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Jabali SH, Yazdani S, Pourasghari H, Maleki M. From bench to policy: a critical analysis of models for evidence-informed policymaking in healthcare. Front Public Health 2024; 12:1264315. [PMID: 38596514 PMCID: PMC11002157 DOI: 10.3389/fpubh.2024.1264315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Background The use of research evidence in policy making is a complex and challenging process that has a long history in various fields, especially in healthcare. Different terms and concepts have been used to describe the relationship between research and policy, but they often lack clarity and consensus. To address this gap, several strategies and models have been proposed to facilitate evidence informed policy making and to identify the key factors and mechanisms involved. This study aims to critically review the existing models of evidence informed policy making (EIPM) in healthcare and to assess their strengths and limitations. Method A systematic search and review conducted to identify and critically assess EIPM models in healthcare. We searched PubMed, Web of Science and Scopus databases as major electronic databases and applied predefined inclusion criteria to select the models. We also checked the citations of the included models to find other scholars' perspectives. Each model was described and critiqued each model in detail and discussed their features and limitations. Result Nine models of EIPM in healthcare were identified. While models had some strengths in comprehension, flexibility and theoretical foundations, analysis also identified limitations including: presupposing rational policymaking; lacking alternatives for time-sensitive situations; not capturing policy complexity; neglecting unintended effects; limited context considerations; inadequate complexity concepts; limited collaboration guidance; and unspecified evidence adaptations. Conclusion The reviewed models provide useful frameworks for EIPM but need further improvement to address their limitations. Concepts from sociology of knowledge, change theory and complexity science can enrich the models. Future EIPM models should better account for the complexity of research-policy relationships and provide tailored strategies based on the policy context.
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Affiliation(s)
- Seyyed Hadi Jabali
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Yazdani
- Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Pourasghari
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Kalbarczyk A, Rao A, Alonge OO. Determinants of factors affecting readiness of academic institutions to conduct knowledge translation in low- and middle-income countries. Front Public Health 2024; 11:1302756. [PMID: 38259768 PMCID: PMC10800438 DOI: 10.3389/fpubh.2023.1302756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Capacity building strategies have been used to improve uptake of knowledge translation (KT) activities among academic institutions, but little is known about their effectiveness, contextual responsiveness, and adaptability. Many of these strategies target individuals while few address institutional gaps. This research describes the determinants for conducting KT (or readiness to conduct such activities) at the institutional level across diverse LMIC contexts to inform the development of capacity building strategies. Methods We conducted a survey to assess organizational readiness to conduct KT to public health researchers and practitioners from six academic institutions in Bangladesh, Ethiopia, DRC, India, Indonesia and Nigeria and members of a global knowledge-to-action working group. We assessed the frequency of barriers and facilitators to KT and their relationship to age, gender, country, and KT experience. We then performed logistic regression to identify determinants of five underlying factors demonstrated to influence KT readiness in LMICs (Institutional Climate, Organization Change Efficacy, Prioritization and Cosmopolitanism, Self-Efficacy and Financial Resource) along with their composite score, which represented an overall readiness score to conduct KT. Results A total of 111 responses were included in the final analysis. Participants represented 10 LMICs; a majority were 30-49 years old (57%) and most were male (53%). Most participants had professional foci in research (84%), teaching (62%), and project coordination (36%) and 59% indicated they had experience with KT. Common facilitators included motivated faculty (57%) and dedicated personnel (40%). Funding (60%), training (37%), and time (37%) were the most frequently reported barriers. In the adjusted model, age, gender, country, and professional focus were significantly associated with at least one factor. Prior experience with KT was significantly and positively (OR = 9.07; CI: 1.60-51.58; p < 0.05) associated with the overall KT readiness to conduct KT. Discussion Different KT readiness factors are relevant for younger (institutional climate) vs. older (self-efficacy) academic professionals, suggesting value in cross-generational collaborations. Leadership and gender were both relevant for organizational change efficacy indicating a need to engage leaders and promote women to influence organizational change. Institutions in different countries may be at different stages of change; readiness assessments can be used to systematically identify needs and develop targeted strategies.
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Affiliation(s)
- Anna Kalbarczyk
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Morankar S, Abraham G, Shroff Z, Birhanu Z. "Research ends with publication": a qualitative study on the use of health policy and systems research in Ethiopia. Health Res Policy Syst 2024; 22:1. [PMID: 38167041 PMCID: PMC10759454 DOI: 10.1186/s12961-023-01091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Decision-making about the design and implementation of health care policies should be supported by research evidence. This article reports on a qualitative study on the experiences of both research institutes and policymakers in Ethiopia in generating and using research evidence to inform health policy decision-making. METHODS Semi-structured interviews were conducted from January through March 2020, with representatives of research institutes and with policymakers in Ethiopia. The data collected during the interviews were analyzed thematically. RESULTS Half of the institutions represented had engaged in health policy and systems research (HPSR). These institutes' capacities were limited by multiple factors, including unsupportive research environments; the limited number of researchers with extensive experience; high turnover among senior researchers; lack of staff motivation mechanisms; underdeveloped research culture; limited technical and analytical capacity among researchers; lack of core funding for HPSR; ineffective financial management; and, lack of connections with health policy platforms. Research institutes also lacked the capacity in strategic packaging of findings to influence policy decision-making, although some programs have recently improved in this area. Meanwhile, there lacked a culture of using evidence in policymaking settings. In general, we found that policymakers had poor attitudes towards the quality or value of the evidence, and had little capacity to interpret evidence and apply findings to policy options. As a result, much of the research produced by the institutes have only been relevant academically, with little impact on policy. However, respondents reported that the environment is slowly changing, and the recent creation of a Research Advisory Council at the Ministry of Health offers a promising model. CONCLUSIONS Despite some recent changes, in Ethiopia researchers and policymakers alike often tend to consider health policy and systems research (HPSR) to be not very valuable since the findings generated are rarely used for evidence-informed policy development. Research institutes and researchers need to strengthen their technical, analytical, and administrative capacities (through, among other efforts, seeking more funding for research, and better incentives to attract, retain and build skills among qualified researchers); they also need to improve their understanding of the evidence-to-policy cycle and how to engage effectively with policymakers.
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Affiliation(s)
- Sudhakar Morankar
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gelila Abraham
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia
- Health Policy and Management Department, Public Health Faculty, Jimma Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Zubin Shroff
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Zewdie Birhanu
- Ethiopian Evidence Based Healthcare and Development Centre: a JBI Center of Excellence, Jimma University, Jimma, Ethiopia.
- Health, Behavior, and Society Department, Public Health Faculty, Institute of Health, Jimma University, Jimma, Ethiopia.
