2018 Jan 26

New citation required but conclusions have not changed

Included studies

Given EPOC's revised study design criteria (EPOC 2017a), we excluded from this update 2 of the studies included in the previous version of this review. We included 1 new study, bringing the total number of included studies in this review to 2.

New review author team

Willem A Odendaal, Kim Ward, Jesse Uneke, Henry Uro‐Chukwu, Dereck Chitama, Yusentha Balakrishna, Tamara Kredo

2018 Jan 26

New search has been performed

This is the first update of a Cochrane Review published in 2009. We conducted a new search and updated other content. We made the following 3 changes to the original Review.

Outcomes

Secondary outcomes

We added the following 2 outcomes.

• Economic outcomes

  • cost‐effectiveness of delivering contracted out clinical health services

  • costs and savings to government, contracted agencies, and patients

  • economic measures of health benefit

• Health system performance as measured in terms of health service delivery, health workforce, health information, availability of essential medicines, and health financing

Search strategy

• Given the added secondary outcomes, we changed the search strategy

Study design criteria

Controlled before‐after (CBA) studies

• To fulfil the EPOC inclusion criteria for a CBA, the study must have at least 2 intervention sites and 2 control sites

• Criteria reported in the 2009 review were as follows: "For this review, the control group for both RCTs and CBAs had to be areas or health facilities where the provision of health services was undertaken by the public using a traditional type of management, i.e. without the possibility for healthcare managers at the lower levels to define the remuneration levels of their staff" (Lagarde 2009, p. 5)