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Table 2 Key findings regarding the nature of evidence from recent systematic reviews

From: Accelerating learning for pro-poor health markets

Authors Title # studies included Conclusions regarding nature of evidence available
Patouillard et al. [27] Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature 52 The authors highlight that only a handful of studies assess the impact of private-sector involvement on usage and quality of health care for the poor. While many studies show increased access to health services for the poor, due to the quality of existing studies it is not possible to prove that private-sector involvement in health care is beneficial to the poor. The authors also recommend a focus on robust evaluation designs in future research, because current data are insufficient and of poor quality.
Berendes et al. [28] Quality of private and public ambulatory health care in low and middle income countries: Systematic review of comparative studies 80 The authors stress the need for more research using standardised outcome measures, and assessing strategies and interventions, to improve private ambulatory health-care services.
Montagu et al. [29] Private versus public strategies for health service provision for improving health outcomes in resource-limited settings 21 Overall the quality of the evidence was rated as either low or very low and the authors conclude there is a need for further evidence comparing health outcomes of public-sector versus private-sector health care.
Kiwanuka et al. [30] Dual practice regulatory mechanisms in the health sector: A systematic review of approaches and implementation 31 Majority of studies identified were policy analyses, country case studies, cross-sectional surveys, or economic models. No impact evaluations were identified, and no studies assessed the impact of regulatory mechanisms on dual practice.
Liu et al. [31] The effectiveness of contracting-out primary health care services in developing countries: A review of the evidence 16 The authors highlight the need for more research on the possible unanticipated consequences of contracting-out interventions. To-date very few evaluations have addressed these.
Koehlmoos et al. [32] Social franchising evaluations: A scoping review 3 systematic reviews, 9 primary studies The authors conclude that there is a lack of rigorous evaluations of the effectiveness of social franchising, and that future research should address issues related to implementation, such as adherence and sustainability.
Evans et al. [33] Systematic review of public health branding 3 experimental studies 5 quasi-experimental 25 observational The authors conclude that there are problems in the existing literature with reference to the standardization of reporting, terminology and measurement. They express the need for more rigorous research designs such as randomised controlled trials and longitudinal designs to determine the effectiveness of public health branding interventions on health behaviour.
  1. Source: extracted from 3ie database of systematic reviews