Health Equity: 01/12/12

Thursday, January 12, 2012

[EQ] Quality in Qualitative Evaluation: A framework for assessing research evidence

Quality in Qualitative Evaluation: A framework for assessing research evidence

A Quality Framework

Liz Spencer, Jane Ritchie, Jane Lewis and Lucy Dillon(2003)

National Centre for Social Research
UK Government Chief Social Researcher’s Office, London: Cabinet Office.

Available online at: http://bit.ly/zcNgfz

“……..This document presents a framework for appraising the quality of qualitative evaluations.
It was developed with particular reference to evaluations concerned with the development and implementation of social policy, programmes and practice.

The framework was devised as part of a programme of research conducted on behalf of the Cabinet Office.
The research on which the framework was built involved:

• a comprehensive review of the literature on qualitative research methods relating to standards in qualitative research;

• a review of qualitative research methods used in Government funded evaluation studies;

• a review of existing frameworks for assessing quality in qualitative research;

• exploratory interviews with a range of people who have an interest in quality assessment of qualitative research and/or policy-related evaluations.
These included academics who have written about qualitative research from either a theoretical or empirical perspective; authors of existing frameworks;
research practitioners; commissioners and funders; and policy-makers who have used qualitative research evidence in the development and evaluation
of policies; a workshop, involving the above groups, to refine the framework initially developed;

• a trial application of the framework to a small number of studies.

All these strands of activity have heavily influenced the content of the framework and the premises that surround its operation.

Content:

I Introduction

II Scope of the Framework

III Application of the Framework

IV Content of the Framework

V Further reading

Rapid Evidence Assessment Toolkit at: http://bit.ly/wqiC2A

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[EQ] Why National eHealth Programs Need Dead Philosophers

Why National eHealth Programs Need Dead Philosophers:
Wittgensteinian Reflections on Policymakers’ Reluctance to Learn from History

Trisha Greenhalgh, Jill Russell, Richard E. Ashcroft, and Wayne Parsons
Queen Mary University of London
The Milbank Quarterly - Volume 89, Number 4, December 2011

Available online at: http://bit.ly/vxvWJ8

Context:
Policymakers seeking to introduce expensive national eHealth programs would be advised to study lessons from elsewhere. But these lessons are unclear, partly because a paradigm war (controlled experiment versus interpretive case study) is raging.

England’s $20.6 billion National Programme for Information Technology (NPfIT) ran from 2003 to 2010, but its overall success was limited. Although case study evaluations were published, policymakers appeared to overlook many of their recommendations and persisted with some of the NPfIT’s most criticized components and implementation methods.

Methods: In this reflective analysis, illustrated by a case fragment from the National Programme for Information Technology NPfIT, we apply ideas from Ludwig Wittgenstein’s postanalytic philosophy to justify the place of the “n of 1” case study and consider why those in charge of national eHealth programs appear reluctant to learn from such studies.

Findings: National eHealth programs unfold as they do partly because no one fully understands what is going on. They fail when this lack of understanding becomes critical to the programs’ mission.

Detailed analyses of the fortunes of individual programs, articulated in such a way as to illuminate the contextualized talk and action (“language games”) of multiple stakeholders, offer unique and important insights. Such accounts, portrayals rather than models, deliver neither statistical generalization (as with experiments) nor theoretical generalization (as with multisite case comparisons or realist evaluations).

But they do provide the facility for heuristic generalization (i.e., to achieve a clearer understanding of what is going on), thereby enabling more productive debate about eHealth programs’ complex, interdependent social practices. A national eHealth program is best conceptualized not as a blueprint and implementation plan for a state-of-the-art technical system but as a series of overlapping, conflicting, and mutually misunderstood language games that combine to produce a situation of ambiguity, paradox, incompleteness, and confusion.

But going beyond technical “solutions” and engaging with these language games would clash with the bounded rationality that policymakers typically employ to make their eHealth programs manageable. This may explain their limited and contained response to the nuanced messages of in-depth case study reports.

Conclusion:
The complexity of contemporary health care, combined with the multiple stakeholders in large technology initiatives, means that national eHealth programs require considerably more thinking through than has sometimes occurred.
We need fewer grand plans and more learning communities. The onus, therefore, is on academics to develop ways of drawing judiciously on the richness of case studies to inform and influence eHealth policy, which necessarily occurs in a simplified decision environment. …”

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[EQ] Advancing the Global Health Agenda

Advancing the Global Health Agenda

Ilona Kickbusch, Director of the Global Health Programme, Graduate Institute of International and Development Studies, Geneva
UN Chronicle, Vol. XLVIII No. 4, 2011 (30.12.2011)

Available online at: http://bit.ly/wq6hn7

“……In just over two decades, global health has gained a political visibility and status that some authors have called a political revolution. As health related issues have become a centre piece of the global agenda, significant resources in development aid have been made available to address major health problems. Global health has gained this political prominence because three agendas have reinforced one another in a variety of ways:

· a security agenda driven by the fear of global pandemics or the intentional spread of disease, in an era where viruses have the potential to spread from one part of the world to another in a matter of hours;

· an economic agenda, which is concerned not only with the economic impact of poor health on development or of pandemic outbreaks in the global marketplace, but increasingly considers the economic relevance of the health sector, in particular of certain industries, such as tobacco, food, and pharmaceuticals, and the growing global market of goods and services in relation to health;

· a social justice agenda advocating health as a social value and human right, which includes action on the social determinants of health, access to medicines, support for the Millennium Development Goals (MDGs) relating to health, and the active engagement of philanthropies and civil society in a broad range of global health initiatives.

The global health agenda brings together two critical action spheres of our time: managing interdependence and globalization, and addressing the growing inequalities within and between nations through development strategies. It also lies at the intersection of many policy arenas and is subject to a special dynamic…..”

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