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Sigudla J, Maritz JE. Exploratory factor analysis of constructs used for investigating research uptake for public healthcare practice and policy in a resource-limited setting, South Africa. BMC Health Serv Res 2023; 23:1423. [PMID: 38102600 PMCID: PMC10724913 DOI: 10.1186/s12913-023-10165-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/17/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Low-resource settings are often less capable of responding to and implementing available quality research evidence for public healthcare practice and policy development due to various factors. In most low-resource settings, limited empirical evidence is available to help deal with localised factors that contribute to low public health research uptake, particularly from the perspective of key research stakeholders. METHODS Although the study initially employed a two-phase exploratory sequential approach, this paper focuses on the results generated from a quantitative approach. Considering the determining factors that affect research uptake in the context of low-resource settings, a measuring instrument was developed and its reliability and validity were assessed using an exploratory factor analysis approach. RESULTS A total of 212 respondents, according to their job roles and titles, were identified as researchers, front-line workers, programme managers, and directors/senior managers of higher learning institutions, indicating that the three constructs applied in the questionnaire, namely (1) individual factors, (2) organisational factors, and (3) research characteristics, demonstrated relatively high reliability with a Cronbach's alpha of greater than 0.791. CONCLUSION The study concludes that the instrument can potentially be used to measure factors that affect research uptake in low-resource settings.
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Affiliation(s)
- Jerry Sigudla
- Department of Health Studies, University of South Africa, Pretoria, South Africa.
| | - Jeanette E Maritz
- Department of Health Studies, University of South Africa, Pretoria, South Africa
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Zewdie A, Ayele M, Melis T, Kasahun AW. Determinants of evidence-based practice among health care professionals in Ethiopia: A systematic review and meta-analysis. PLoS One 2023; 18:e0293902. [PMID: 37943797 PMCID: PMC10635493 DOI: 10.1371/journal.pone.0293902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Evidence-based practice (EBP) is the art of using up-to-date information for clinical decision-making. Healthcare professionals at all levels are expected to use the latest research evidence for quality care. In Ethiopia inclusive and nationally representative summarized evidence regarding the level of EBP among health professionals is scarce. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of EBP utilization and its determinants among Ethiopian health professionals. METHOD A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Google Scholar, and African Online Journal databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Factors associated with EBP were identified using STATA v. 14. RESULT Overall, 846 articles were retrieved and finally 23 articles were included in this review. The pooled prevalence of good EBP among health professionals was 52.60% (95%CI; 48.15%-57.05%). Knowledge about EBP (AOR = 2.38, 95% CI: (2.08-2.72)), attitude (AOR = 2.09, 95% CI: (1.67-2.60)), educational status (AOR = 3.12, 95% CI: (2.18-4.47)), work experience (AOR = 2.59, 95% CI: (1.48-4.22)), EBP training (AOR = 2.26, 95% CI: (1.87-2.74)), presence of standard guideline (AOR = 1.94, 95% CI: (1.51-2.50)), internet access (AOR = 1.80, 95% CI: (1.47-2.20)), presence of enough time (AOR = 2.01, 95% CI: (1.56-2.60)) and marital status (AOR = 1.73, 95% CI: (1.32-2.28)) were determinants of EBP. CONCLUSION Around half of health professionals in Ethiopia have good EBP utilization which was low. Knowledge, attitude, educational status, work experience, EBP training, presence of standard guidelines, internet access, presence of enough time, and single marital status were positively associated with EBP. Therefore future interventions should focus on increasing their knowledge and changing their attitude through providing training and addressing organizational barriers like availing standard guidelines, accessing the internet, and minimizing professionals' workload that enables them to critically appraise and integrate the latest evidence for clinical decision-making to improve the quality of care.
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Affiliation(s)
- Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Mulat Ayele
- Department of Midwifery, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
| | - Tamirat Melis
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Abebaw Wasie Kasahun
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
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Barreto JOM, Romão DMM, Setti C, Machado MLT, Riera R, Gomes R, Machado DA, Abreu J, de Andrade KRC, Boeira LDS, Pozza L, Souza NM, Logullo P, Silva RB, de Oliveira SMDVL, Mota SEDC, Dias TS, Toma TS, da Silva SF. An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes. Health Res Policy Syst 2023; 21:105. [PMID: 37828575 PMCID: PMC10571264 DOI: 10.1186/s12961-023-01052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/15/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Evidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM. PURPOSE To present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System. METHODS A committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions. RESULTS The development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas). CONCLUSIONS The competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.
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Affiliation(s)
| | | | - Cecilia Setti
- Hospital Sírio-Libanês, São Paulo, Brazil
- Veredas Institute, São Paulo, Brazil
| | | | - Rachel Riera
- Hospital Sírio-Libanês, São Paulo, Brazil
- Unifesp (Federal University of São Paulo), São Paulo, Brazil
| | - Romeu Gomes
- Hospital Sírio-Libanês, São Paulo, Brazil
- IFF/Fiocruz (National Institute of Women, Children and Adolescents Health Fernandes Figueira), Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Patrícia Logullo
- Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Diseases (NDORMS), and UK EQUATOR Centre, University of Oxford, Oxford, United Kingdom
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Sell K, Jessani NS, Mesfin F, Rehfuess EA, Rohwer A, Delobelle P, Balugaba BE, Schmidt BM, Kedir K, Mpando T, Niyibizi JB, Osuret J, Bayiga-Zziwa E, Kredo T, Mbeye NM, Pfadenhauer LM. Developing, implementing, and monitoring tailored strategies for integrated knowledge translation in five sub-Saharan African countries. Health Res Policy Syst 2023; 21:91. [PMID: 37667309 PMCID: PMC10478471 DOI: 10.1186/s12961-023-01038-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Integrated knowledge translation (IKT) through strategic, continuous engagement with decision-makers represents an approach to bridge research, policy and practice. The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA +), comprising research institutions in Ethiopia, Malawi, Rwanda, South Africa, Uganda and Germany, developed and implemented tailored IKT strategies as part of its multifaceted research on prevention and care of non-communicable diseases and road traffic injuries. The objective of this article is to describe the CEBHA + IKT approach and report on the development, implementation and monitoring of site-specific IKT strategies. METHODS We draw on findings derived from the mixed method IKT evaluation (conducted in 2020-2021), and undertook document analyses and a reflective survey among IKT implementers. Quantitative data were analysed descriptively and qualitative data were analysed using content analysis. The authors used the TIDieR checklist to report results in a structured manner. RESULTS Preliminary IKT evaluation data (33 interviews with researchers and stakeholders from policy and practice, and 31 survey responses), 49 documents, and eight responses to the reflective survey informed this article. In each of the five African CEBHA + countries, a site-specific IKT strategy guided IKT implementation, tailored to the respective national context, engagement aims, research tasks, and individuals involved. IKT implementers undertook a variety of IKT activities at varying levels of engagement that targeted a broad range of decision-makers and other stakeholders, particularly during project planning, data interpretation, and output dissemination. Throughout the project, the IKT teams continued to tailor IKT strategies informally and modified the IKT approach by responding to ad hoc engagements and involving non-governmental organisations, universities, and communities. Challenges to using systematic, formalised IKT strategies arose in particular with respect to the demand on time and resources, leading to the modification of monitoring processes. CONCLUSION Tailoring of the CEBHA + IKT approach led to the inclusion of some atypical IKT partners and to greater responsiveness to unexpected opportunities for decision-maker engagement. Benefits of using systematic IKT strategies included clarity on engagement aims, balancing of existing and new strategic partnerships, and an enhanced understanding of research context, including site-specific structures for evidence-informed decision-making.
