The evidence is concentrated in two types of PMM strategies : implementation strategies ( in-service training , continuing education , supervision ) and performance-based financing .
Major gaps exist in accountability arrangements particularly the use of audit and feedback .
The least studied types of outcomes were unintended effects , harm and social equity .
Conclusions The evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes .
The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects .
Introduction We mapped available evidence on  performance measurement and management ( PMM ) strategies in primary healthcare ( PHC ) systems of low-income and middle-income countries ( LMICs ) .
Widely used , their effectiveness remains inconclusive .
This evidence gap map characterises existing research and evidence gaps .
Effect on tuberculosis outcomes of educational outreach to South African clinics during two randomised trials.
SETTING Public sector primary care clinics in Free State Province , South Africa . OBJECTIVES To investigate the effects of on-site in-service clinical skills training for nurse practitioners on tuberculosis ( TB ) treatment outcomes in the same clinics . DESIGN Analysis of TB programme data from clinics taking part in two consecutive r and omised trials of educational outreach aim ed at improving respiratory and human immunodeficiency virus/acquired immune-deficiency syndrome care based on the Practical Approach to Lung Health . We compared treatment outcomes between  control and intervention clinics among all patients diagnosed with TB during either trial . RESULTS During the two trials , participating clinics treated 4187 and 2333 TB patients , respectively . Neither intervention was associated with better outcomes overall . However , among retreatment patients , cure or completion rates in intervention clinics were significantly higher during the second trial ( OR 1.78 , 95%CI 1.13 - 2.76 ) . Patients in clinics that had received both interventions had higher cure or completion rates ( OR 1.99 , 95%CI 1.53 - 2.58 ) and lower default rates ( OR 0.25 , 95%CI 0.097 - 0.63 ) than patients in clinics that had received neither intervention . CONCLUSION Although not primarily focused on TB treatment , the interventions appeared to improve successful treatment completion rates among TB retreatment cases . Integrated care programmes support attainment of important TB programme goals
The evidence is concentrated in two types of PMM strategies : implementation strategies ( in-service training , continuing education , supervision ) and performance-based financing .
Major gaps exist in accountability arrangements particularly the use of audit and feedback .
The least studied types of outcomes were unintended effects , harm and social equity .
Conclusions The evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes .
The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects .
Introduction We mapped available evidence on  performance measurement and management ( PMM ) strategies in primary healthcare ( PHC ) systems of low-income and middle-income countries ( LMICs ) .
Widely used , their effectiveness remains inconclusive .
This evidence gap map characterises existing research and evidence gaps .