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Table 3 Steps and components of the local health systems analysis and results (capacity-building needs)

From: Action research and health system strengthening: the case of the health sector support programme in Mauritania, West Africa

Steps of the analysisEssential components to be evaluatedResults: Defined capacity-building needs within the two districts
1. Description of the local health systemContext (geographic, sociodemographic, socioeconomic)
Coverage of health facilities
HRH
Stakeholder analysis and mapping
Definition of an adequate coverage plan of health services within a district (difference between urban and rural district)
Coordination capacity with a multitude of actors in Dar Naim
Capacity to assess HRH needs
2. Analysis of interactions between the demand, need and supply dimension of healthcare servicesEvaluation of the offered package of activities, compared to the demand from the population and the needs defined by health actorsDefinition of a comprehensive integrated package
Capacity in terms of mental health, basic obstetric care, etc.
3. Analysis of accessibility and quality of careAnalysis of accessibility by evaluating the existing data (e.g. data provided by the Health Information System) and framework [24]
Analysis of quality of care in four dimensions: cost-efficiency, continuity of care, integrated care and patient-centred care [25]
Capacity in data analysis and monitoring and evaluation
Knowledge of and experience in patient-centred care
General capacity to enhance quality of care (among all health actors)
4. Pharmacy managementAnalysis of the process: from supply to management to prescriptionGeneral knowledge on pharmacy management
Provision of tools
5. Evaluation of local healthcare financing arrangements Provision of tools
Awareness on transparency
Knowledge on health insurance and social protection schemes
6. Analysis of the stewardship function of the local health systemEvaluation of the various functions of a DHT [26]; evaluation of the team’s interactions with local, regional and central actorsLeadership skills
General public health knowledge according to defined functions of a DHT [26]: Response to local needs in terms of healthcare, coordination of actors, management of health services, activities and health staff, supervision and training, adaptation of national strategies to local context
Capacity to analyse health information data
7. Analysis of community participationAnalysis of formal and informal health committees; evaluation of the level of community participation [27, 28]Awareness on advantages of a genuine partnership and a non-utilitarian vision of community participation
Capacity to define a strategy adapted to an urban context (Dar Naim)
8. Synthesis and lessons learned Capacity to prioritise
A systems vision
  1. DHT district health team, HRH human resources for health