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Affiliation(s)
- Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - Nasreen S Jessani
- Centre for Evidence-Based Healthcare, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Firaol Mesfin
- Non-Communicable Diseases Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Eva A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Anke Rohwer
- Centre for Evidence-Based Healthcare, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Peter Delobelle
- Chronic Diseases Initiative for Africa, University of Cape Town, Cape Town, South Africa
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bonny E Balugaba
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Bey-Marrié Schmidt
- School of Public Health, University of the Western Cape, Cape Town, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Kiya Kedir
- Non-Communicable Diseases Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Talitha Mpando
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Jean Berchmans Niyibizi
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Esther Bayiga-Zziwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Tamara Kredo
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics and Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nyanyiwe Masingi Mbeye
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Damba FU, Mtshali NG, Chimbari MJ. Factors influencing the utilization of doctoral research findings at a university in KwaZulu-Natal, South Africa: Views of academic leaders. PLoS One 2023; 18:e0290651. [PMID: 37651413 PMCID: PMC10470883 DOI: 10.1371/journal.pone.0290651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 08/11/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Translation of health research findings into policy remains a challenge in sub-Saharan Africa. Factors influencing health research utilization are poorly described in literature. Therefore, identifying factors that influence the utilization of research findings for policy formulation is essential to facilitate implementation of evidence-based interventions. The purpose of this study was to explore the views of academic leaders as to why doctoral research is not adequately used in policymaking. METHODS In-depth interviews were held with purposively selected key informants from the College of Health Sciences. An open-ended interview guide aimed at exploring college leadership views on factors influencing utilization of PhD generated knowledge into policy was used. Data was analysed thematically using NVivo 12 software. Thematic analysis was used to generate themes around the factors influencing utilization of doctoral research into policy. RESULTS Factors such as inaccessibility of research results, lack of funding, poor quality of research, lack of continuity in translating research into policy, lack of timeliness of research results and lack of collaboration between researchers and policymakers hindered the utilization of PhD generated knowledge. Participants recommended engagement with the Department of Health/policymakers, collaboration with Department of Health/policymakers, increasing enrolment of South African citizens into PhD program, making final research products available to Department of Health/policymakers, and provision of funding for dissemination of research results. CONCLUSION The study demonstrated that final doctoral research results are mainly disseminated through journal articles and theses. Participants cited inaccessibility of research findings, lack of funding and poor-quality research as the most common factors hindering utilization of doctoral research findings. The study also recommended availing adequate funding for dissemination of research results, collaboration between researchers and policymakers, facilitation of policymaker-researcher engagement to find best ways of using research findings to influence policy and making final research products accessible to policymakers. Further research to gain the perspective of policymakers as to why doctoral research is not adequately used in policy formulation is recommended.
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Affiliation(s)
- Florence Upenyu Damba
- School of Nursing and Public Health, College of Health Sciences, Howard College, University of KwaZulu-Natal, Berea, Durban, South Africa
| | - Ntombifikile Gloria Mtshali
- School of Nursing and Public Health, College of Health Sciences, Howard College, University of KwaZulu-Natal, Berea, Durban, South Africa
| | - Moses John Chimbari
- School of Nursing and Public Health, College of Health Sciences, Howard College, University of KwaZulu-Natal, Berea, Durban, South Africa
- Great Zimbabwe University, Masvingo, Zimbabwe
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Seedat J. The knowledge-to-action process model for knowledge translation in oral care in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2023; 70:e1-e9. [PMID: 37526536 PMCID: PMC10397355 DOI: 10.4102/sajcd.v70i1.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/13/2022] [Accepted: 06/12/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Literature supports the mismatch between empirical evidence and service delivery. Given this knowledge gap, it is important that research undertaken has a theoretical foundation, considers the context and stakeholders to confirm its need and that it can be feasibly implemented and sustained. OBJECTIVES The study aimed to facilitate knowledge translation in oral care using the knowledge-to-action (K2A) process model among nurses. METHOD The study was completed in an acute hospital in South Africa. A qualitative design with ethnography incorporating video-recordings and semi-structured interviews were used. A total of 139 nurses were recruited using random purposive sampling and received training on oral care, which was monitored. Inductive thematic analysis was completed. RESULTS The model facilitated information transfer and implementation of oral care by nurses. CONCLUSION With clear directions for use and theoretical underpinning, the K2A model was well-suited to the needs of the study and stakeholders, and the complexity of the context. For challenging contexts such as public healthcare institutions in South Africa, this was ideal and critical to the success of the intervention.Contribution: When nursing managers show interest and recognise nurses for their role in implementation of interventions, the buy-in, support and sustained use of that intervention is enhanced. A model such as the K2A promotes involvement of all stakeholders (e.g. nurses and their managers) in the design and planning for implementation of an intervention, and these are critical for the successful and feasible use of the intervention.
