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dc.rights.licenseCreative Commons Attribution Non Commercial (CC BY-NC 4.0)
dc.contributor.authorMarchal, Bruno
dc.contributor.authorAbejirinde, Ibukun-Oluwa Omolade
dc.contributor.authorSulaberidze, Lela
dc.contributor.authorChikovani, Ivdity
dc.contributor.authorUchaneishvili, Maia
dc.contributor.authorShengelia, Natia
dc.contributor.authorDiaconu, Karin
dc.contributor.authorVassall, Anna
dc.contributor.authorZoidze, Akaki
dc.contributor.authorGiralt, Ariadna Nebot
dc.contributor.authorWitter, Sophie
dc.date.accessioned2021-07-14T08:37:50Z
dc.date.available2021-07-14T08:37:50Z
dc.date.issued2021-06-29
dc.identifierhttps://eresearch.qmu.ac.uk/bitstream/handle/20.500.12289/11352/11352.pdf
dc.identifier.citationMarchal, B., Abejirinde, I. O. O., Sulaberidze, L., Chikovani, I., Uchaneishvili, M., Shengelia, N., Diaconu, K., Vassall, A., Zoidze, A., Giralt, A. N. & Witter, S. (2021) How do participatory methods shape policy? Applying a realist approach to the formulation of a new tuberculosis policy in Georgia. BMJ Open, 11(6): e047948.
dc.identifier.issn2044-6055
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/11352
dc.identifier.urihttps://doi.org/10.1136/bmjopen-2020-047948
dc.descriptionFrom PubMed via Jisc Publications Router
dc.description.abstractThis paper presents the iterative process of participatory multistakeholder engagement that informed the development of a new national tuberculosis (TB) policy in Georgia, and the lessons learnt. Guided by realist evaluation methods, a multistakeholder dialogue was organised to elicit stakeholders' assumptions on challenges and possible solutions for better TB control. Two participatory workshops were conducted with key actors, interspersed by reflection meetings within the research team and discussions with policymakers. Using concept mapping and causal mapping techniques, and drawing causal loop diagrams, we visualised how actors understood TB service provision challenges and the potential means by which a results-based financing (RBF) policy could address these. The study was conducted in Tbilisi, Georgia. A total of 64 key actors from the Ministry of Labour, Health and Social Affairs, staff of the Global Fund to Fight AIDS, TB and Malaria Georgia Project, the National Centre for Disease Control and Public Health, the National TB programme, TB service providers and members of the research team were involved in the workshops. Findings showed that beyond provider incentives, additional policy components were necessary. These included broadening the incentive package to include institutional and organisational incentives, retraining service providers, clear redistribution of roles to support an integrated care model, and refinement of monitoring tools. Health system elements, such as effective referral systems and health information systems were highlighted as necessary for service improvement. Developing policies that address complex issues requires methods that facilitate linkages between multiple stakeholders and between theory and practice. Such participatory approaches can be informed by realist evaluation principles and visually facilitated by causal loop diagrams. This approach allowed us leverage stakeholders' knowledge and expertise on TB service delivery and RBF to codesign a new policy. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]
dc.languageeng
dc.relation.ispartofBMJ Open
dc.rights© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectHealth Policy
dc.subjectQualitative Research
dc.subjectTuberculosis
dc.titleHow do participatory methods shape policy? Applying a realist approach to the formulation of a new tuberculosis policy in Georgia
dc.typeArticle
dcterms.accessRightspublic
dcterms.dateAccepted2021-06-10
dc.date.updated2021-07-14T01:23:37Z
dc.description.volume11
dc.description.ispublishedpub
refterms.dateFCD2021-07-15
refterms.depositExceptionpublishedGoldOA
qmu.authorDiaconu, Karin
qmu.authorWitter, Sophie
qmu.centreInstitute for Global Health and Development
dc.description.statuspub
dc.description.number6
refterms.versionVoR
refterms.dateDeposit2021-07-15


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Creative Commons Attribution Non Commercial (CC BY-NC 4.0)
Except where otherwise noted, this item's license is described as Creative Commons Attribution Non Commercial (CC BY-NC 4.0)