Human Resources for Health in Maternal, Neonatal and - HRH ...

findings. Differences and similarities among studies and reports are used to draw conclusions
across the literature.
The strength of this approach lies in its ability to expose the heterogeneity of the literature in
terms of the range of documentation that reports on HR interventions in MNRH in LMIC
community contexts and the array of methods of investigation, reporting and findings. The
approach allows knowledge gaps to be exposed and patterns revealed across a range of
literature. Limitations of this approach however lie in the lack of in depth analysis that is
achievable due to the volume and spread of documentation. Further synthesis is therefore
required which is beyond the scope of this review. In addition not all decisions concerning
the choice of studies selected for synthesis is explicit due to the subjective nature of the
method that relied on judgements although informed ones.
A critical realist perspective is adopted for this review which acknowledges that there are
multiple descriptions and explanations of phenomena that are the result of the interaction of
complex factors involving structures and ideologies. The knowledge that is analysed in this
review is regarded as co-determined by a myriad of causal factors which lead to variations in
experiences that are constantly emerging and changing (Collier 1994). The objective of the
literature review therefore is to obtain an understanding of the causal conditions, powers and
interactions relevant to HRH at community level so that adequate judgements can be made
about possible scenarios that may unfold.
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