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Affiliation(s)
- Jaishika Seedat
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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10
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Jaca A, Mulopo C, Wiysonge CS, Schmidt BM. A mapping exercise to identify the strengths, and gaps in knowledge translation activities at Cochrane South Africa. Pan Afr Med J 2023; 45:64. [PMID: 37637392 PMCID: PMC10460110 DOI: 10.11604/pamj.2023.45.64.38075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/13/2022] [Indexed: 08/29/2023] Open
Abstract
Knowledge translation (KT) is a set of activities or processes for synthesising, disseminating, and applying research evidence in decision-making for the benefit of society. For KT to be successful, it is paramount for researchers to play an active role in encouraging evidence uptake and use in decision-making. We carried out a mapping exercise and interviews with research cluster heads at Cochrane South Africa (CSA) of the KT activities and processes being implemented (or are planned for implementation). We organized the mapping and interview results according to the KT themes described in the Cochrane KT framework. The KT framework comprises six themes, namely, (i) prioritization and co-production of research evidence; (ii) building a sustainable infrastructure for knowledge translation; (iii) engaging with audiences for knowledge exchange or dialogue; (iv) packaging, communication and dissemination which entails disseminating research to users; (v) building audience capacity to use evidence or training activities; and (vi) advocacy or improving the culture of using evidence. Through the mapping exercise and interviews, we learned that CSA researchers excelled in implementing activities and processes linked to most of the KT themes, including producing different types of systematic reviews and providing reliable evidence for health decision-making. Cochrane South Africa (CSA) researchers are also involved in mentoring and training postgraduate students and various health decision-makers (e.g., health professionals, guideline panels and policy-makers). While they excel in the above-mentioned activities, "packaging, communication, and dissemination of research evidence" (theme iv) was identified as an area of improvement.
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Affiliation(s)
- Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Chanelle Mulopo
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa
| | - Bey-Marrié Schmidt
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health, University of the Western Cape, Bellville, South Africa
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Barreto JOM, Romão DMM, Setti C, Machado MLT, Riera R, Gomes R, da Silva SF. Competency profiles for evidence-informed policy-making (EIPM): a rapid review. Health Res Policy Syst 2023; 21:16. [PMID: 36755283 PMCID: PMC9909856 DOI: 10.1186/s12961-023-00964-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Evidence-informed policy-making (EIPM) requires a set of individual and organizational capacities, linked with background factors and needs. The identification of essential knowledge, skills and attitudes for EIPM can support the development of competency profiles and their application in different contexts. PURPOSE To identify elements of competency (knowledge, skills and attitudes) for EIPM, according to different professional profiles (researcher, health professional, decision-maker and citizen). METHODS Rapid umbrella review. A structured search was conducted and later updated in two comprehensive repositories (BVSalud and PubMed). Review studies with distinctive designs were included, published from 2010 onwards, without language restrictions. Assessment of the methodological quality of the studies was not performed. A meta-aggregative narrative synthesis was used to report the findings. RESULTS Ten reviews were included. A total of 37 elements of competency were identified, eight were categorized as knowledge, 19 as skills and 10 as attitudes. These elements were aggregated into four competency profiles: researcher, health professional, decision-maker and citizen. The competency profiles included different sets of EIPM-related knowledge, skills and attitudes. STRENGTHS AND LIMITATIONS This study is innovative because it aggregates different profiles of competency from a practical perspective, favouring the application of its results in different contexts to support EIPM. Methodological limitations are related to the shortcuts adopted in this review: complementary searches of the grey literature were not performed, and the study selection and data extraction were not conducted in duplicate. FINAL CONSIDERATIONS CONCLUSIONS AND IMPLICATIONS OF THE FINDINGS: EIPM requires the development of individual and organizational capacities. This rapid review contributes to the discussion on the institutionalization of EIPM in health systems. The competency profiles presented here can support discussions about the availability of capacity and the need for its development in different contexts.
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Affiliation(s)
- Jorge Otávio Maia Barreto
- Hospital Sírio-Libanês (HSL), São Paulo, Brazil. .,Fundação Oswaldo Cruz (Fiocruz), Brasília, Brazil.
| | - Davi Mamblona Marques Romão
- grid.413471.40000 0000 9080 8521Hospital Sírio-Libanês (HSL), São Paulo, Brazil ,Instituto Veredas, São Paulo, Brazil
| | | | - Maria Lúcia Teixeira Machado
- grid.413471.40000 0000 9080 8521Hospital Sírio-Libanês (HSL), São Paulo, Brazil ,grid.411247.50000 0001 2163 588XUniversidade Federal de São Carlos (UFSCar), São Paulo, Brazil
| | - Rachel Riera
- grid.413471.40000 0000 9080 8521Hospital Sírio-Libanês (HSL), São Paulo, Brazil ,grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Romeu Gomes
- grid.413471.40000 0000 9080 8521Hospital Sírio-Libanês (HSL), São Paulo, Brazil ,grid.418068.30000 0001 0723 0931Fundação Oswaldo Cruz (IFF/Fiocruz), Rio de Janeiro, Brazil
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Baynes C, Steyn P, Soi C, Dinis A, Tembe S, Mehrtash H, Narasimhan M, Kiarie J, Sherr K. Use of implementation science to advance family planning programs in low- and middle-income countries: A systematic review. Front Glob Womens Health 2022; 3:1038297. [PMID: 36561275 PMCID: PMC9763469 DOI: 10.3389/fgwh.2022.1038297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Objective As environmental and economic pressures converge with demands to achieve sustainability development goals, low- and middle-income countries (LMIC) increasingly require strategies to strengthen and scale-up evidence-based practices (EBP) related to family planning (FP). Implementation science (IS) can help these efforts. The purpose of this article is to elucidate patterns in the use of IS in FP research and identify ways to maximize the potential of IS to advance FP in LMIC. Design and methods We conducted a systematic review that describes how IS concepts and principles have been operationalized in LMIC FP research published from 2007-2021. We searched six databases for implementation studies of LMIC FP interventions. Our review synthesizes the characteristics of implementation strategies and research efforts used to enhance the performance of FP-related EBP in these settings, identifying gaps, strengths and lessons learned. Results Four-hundred and seventy-two studies were eligible for full-text review. Ninety-two percent of studies were carried out in one region only, whereas 8 percent were multi-country studies that took place across multiple regions. 37 percent of studies were conducted in East Africa, 21 percent in West and Central Africa, 19 percent in Southern Africa and South Asia, respectively, and fewer than 5 percent in other Asian countries, Latin America and Middle East and North Africa, respectively. Fifty-four percent were on strategies that promoted individuals' uptake of FP. Far fewer were on strategies to enhance the coverage, implementation, spread or sustainability of FP programs. Most studies used quantitative methods only and evaluated user-level outcomes over implementation outcomes. Thirty percent measured processes and outcomes of strategies, 15 percent measured changes in implementation outcomes, and 31 percent report on the effect of contextual factors. Eighteen percent reported that they were situated within decision-making processes to address locally identified implementation issues. Fourteen percent of studies described measures to involve stakeholders in the research process. Only 7 percent of studies reported that implementation was led by LMIC delivery systems or implementation partners. Conclusions IS has potential to further advance LMIC FP programs, although its impact will be limited unless its concepts and principles are incorporated more systematically. To support this, stakeholders must focus on strategies that address a wider range of implementation outcomes; adapt research designs and blend methods to evaluate outcomes and processes; and establish collaborative research efforts across implementation, policy, and research domains. Doing so will expand opportunities for learning and applying new knowledge in pragmatic research paradigms where research is embedded in usual implementation conditions and addresses critical issues such as scale up and sustainability of evidence-informed FP interventions.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42020199353.
