NAHT proposes, and is trialling, a system of peer review where good schools challenge others on their pathway to improvement, as one alternative, says NAHT's general secretary, Russell Hobby.
In essence, a responsible clinician using best available evidence often appears to be removing hope and therefore a pathway to improvement.
The creation of registries for long-term outcomes research and for system validation offers a clear pathway to improvement of the programs.
This is a proxy measure of effectiveness, because it lies on the pathway to improvements in health, and reflects team decision making which has taken account of clinical and non-clinical information.
As noted in Naimoli et al. (2008), different countries have different pathways to coverage improvement.
Using a grounded theory approach, we conducted in-depth case studies to understand pathways to coverage improvement by comparing immunization programme experience in 12 districts in three countries (Ethiopia, Cameroon and Ghana).
The case studies reported here are unique in their focus on the positive drivers of change and the use of evidence to elaborate the implementation processes and dynamic pathways to coverage improvement.
The case studies are unique in their focus on the positive drivers of change and the identification of pathways to coverage improvement, an approach that should be considered in future studies and routine assessments of district-level immunization system performance.
Finally, we believe that applying an assets-based lens to programme design, as applied in this study, allows the identification of varied local and successful pathways to coverage improvement and should be considered in future studies and routine assessments of district-level immunization system performance.
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