Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2013
ReviewInterventions for hiring, retaining and training district health systems managers in low- and middle-income countries.
District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. ⋯ There is low quality evidence that contracting-in may improve health care accessibility and utilization and that intermittent training courses may improve district health systems managers' performance. More evidence is required before firm conclusions can be drawn regarding the effectiveness of these interventions in diverse settings. Other interventions that might be promising candidates for hiring and retaining (e.g., government regulations, professional support programs) as well as training district health systems managers (e.g., in-service workshops with on-site support) have not been adequately investigated.