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Affiliation(s)
- Colin Baynes
- Department of Global Health, University of Washington, Seattle, WA, United States,Correspondence: Colin Baynes
| | - Petrus Steyn
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Caroline Soi
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Aneth Dinis
- Department of Global Health, University of Washington, Seattle, WA, United States,The National Directorate of Public Health, Ministry of Health of Mozambique, Maputo, Mozambique
| | - Stelio Tembe
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Hedieh Mehrtash
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - James Kiarie
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, United States,Department of Epidemiology, University of Washington, Seattle, WA, United States,Department of Industrial and Systems Engineering, University of Washington, Seattle, WA, United States
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13
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Binagwaho A, Hirwe D, Mathewos K. Health System Resilience: Withstanding Shocks and Maintaining Progress. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2200076. [PMID: 36109051 PMCID: PMC9476489 DOI: 10.9745/ghsp-d-22-00076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/15/2022] [Indexed: 12/03/2022]
Abstract
Building a resilient system capable of responding to health threats while maintaining essential health service delivery requires health systems to embed implementation research capacity to create the knowledge needed, ensure the affordability and accessibility of health care services at all levels of delivery, and provide the range of services needed to meet the population’s needs.
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Affiliation(s)
| | - Dennis Hirwe
- University of Global Health Equity, Kigali, Rwanda
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14
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Ahmadi A, Yazdizadeh B, Doshmangir L, Majdzadeh R, Asghari S. PROTOCOL: Systematic review of methods to reduce risk of bias in knowledge translation interventional studies in health-related issues. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1236. [PMID: 36911351 PMCID: PMC9005927 DOI: 10.1002/cl2.1236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Review studies have reported on the low quality of study methodologies and poor reporting of knowledge translation (KT) interventional studies. This flaw cause the result of such studies to become misleading. OBJECTIVES The present review is designed to evaluate the effect of methodological factors on the results of interventional studies that aimed to evaluate KT strategies at the policy level. SEARCH METHODS Bibliographic databases and grey literature databases will be searched. The retrieved studies will be recorded in Covidence. After screening titles and abstracts, the full texts of selected studies will be assessed against the inclusion criteria. Disagreements will be resolved through discussion or by consultation with a third author. SELECTION CRITERIA Primary studies are studies that aimed to estimate the efficacy of KT strategies to improve evidence-informed policymaking. Study participants include policymakers and the intervention is a KT strategy. The main outcome is the desired changes in policy-makers towards evidence-informed decision-making. DATA COLLECTION AND ANALYSIS The main effect sizes will be expressed as standard mean difference and its variance for the main efficacy outcome of KT strategies in primary studies. Forest plot meta-analysis will be used to synthesize the effect of each group of KT strategies. The contribution of ROB to the efficacy of KT interventions will be assessed via Meta-epidemiology analysis. The overall estimate will be calculated using inverse-variance random-effects meta-analysis with a 95% confidence interval for the estimate.
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Affiliation(s)
- Ayat Ahmadi
- Knowledge Utilization Research CenterTehran University of Medical SciencesTehranIran
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research CenterTehran University of Medical SciencesTehranIran
| | - Leila Doshmangir
- Department of Health Policy & ManagementTabriz Health Services Management Research Center, School of Management & medical informatics, Tabriz University of Medical SciencesTabrizIran
| | - Reza Majdzadeh
- Community Based Participatory Research Center, Knowledge Utilization Research CenterTehran University of Medical ScienceTehranIran
| | - Shabnam Asghari
- Family MedicineMemorial University of NewfoundlandSt. John'sCanada
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15
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Mwendera CA, Mzilahowa T, Njiokou F, N'falé S, Amegee Quach J, Thomsen E, Dabire R, Ranson H, Alhassan N, Oronje R, Worrall E. Knowledge translation and evidence generation to increase the impact of vector control in Burkina Faso, Cameroon and Malawi. BMJ Glob Health 2022; 7:e008378. [PMID: 35545288 PMCID: PMC9096501 DOI: 10.1136/bmjgh-2021-008378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/13/2022] [Indexed: 11/07/2022] Open
Abstract
Lack of context-specific evidence and inadequate evidence-use for decision-making contribute to poor health. This paper reports on our work aimed at addressing the knowledge translation (KT) gap between evidence generators and users. We present our experiences of strengthening KT via technical advisory groups (TAGs) in parallel with increasing evidence generation through research fellowships and operational research. Vectorborne diseases (VBDs) impose substantial health and economic burdens in sub-Saharan Africa despite being preventable with vector control. The Partnership for Increasing the Impact of Vector Control aimed to reduce the burden of VBDs in Burkina Faso, Cameroon, Malawi and at regional and global levels. TAGs can promote evidence-use in policy and practice by engaging relevant stakeholders in both research and policy processes. TAGs and related activities are best facilitated by a coordinator with skills in research and policy. Contextual factors should influence the design and governance of TAGs, which will likely evolve over time. Relevant national stakeholders should be included in TAGs and be actively involved in developing research agendas to increase the relevance and acceptability of research findings for decision-making. The countries present three differing contexts with longer-term research and evaluation necessary to draw lessons on impact.
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Affiliation(s)
| | - Themba Mzilahowa
- Malaria Alert Centre, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Flobert Njiokou
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon
| | - Sagnon N'falé
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Jessica Amegee Quach
- Centre for Capacity Research, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Edward Thomsen
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Roch Dabire
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Hilary Ranson
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rose Oronje
- African Institute for Development Policy, Nairobi, Kenya
| | - Eve Worrall
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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Kiendrébéogo JA, Tapsoba C, Kafando Y, Kaboré I, Sory O, Yaméogo SP. The Landscape of Strategic Health Purchasing for Universal Health Coverage in Burkina Faso: Insights from Five Major Health Financing Schemes. Health Syst Reform 2022; 8:2097588. [PMID: 35960162 DOI: 10.1080/23288604.2022.2097588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Strategic health purchasing is a key strategy in Burkina Faso to spur progress toward universal health coverage (UHC). However, a comprehensive analysis of existing health financing arrangements and their purchasing functions has not been undertaken to date. This article provides an in-depth analysis of five key health financing schemes in Burkina Faso: Gratuité (a national free health care program for women and children under age 5), crédits délégués (delegated credits), crédits transférés (transfers to municipalities), community-based health insurance, and occupation-based health insurance. This study involved a document review and complementary key informant interviews using the Strategic Health Purchasing Progress Tracking Framework developed by the Strategic Purchasing Africa Resource Center (SPARC). Data were collected using the framework's accompanying Microsoft Excel-based tool. We analyzed the data manually to examine and identify the strengths and weaknesses of governance arrangements and purchasing functions and capacities. The study provides insight into areas that are working well from a strategic purchasing perspective and, more importantly, areas that need more attention. Areas for improvement include low financial and managerial autonomy for some schemes, weak accountability measures, lack of explicit quality standards for contracting and for service delivery, budget overruns and late provider payment, provider payment that is not linked to provider performance, fragmented health information systems, and information generated is not linked to purchasing decisions. Improvements in purchasing functions are required to address shortcomings while consolidating achievements. This study will inform next steps for Burkina Faso to improve purchasing and advance progress toward UHC.
