Authors ' conclusions Training probably improves quality of care ( i.e. adherence to recommended practice ) , regulation may improve quality of care , and we are uncertain about the effects of co‐ordination on quality of private for‐profit healthcare services in LMICs .
Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality st and ards .
Such government guidance , referred to as public stewardship , encompasses government policies , regulatory mechanisms , and implementation strategies for ensuring accountability in the delivery of services .
However , the effectiveness of these strategies in low‐ and middle‐income countries ( LMICs ) have not been the subject of a systematic review .
Objectives To assess the effects of public sector regulation , training , or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries .
Effectiveness of evidence-based medicine on knowledge, attitudes, and practices of family planning providers: a randomized experiment in Jordan
Background Provider misconceptions and biases about contraceptive methods are major barriers to family planning access for women in low- and middle-income countries , including Jordan .  Evidence -Based Medicine ( EBM ) programs aim to reduce biases and misconceptions by providing doctors with the most up-to- date scientific evidence on contraceptive methods . Methods We evaluate the effects of an EBM program  conducted in Jordan on private providers ’ knowledge , attitudes , and practice s. Family planning providers r and omly assigned to a treatment group were invited to attend a roundtable seminar on the injectable contraceptive Depot Medroxy Progesterone Acetate ( DMPA ) , and to receive two 15 min one-on-one educational visits that reinforce the messages from the seminar . Results There was low compliance with the EBM program . The study fails to detect an impact on providers ’ knowledge of DMPA ’s side effects or on reported clinical practice s. There is suggestive evidence of a positive impact on providers ’ attitudes toward and confidence in prescribing the contraceptive to their patients . There is also evidence of positive selection into program participation . Conclusions We conclude that EBM may not be effective as a st and -alone program targeting a family planning method with a high level of provider and consumer bias . Evidence of positive selection into program participation underscores the importance of r and omization to avoid overestimating the true effects of interventions .Trial registration AEA RCT Registry , AEA RCT R0000539 ,
Authors ' conclusions Training probably improves quality of care ( i.e. adherence to recommended practice ) , regulation may improve quality of care , and we are uncertain about the effects of co‐ordination on quality of private for‐profit healthcare services in LMICs .
Background Governments use different approaches to ensure that private for‐profit healthcare services meet certain quality st and ards .
Such government guidance , referred to as public stewardship , encompasses government policies , regulatory mechanisms , and implementation strategies for ensuring accountability in the delivery of services .
However , the effectiveness of these strategies in low‐ and middle‐income countries ( LMICs ) have not been the subject of a systematic review .
Objectives To assess the effects of public sector regulation , training , or co‐ordination of the private for‐profit health sector in low‐ and middle‐income countries .