Rapid methods for identifying barriers and solutions to improve access to community health services: a scoping review protocol

Abstract

ObjectivesLow attendance rates for community health services reflect important barriers that prevent people from receiving the care they need. Services and health systems that seek to advance Universal Health Coverage need to understand and act on these factors. Formal qualitative research is the best way to elicit barriers and identify potential solutions, however traditional approaches take months to complete and can be very expensive. We aim to map the methods that have been used to rapidly elicit barriers to accessing community health services and identify potential solutions.Methods and analysisWe will search MEDLINE, Embase, the Cochrane Library and Global Health for empirical studies that use rapid methods (<14 days) to elicit barriers and potential solutions from intended service beneficiaries. We will exclude hospital-based and 100% remotely delivered services. We will include studies conducted in any country from 1978 to present. We will not limit by language. Two reviewers will independently perform screening and data extraction, with disagreements resolved by a third reviewer. We will tabulate the different approaches used and present data on time, skills and financial requirements for each approach, as well as the governance framework and any strengths and weaknesses presented by the study authors. We will follow Joanna Briggs Institute (JBI) scoping review guidance and report the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.Ethics and disseminationEthical approval is not required. We will share our findings in the peer-reviewed literature, at conferences, and with WHO policymakers working in this space.RegistrationOpen Science Framework (https://osf.io/a6r2m).

Identifying barriers and potential solutions to improve equitable access to community eye services in Botswana, India, Kenya, and Nepal: a rapid exploratory sequential mixed methods study protocol

“…Building on established rapid qualitative analysis, our team has conducted a scoping review to identify rapid approaches that have been specifically used to assess barriers and solutions to improve access to community health services. 79 We identified a number of innovative methodological techniques that can be used to In line with findings from a broader review of rapid methods, 69 we found that many approaches focused on eliminating or expediting the transcription phase, either by performing simultaneous data collection and analysis, or by coding data directly from audio. This is a common design feature of studies that use 'RAP' sheets (Rapid Assessment Procedure data templates): data collectors enter quotes and/or open codes into analytic matrices during the interview or afterward, working directly from the audio recording.…”

Identifying barriers and potential solutions to improve equitable access to community eye services in central Kenya: a rapid exploratory sequential mixed methods study

“…The decision to use an analytic matrix and collective interpretation was based on the findings of our previous systematic review, which had found these techniques to be rapid and robust. 30 Our matrix had one participant per column and one sub-theme per row -with a new row created every time a sub-theme (a unique barrier or solution) was identified. Each subtheme (e.g.…”

“…The decision to use an analytic matrix and collective interpretation was based on the findings of our previous systematic review, which had found these techniques to be rapid and robust. 30…”

“…Our decision to use direct-from-audio transcription was based on findings from a background systematic review that we conducted on rapid qualitative approaches. 30 Interviewees did not review their transcribed quotes in the matrix. In-person interviews were conducted in private rooms in four different health facilities where interviewees’ responses could not be overheard.…”

Comparison of telephone and in-person interview modalities: duration, richness, and costs in the context of exploring determinants of equitable access to community health services in Meru, Kenya

“…The incentive to deliver timely and affordable findings is further underlined by our desire to see embedded qualitative research adopted more widely across routine programmatic quality improvement initiatives, so that the voices of intended service beneficiaries can be included in decision making. Based on the findings of a recent scoping review on rapid qualitative research methods 5 we have developed a rapid 'abductive' interview approach that uses a deductive analytic matrix to facilitate rapid iterative analysis of data whilst "making space for inductive identification of themes and issues not predicted at the outset". 1 Our work employs a phenomenological approach, grounded in a pragmatist philosophical paradigm.…”