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Affiliation(s)
- Joël Arthur Kiendrébéogo
- Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.,Department of Health Research, Recherche pour la Santé et le Développement (RESADE), Burkina Faso
| | - Charlemagne Tapsoba
- Department of Health Research, Recherche pour la Santé et le Développement (RESADE), Burkina Faso.,Department of Health Promotion and Prevention, Centre de Recherche en Santé de Nouna (CRSN), Burkina Faso
| | - Yamba Kafando
- Department of Health Research, Recherche pour la Santé et le Développement (RESADE), Burkina Faso
| | - Issa Kaboré
- Department of Health Research, Recherche pour la Santé et le Développement (RESADE), Burkina Faso
| | - Orokia Sory
- Department of Health Research, Recherche pour la Santé et le Développement (RESADE), Burkina Faso
| | - S Pierre Yaméogo
- Secrétariat Technique en charge de la Couverture Sanitaire Universelle (ST/CSU) au Ministère de la Santé du Burkina Faso, Burkina Faso
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17
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Mahendradhata Y, Kalbarczyk A. Editorial: Knowledge Translation for Disease Control in Low- and Middle-Income Countries. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.851122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Chapman E, Pantoja T, Kuchenmüller T, Sharma T, Terry RF. Assessing the impact of knowledge communication and dissemination strategies targeted at health policy-makers and managers: an overview of systematic reviews. Health Res Policy Syst 2021; 19:140. [PMID: 34865640 PMCID: PMC8645346 DOI: 10.1186/s12961-021-00780-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background The use of research evidence as an input for health decision-making is a need for most health systems. There are a number of approaches for promoting evidence use at different levels of the health system, but knowledge of their effectiveness is still scarce. The objective of this overview was to evaluate the effectiveness of knowledge communication and dissemination interventions, strategies or approaches targeting policy-makers and health managers. Methods This overview of systematic reviews used systematic review methods and was conducted according to a predefined and published protocol. A comprehensive electronic search of 13 databases and a manual search in four websites were conducted. Both published and unpublished reviews in English, Spanish or Portuguese were included. A narrative synthesis was undertaken, and effectiveness statements were developed, informed by the evidence identified. Results We included 27 systematic reviews. Three studies included only a communication strategy, while eight only included dissemination strategies, and the remaining 16 included both. None of the selected reviews provided “sufficient evidence” for any of the strategies, while four provided some evidence for three communication and four dissemination strategies. Regarding communication strategies, the use of tailored and targeted messages seemed to successfully lead to changes in the decision-making practices of the target audience. Regarding dissemination strategies, interventions that aimed at improving only the reach of evidence did not have an impact on its use in decisions, while interventions aimed at enhancing users’ ability to use and apply evidence had a positive effect on decision-making processes. Multifaceted dissemination strategies also demonstrated the potential for changing knowledge about evidence but not its implementation in decision-making. Conclusions There is limited evidence regarding the effectiveness of interventions targeting health managers and policy-makers, as well as the mechanisms required for achieving impact. More studies are needed that are informed by theoretical frameworks or specific tools and using robust methods, standardized outcome measures and clear descriptions of the interventions. We found that passive communication increased access to evidence but had no effect on uptake. Some evidence indicated that the use of targeted messages, knowledge-brokering and user training was effective in promoting evidence use by managers and policy-makers. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00780-4.
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Affiliation(s)
| | - Tomas Pantoja
- Family Medicine Department, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Tanja Kuchenmüller
- Evidence to Policy and Impact, Research for Health - Science Division - World Health Organization, Geneva, Switzerland
| | | | - Robert F Terry
- Manager Research Policy, The Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.
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Shafaghat T, Zarchi MKR, Nasab MHI, Kavosi Z, Bahrami MA, Bastani P. Force field analysis of driving and restraining factors affecting the evidence-based decision-making in health systems; comparing two approaches. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:419. [PMID: 35071625 PMCID: PMC8719555 DOI: 10.4103/jehp.jehp_1142_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND All policies and decisions need evidence examined by scientific methods. Moving toward evidence-based decision-making (EBDM) as a change in organizations, especially health systems (HSs), is inevitable. This study was conducted to identify the factors affecting EBDM in HSs from two approaches and to score them. MATERIALS AND METHODS A mixed-method study was carried out using the force field analysis regarding the change toward EBDM in HS in 2020. This study included six steps to identify and score the key driving forces (DFs) and restraining forces (RFs) to change toward the EBDM in HS: first, finding forces from literature; second, selecting key DFs and RFs through focus group discussion; third, scoring the first group of DFs and RFs by the experts through electronic forms; fourth, determining key DFs and RFs from the managers' perspective using qualitative interviews; fifth, scoring the second group of DFs and RFs by the experts; and sixth, comparison between forces resulted from two approaches. RESULTS According to the literature and experts' opinions, "relevant, reliable, interpretable, and understandable evidence" and "interaction between researchers and decision-makers" were the strongest forces to change, and "lack of organizational commitment and support" and "lack of relevant/high-quality evidence" were the strongest forces against the change toward EBDM in HS. Further, based on managers' perspective and scores by the experts, "suitable supervision and control" and "reforming the planning and decision-making system" were the strongest forces to change, and "inadequate knowledge of the managers and staff about the principles and contents of EBDM" and "issues beyond the authorities of managers" were the strongest forces against the change toward EBDM in HS. CONCLUSIONS Based on the findings, HSs' managers can focus to reduce RFs and promote DFs for implementing EBDM strategies, so they can provide better services by making more efficient decisions.
