and theoretically-informed model of complex relationships between the contexts, mechanisms and outcomes of the interventions, along with transferable best practices for scalability (i.e. expansion within similar contexts) and generalisability (i.e. to different contexts, such as other health areas and countries) for future health systems strengthening.

Publications and outputs

Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. Mirzoev, T., Manzano A., Ha BTT., Agyepong IA., Trang DTH., Danso-Appiah A., Thi LM., Ashinyo ME., Vui LT., Gyimah L., Chi NTQ., Yevoo L., Duong DTT., Awini E., Hicks JP., Cronin de Chavez  A., Kane, S. (2021). PLoS ONE, 16(1), e0245755.

Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries. Mirzoev, T; Cronin de Chavez, A; Manzano, A; Agyepong, I; Ashinyo, M; Danso-Appiah, A; Gyimah, L; Yevoo, L; Awini, E; Ha, B; Do Thi Hanh, T; Nguyen, Q-C; Le, T; Le, V; Hicks, J; Wright, J; Kane, S (2021). BMJ Open; 2021; 11:e046992.

Understanding the barriers to integrating maternal and mental health at primary health care in Vietnam | Health Policy and Planning | Oxford Academic (oup.com)

Conferences

HSR2022 - Seventh Global Symposium on Health Systems Research

14th EES Biennial Conference: Evaluation in an Uncertain World: Complexity, Legitimacy and Ethics - EES (europeanevaluation.org)

Navigating the Context and External Validity Conundrums in Realist Cross-Country Evaluations (18 April 2024) 

Project website

https://www.lshtm.ac.uk/research/centres-projects-groups/response#welcome