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Title: Designing evaluation studies to optimally inform policy: What factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?
Authors: Wu, S 
Legido-Quigley, H 
Spencer, J
Coker, R.J 
Khan, M.S
Keywords: adult
behavior change
clinical article
controlled study
decision making
evaluation study
health care personnel
human experiment
middle income country
outcome assessment
qualitative research
resource allocation
scale up
thematic analysis
administrative personnel
decision making
developing country
evaluation study
health care personnel
health care planning
health care policy
information processing
pilot study
program evaluation
Administrative Personnel
Decision Making
Developing Countries
Evaluation Studies as Topic
Focus Groups
Health Personnel
Health Policy
Health Resources
Pilot Projects
Policy Making
Program Evaluation
Qualitative Research
Resource Allocation
Issue Date: 2018
Citation: Wu, S, Legido-Quigley, H, Spencer, J, Coker, R.J, Khan, M.S (2018). Designing evaluation studies to optimally inform policy: What factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?. Health Research Policy and Systems 16 (1) : 16. ScholarBank@NUS Repository.
Abstract: Background: In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Methods: Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Results: Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Conclusions: Our qualitative study indicates that training programme evaluations that focus narrowly on direct training outcomes may not provide sufficient information for policy-makers to make decisions on future training programmes. Based on our findings, we have developed an evidence-based framework, which incorporates but expands beyond the Kirkpatrick model, to provide conceptual and practical guidance that aids in the design of training programme evaluations better suited to meet the information needs of policy-makers and to inform policy decisions. © 2018 The Author(s).
Source Title: Health Research Policy and Systems
ISSN: 1478-4505
DOI: 10.1186/s12961-018-0292-2
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