3. Strengthening Health Systems

A recent review evaluated evidence on the effect of various financing strategies on use of health care. It found that most research was small scale and had findings of limited applicability. Well-designed, large-scale evaluations of the effect of alternative financing interventions were lacking, and a multitude of case studies described specific experiences but with little methodological rigor. The review recommended larger-scale, more systematic studies in a range of settings, including nonrandomized designs when randomization is impossible or inappropriate and multi-center case studies that examine why arrangements do or do not work in different settings. The study proposed developing and applying quality criteria for quantitative and case study research along the lines of guidelines recently developed for randomized group trials.

Source: Palmer and others 2004.