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Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, Department of Health Care Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Department of Health Care Management, Health Policy and Management Research Center, School of Public Health, Shahid Saoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Kavosi
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahammad Amin Bahrami
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
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Mojiri S, Sahebzadeh M, Ahmadzadeh K, Daei A, Ashrafi-Rizi H, Demneh MT, Sajadi HS, Soleymani MR. Effective factors on establishment of knowledge translation in the health system policy-making: A protocol for systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:394. [PMID: 34912930 PMCID: PMC8641722 DOI: 10.4103/jehp.jehp_1298_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/07/2021] [Indexed: 06/14/2023]
Abstract
Despite the importance and position of evidence-based policymaking in the proper management of the health system, studies show that the lack or improper and untimely use of evidence are still one of the main challenges of health systems. Knowledge translation as a solution to this challenge is a process that includes a period of time that starts of decision to choose the research topic and continue to publish of research results, in which the interaction of the researchers and stakeholders is the key factor and the main axis of the process. Since the recognition and promotion of knowledge translation processes resulting from research in health system policy-making will lead to the improvement of the health system, this review protocol was designed to identify factors affecting knowledge translation implementation, including barriers and facilitators of this process. Identifying these factors can be used as a guide for health system decision-makers and research managers in planning to select appropriate policies for deployment of the knowledge translation process to increase the use of research results in the health system.
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Affiliation(s)
- Shahin Mojiri
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mandana Sahebzadeh
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khadijeh Ahmadzadeh
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Medical Library and Information Sciences, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Ashrafi-Rizi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Taheri Demneh
- Department of Industrial Engineering and Futures Studies, University of Isfahan, Isfahan, Iran
| | - Haniye Sadat Sajadi
- Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Soleymani
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Niyibizi JB, Nganabashaka JP, Ntawuyirushintege S, Tumusiime D, Umwali G, Rulisa S, Nyandwi A, Okop KJ, Ntaganda E, Sell K, Levitt N, Jessani NS, Bavuma CM. Using Citizen Science Within an Integrated Knowledge Translation (IKT) Approach to Explore Cardiovascular Disease Risk Perception in Rwanda. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.752357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BackgroundCollaborative approaches to generating knowledge between knowledge users (KUs) and researchers as a means of enhancing evidence-informed decision making have been gaining ground over the last few years. The principal study targeted rural and urban communities within the catchment areas of Cyanika health centre (Burera district, Northern Province) and Kacyiru health centre (Gasabo district, in City of Kigali), respectively to understand perceptions and preferences of communication with respect to cardiovascular disease (CVD) risk in Rwanda. This paper describes the integration of citizen science within an integrated knowledge translation (IKT) approach for this study.MethodsThe citizen science approach included deliberate, selective and targeted engagement of KUs at various steps throughout the study. It incorporated national and district levels stakeholders, primary health care stakeholders, local community leaders and influencers, and local community members (selected and trained to be termed citizen scientists) in the process of implementation. Data for this paper included minutes, reports and notes from meetings and workshops which were perused to report the immediate outcomes and challenges of citizen science within an IKT approach for a study such as described for Rwanda.ResultsAs a result of a deliberate IKT strategy, key national stakeholders attended and contributed to all phases of citizen science implementation. Project-based and relationship-based immediate outcomes were documented. In line with local community health issues reported by the citizen scientists, the local community stakeholders pledged home grown solutions. These included enhancement of compliance to implement the “kitchen garden per household” policy, teaching local residents on preparation of healthy diet from locally available food items, organizing collective physical activity, fighting against locally made substandard beverages and teaching local residents on CVD (risk factors). As an indicator of the probable uptake of research evidence, district officials appreciated citizen scientists’ work and decided to consider presented results in their next fiscal year action plan.ConclusionCitizen science proved to be an important strategy for research co-production in Rwanda. While this strategy falls within the remit of a larger IKT approach it focuses on the role and ownership of research by local community residents. This study demonstrated that to improve the relevance and impact of research in local community a deliberate IKT approach that incorporates citizen science can be invaluable.
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Tourani S, Rafiei N, Rimaz S, Malakouti SK, Heidari A. Knowledge Translation Improvement Strategies in Universities of Medical Sciences in Iran: A Qualitative Study. Ethiop J Health Sci 2021; 31:129-138. [PMID: 34158760 PMCID: PMC8188096 DOI: 10.4314/ejhs.v31i1.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Recently, one of the challenges in the health system of the country is the need for research contributing to policy-making. Therefore, it is crucial to develop activities in the field of knowledge Translation (KT). This study aimed to propose KT improvement strategies in universities of medical sciences in Iran. Methods In this qualitative study, 18 semi-structured interviews were conducted with key informants from the medical universities in Iran during January-July 2018. The transcribed documents were analyzed using the Gale framework analysis approach. Data organization was carried out using MAXQDA version 10 software. Results According to framework analysis, six KT improvement strategies were identified including improving the abilities and skills of researchers, improving the processes and quality of knowledge production, revising policies and laws, improving the prerequisites, culture-building, and promoting the use of evidence. Conclusion Given the challenges and strategies outlined in this study, it seems that the mechanism of KT and its effects on improving health plans for policymakers and researchers has not been elucidated yet. Therefore, considerable changes in prerequisites, knowledge production processes, academic procedures, policies and laws are necessary for implementing KT in universities of medical sciences in Iran.
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Affiliation(s)
- Sogand Tourani
- Department of Health Services Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Narges Rafiei
- Department of Health Services Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Iran
| | - Shahnaz Rimaz
- Radiation Biology Research Center, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Kazem Malakouti
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Heidari
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Villegas AC, Saylor D, Kvalsund M, Atadzhanov M, Chiluba C, Chishimba L, Zimba S, Chomba M, Siddiqi OK. Task-shifting to optimize outpatient neurological care in Zambia. HUMAN RESOURCES FOR HEALTH 2021; 19:88. [PMID: 34271924 PMCID: PMC8283831 DOI: 10.1186/s12960-021-00619-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 06/10/2021] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate opportunities for task shifting to decongest an outpatient neurology clinic in Zambia by describing current patient flow through the clinic and potential nodes for intervention using process mapping. BACKGROUND Zambia has a population of approximately 18 million people with 4 full-time adult neurologists, as of 2018, who all practice at the University Teaching Hospital (UTH), the main tertiary care center in the country. As a result of this provider-to-patient ratio, the outpatient neurology clinic is overcrowded and overbooked. Task-shifting programs have shown to improve efficiency, access and quality of care through the use of less specialized healthcare workers in low- and middle-income countries (LMIC). METHODS We evaluated patient flow in the UTH neurology outpatient clinic through the development and analysis of a process map. The characteristics of the clinic population between 2014 and 2018 were retrospectively reviewed from the clinic register. Between July and August 2018, we prospectively collected appointment lag times and time each patient spent waiting at various points in the clinic process. We conducted interviews with clinic staff and neurologists to generate a detailed process map of current pathways to care within the clinic. We then devised task-shifting strategies to help reduce patient wait times based on the overview of clinic process mapping and patient demographics. RESULTS From 2014 to 2018, there were 4701 outpatients seen in the neurology clinic. The most common neurological diagnoses were epilepsy (39.2%), headache (21.5%) and cerebrovascular disease (16.7%). During prospective data collection, patients waited an average of 57.8 (SD 73.4) days to be seen by a neurologist. The average wait time from arrival in the clinic to departure was 4.0 (SD 2.5) h. The process map and interviews with clinic staff revealed long waiting times due to a paucity of providers. Nurses and clerks represent an influential stakeholder group, but are not actively involved in any activity to reduce wait times. A large proportion of follow-up patients were stable and seen solely to obtain medication refills. CONCLUSIONS Epilepsy, headache, and stroke make up the largest percentage of outpatient neurological illness in Zambia. Targeting stable patients in these diagnostic categories for a task-shifting intervention may lead to substantially decreased patient wait times. Potential interventions include shifting clinical follow-ups and medication refills to less specialized healthcare workers.
