Meta-evaluation in Primary Health Care Evaluative Studies: a Scoping Review

Abstract

Background: The evaluation of health policies and programs expanded in both practical and theoretical-methodological fields, with a strong influence on health system quality, decisions of managers, sustainability, and improvement of the primary care services. However, guaranteeing the qualification and credibility of the evaluation processes using meta-evaluations is a huge challenge for evaluators. This review aimed to map meta-evaluation use in Primary Health Care evaluative studies.Methods: We conducted a scoping review based on the Joanna Briggs Institute manual and guided by PRISMA Extension for Scoping Reviews (PRISMA-ScR). A systematic and comprehensive three-step search was performed in January and February 2021 in multidisciplinary health science databases and gray literature. No limits concerning publication dates were set. Data extraction and eligibility were performed by two independent authors and interpreted using thematic analysis. The themes were collated, and a narrative summary of the findings reported.Results: There were 11,641 potential studies identified from the search, finally, 23 studies were included in the analysis. Four thematic groups were identified: search results; characteristics of the included studies; meta- evaluation type, involved stakeholders, and Evaluative standards applied; potentialities and challenges in the meta-evaluation primary health care. Most were summative meta-evaluations focusing on health programs and primary care management and followed the quality standards of the Joint Committee on Standards for Educational Evaluation. We observed low involvement of service users and active participation of managers, health professionals, researchers like stakeholders. We also highlight the importance of formative and democratic meta-evaluations expanding the use of evaluations.Conclusion: Results showed the potential and challenges of using meta-evaluation in primary health care during or when the evaluations have been completed. Highlighted the importance of permanent and systematic analysis of the quality of evaluations. Meta-evaluators have the technical responsibility of the evaluation process, stimulus to the action of those involved, and decision-making capacity. There is a paucity of published literature on meta-evaluation in primary health care. Hence, further studies are recommended to qualify the processes and results of the evaluations capable of contributing to the improvement and qualification of public policies and health practices.