About the Evidence Gap Map

This evidence gap map catalogs existing literature on the effects of health systems strengthening efforts on health system outcomes. The literature is organized around USAID's Health System Strengthening Learning Agenda, which articulates six questions designed to spur learning about how to improve health system equity, quality, and resource optimization -- the desired intermediate outcomes of USAID's Vision for Health System Strengthening 2030. By capturing existing evidence relevant to these learning questions, the map aims to inform adaptations to health systems strengthening approaches, guide strategic investments, and demonstrate the impact of health systems strengthening.

Methodology

USAID's Local Health System Sustainability Project (LHSS) started the evidence mapping exercise by developing a process framework to define inclusion criteria, search terms, and evidence categories to serve as filters. The mapping exercise focused on peer-reviewed and gray literature from 2017 to 2022. LHSS used the PubMed database to identify relevant peer-reviewed articles. For gray literature, LHSS searched USAID's Development Experience Clearinghouse and other websites, including those of the World Health Organization, the Joint Learning Network for Universal Health Coverage, and USAID implementing partners.

LHSS's process framework included four steps.

Step one - Run search terms in PubMed and the other targeted websites for title and abstract screening.

Step two - Second reviewer screens initial articles to ensure agreement on relevance and inclusion.

Step three - Conduct full-text reviews and tagging according to the defined filters.

Step four - Check and validate all categorization and tagging.

How To Navigate

The evidence gap map has two main navigation features. Once a user selects a learning question, all articles tagged to that learning question can be accessed by clicking "View Records." Alternatively, the user can click the "Filters" button to select from among seven categories and click "Update" to refine and narrow their search. This will update the numbers of resources available for each learning question theme and health system outcome. (Note: In addition to the three intermediate health system outcomes of equity, quality, and resource optimization, the map also identifies evidence related to resilience.) The user can then explore the relevant articles either by clicking on the circles within the map, or by clicking on "View Records." All articles have links to publicly available sites hosting the documents.

To reset and remove applied filters, the user can go back to Filters, click on "Clear Filter," and then on "Update."

References can be downloaded in the .ris format. Additional formats for downloading references are being explored to make exporting more accessible.

Click for PDF of Learning Products

How to Contribute

The health systems strengthening evidence gap map is a live repository. If you know of publicly available resources relevant to any of USAID's Health System Strengthening Learning Agenda questions that are not captured in the current iteration, please send your submission by filling out this form.