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Background This article aims to explain the rationale and design for developing an evidence-based scorecard to monitor country-level implementation of the 71st World Health Assembly resolution on rheumatic fever and rheumatic heart disease (RHD) in Africa. Rationale A scorecard provides a simple and reliable tool for tracking progress over time and establishing accountability mechanisms. Methods Development of the scorecard will incorporate engaging RHD stakeholders identified and categorised at a country level. We will conduct individual interviews to understand the barriers and facilitators to implementing the resolution. The Delphi technique will facilitate structured group discussions to develop appropriate indicators. Indicators will be linked to the resolution's goals to create strategic lines of action, to inform the scorecard. The scorecard will be quantitatively validated in real-life settings. Discussion We deem that the rigor of the development process of this study will produce an evidence-based scorecard that is fit for purpose across Africa.

Our study aimed to systematically identify RHD stakeholders and categories of stakeholders to consider when developing a scorecard that reflects a broad stakeholder input.We used the Schiller et al.(2013) framework to identify RHD stakeholders and stakeholder categories in Tanzania and Uganda. The process involved identifying stakeholders by searching literature related to incidence, prevalence, morbidity, mortality, health services, or health outcomes of Group A streptococcus, acute rheumatic fever, or rheumatic heart disease in these countries. The strategy was completed for two electronic databases in 2016 and in 2020 to update the results. We also engaged known stakeholders to obtain practice-based insight. We then categorised and visually represented the identified stakeholders.We identified 139 stakeholders in Uganda, with 68% being from 15 different countries across 31 locations. In comparison, local Ugandan stakeholders were dispersed in six locations across the country. In Tanzania, we identified 128 stakeholders, with 66% being locally based and dispersed in seven locations across the country and stakeholders from different countries were situated in 18 countries across 28 locations. We categorised all identified stakeholders into one or more of five categories 1) Civil Society and General Public, 2) Education Sector, 3) Research, Training and Capacity Building, 4) Healthcare service delivery, and 5) Health Policy and Administration.The stakeholder categories identified include multiple sectors and stakeholders from multiple countries, this reflects the complexities of RHD. This also highlights the need for collaboration and partnership as a critical action for preventing and controlling RHD.

A growing number of researchers are preparing systematic reviews of qualitative evidence, often referred to as ‘qualitative evidence syntheses’. Cochrane published its first qualitative evidence synthesis in 2013 and published 27 such syntheses and protocols by August 2020. Most of these syntheses have explored how people experience or value different health conditions, treatments and outcomes. Several have been used by guideline producers and others to identify the topics that matter to people, consider the acceptability and feasibility of different healthcare options and identify implementation considerations, thereby complementing systematic reviews of intervention effectiveness.Guidance on how to conduct and report qualitative evidence syntheses exists. However, methods are evolving, and we still have more to learn about how to translate and integrate existing methodological guidance into practice. Cochrane’s Effective Practice and Organisation of Care (EPOC) ( www.epoc.org ) has been involved in many of Cochrane’s qualitative evidence syntheses through the provision of editorial guidance and support and through co-authorship. In this article, we describe the development of a template and guidance for EPOC’s qualitative evidence syntheses and reflect on this process.

This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: To identify, appraise, and synthesise qualitative studies exploring healthcare workers' perceptions and experiences of PHC integration; to identify the factors influencing healthcare workers' perceptions and experiences of PHC integration interventions; and to guide an update of the Cochrane PHC integration effectiveness review (Dudley 2011), by identifying contextual variation that may be associated with variation in effectiveness.