Evidence-based medicine--the view from Fiji

Promoting development and use of systematic reviews in a developing country

INTRODUCTION

One major barrier to develop health systems is the limited capacity for conducting research and implementation of research findings. We assessed the views of researchers, decision makers and research policy makers on how the development and usage of evidence from systematic reviews can be promoted in a country with limited resources.

METHODS

We surveyed 131 participants in six systematic review workshops for their views on important items influencing the production and usage of systematic reviews in a developing country. They were also asked to propose interventions to deal with potential barriers. We analysed the quantitative data using multidimensional scaling methods, and the qualitative data using content analysis approach.

RESULTS

We identified seven clusters of items that contribute to the promotion of conducting and using systematic reviews. For each cluster a set of interventions are proposed that health care decision makers and research policy makers may use for promoting conduct and use of systematic reviews. The clusters are 'importance for policy makers', 'access to international research', 'priority and support for systematic reviews', 'competency and willingness of researchers to conduct reviews', 'importance for end-users', 'quality of local primary research' and 'visibility and access to local research'.

DISCUSSION

The proposed interventions focus on national level initiatives for making the systematic reviews 'wanted' and improving the capacity to conduct research. Our findings emphasize the essential role of policy makers for promoting systematic reviews. They demonstrate that many barriers stem from the lower quality of and lack of access to primary research originating from developing countries.

Is evidence-based medicine relevant to the developing world?

Systematic reviews have yet to achieve their potential as a resource for practitioners in developing countries, argue Chinnock et al.