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Integrating interventions supported by development assistance for health into local health system

Evidence from a China–World Bank–UK rural health system strengthening project (1998–2007)

Dados Bibliográficos

ID21879993
AutoresAidan Huang (0000-0003-4602-3913, Tsinghua University), Yingxi Zhao (0000-0002-4937-4703, University of Oxford), Chunkai Cao (Vanke (China)), MoHan Lyu (Duke University), Kun Tang (0000-0001-7382-9344, Vanke (China), autor correspondente)
Ano2024
Volume9
Fascículo5
Páginase012853
Data de publicação2024-05-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoBMJ Global Health (JOURNAL)
Identificadores do periódicoISSN: 2059-7908 • E-ISSN: 2059-7908
EditoraBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-012853
PMID38789275
OpenAlexW4398785166
IdiomaEN
Referências citadas55

INTRODUCTION: To empirically investigate sustainability of development assistance for health (DAH), we conducted a retrospective case study on the Basic Health Services Project (BHSP) for rural health system strengthening, supported by the World Bank and the UK in China between 1998 and 2007. Specifically, this study examines the integration of the BHSP interventions into China's health system. METHODS: From December 2021 to December 2022, we reviewed 64 published papers and project or policy documents, and conducted semistructured interviews with 22 key informants, ranging from managers of donor agencies and the government to township-level hospital directors. From February to March 2023, the data were analysed under an analytical framework for integration of targeted health interventions into health systems. RESULTS: Evidence of the BHSP shows that the integration outcomes can vary by the levels of integration (national or subnational), geographical coverage (project areas or both project and non-project areas) and approach to integration (policy or routinisation). The country's health system reform facilitated the integration of the interventions relevant to the reform policies, as the BHSP was one of the pilot schemes. However, interventions incompatible with this broad context were integrated to a limited extent. This integration occurred through embedding the project within the existing system, with a higher degree of embeddedness leading to smoother integration. Cross-sectoral leading groups and a technical support system heightened the project visibility and enabled contextualised local adaptation, contributing to the smooth integration of the project interventions. CONCLUSION: The DAH-supported interventions can achieve sustainability by being integrated into the local health system. This integration can take various forms to improve health outcomes, including being accepted and internalised, modified as well as innovated and expanded. The host country and development partners can promote DAH sustainability by contextually integrating these interventions within the project scope

Business · Economic growth · Economics · Embeddedness · Geography · Health care · Political science · Psychological intervention · Public relations · Sociology · Sustainability · Global Maternal and Child Health · Healthcare Systems and Reforms · International Development and Aid · Medicine · Nursing · Health Policy

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