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Affiliation(s)
- Ana C Villegas
- School of Public Health, Boston University, Boston, MA, USA
| | - Deanna Saylor
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle Kvalsund
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
- International Neurologic & Psychiatric Epidemiology Program, Department of Neurology & Ophthalmology, Michigan State University, East Lansing, MI, USA
| | - Masharip Atadzhanov
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Clarence Chiluba
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Lorraine Chishimba
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Stanley Zimba
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Mashina Chomba
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Omar K Siddiqi
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
- Global Neurology Program, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
- Center for Virology and Vaccine Research, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Jessani NS, Rohwer A, Schmidt BM, Delobelle P. Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa: application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Health Res Policy Syst 2021; 19:82. [PMID: 34001141 PMCID: PMC8127442 DOI: 10.1186/s12961-021-00733-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/03/2021] [Indexed: 11/11/2022] Open
Abstract
Background In response to the “know–do” gap, several initiatives have been implemented to enhance evidence-informed decision-making (EIDM). These include individual training, organizational culture change management, and legislative changes. The importance of relationships and stakeholder engagement in EIDM has led to an evolution of models and approaches including integrated knowledge translation (IKT). IKT has emerged as a key strategy for ensuring that engagement is equitable, demand-driven, and responsive. As a result, the African-German Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) incorporated an IKT approach to influence noncommunicable diseases (NCD) policy and practice. We documented the phased process of developing, implementing, and monitoring the IKT approach in South Africa; and explored the appropriateness of using the exploration, preparation, implementation, and sustainment (EPIS) framework for this purpose. Methods We mapped the South Africa IKT approach onto the EPIS framework using a framework analysis approach. Notes of team meetings, stakeholder matrices, and engagement strategies were analysed and purposefully plotted against the four phases of the framework in order to populate the different constructs. We discussed and finalized the analysis in a series of online iterations until consensus was reached. Results The mapping exercise revealed an IKT approach that was much more iterative, dynamic, and engaging than initially thought. Several constructs (phase-agnostic) remained important and stable across EPIS phases: stable and supportive funding; committed and competent leadership; skilled and dedicated IKT champions; diverse and established personal networks; a conducive and enabling policy environment; and boundary-spanning intermediaries. Constructs such as “innovations” constantly evolved and adapted to the changing inner and outer contexts (phase-specific). Conclusions Using the EPIS framework to interrogate, reflect on, and document our IKT experiences proved extremely relevant and useful. Phase-agnostic constructs proved critical to ensure resilience and agility of NCD deliberations and policies in the face of highly dynamic and changing local contexts, particularly in view of the current coronavirus disease 2019 (COVID-19) pandemic. Bridging IKT with a framework from implementation science helps to reflect on this process and can guide the development and planning of similar interventions and strategies.
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Affiliation(s)
- Nasreen S Jessani
- Division of Epidemiology and Biostatistics, Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. .,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Anke Rohwer
- Division of Epidemiology and Biostatistics, Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Bey-Marrie Schmidt
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Peter Delobelle
- Chronic Disease Initiative for Africa, University of Cape Town, Cape Town, South Africa.,Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
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Whitehorn A, Fu L, Porritt K, Lizarondo L, Stephenson M, Marin T, Aye Gyi A, Dell K, Mignone A, Lockwood C. Mapping Clinical Barriers and Evidence-Based Implementation Strategies in Low-to-Middle Income Countries (LMICs). Worldviews Evid Based Nurs 2021; 18:190-200. [PMID: 33973346 PMCID: PMC8251858 DOI: 10.1111/wvn.12503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 11/30/2022]
Abstract
Background Low‐to‐middle income countries (LMICs) experience a high burden of disease from both non‐communicable and communicable diseases. Addressing these public health concerns requires effective implementation strategies and localization of translation of knowledge into practice. Aim To identify and categorize barriers and strategies to evidence implementation in LMICs from published evidence implementation studies. Methods A descriptive analysis of key characteristics of evidence implementation projects completed as part of a 6‐month, multi‐phase, intensive evidence‐based clinical fellowship program, conducted in LMICs and published in the JBI Database of Systematic Reviews and Implementation Reports was undertaken. Barriers were identified and categorized to the Donabedian dimensions of care (structure, process, and outcome), and strategies were mapped to the Cochrane effective practice and organization of care taxonomy. Results A total of 60 implementation projects reporting 58 evidence‐based clinical audit topics from LMICs were published between 2010 and 2018. The projects included diverse populations and were predominantly conducted in tertiary care settings. A total of 279 barriers to implementation were identified. The most frequently identified groupings of barriers were process‐related and associated predominantly with staff knowledge. A total of 565 strategies were used across all projects, with every project incorporating more than one strategy to address barriers to implementation of evidence‐based practice; most strategies were categorized as educational meetings for healthcare workers. Linking Evidence to Action Context‐specific strategies are required for successful evidence implementation in LMICs, and a number of common barriers can be addressed using locally available, low‐cost resources. Education for healthcare workers in LMICs is an effective awareness‐raising, workplace culture, and practice‐transforming strategy for evidence implementation.
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Affiliation(s)
| | - Liang Fu
- JBI, The University of Adelaide, Adelaide, SA, Australia.,Department of Nursing, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, China.,School of Nursing, Fudan University, Shanghai, China
| | - Kylie Porritt
- JBI, The University of Adelaide, Adelaide, SA, Australia
| | | | | | - Tania Marin
- JBI, The University of Adelaide, Adelaide, SA, Australia
| | - Aye Aye Gyi
- JBI, The University of Adelaide, Adelaide, SA, Australia
| | - Kim Dell
- JBI, The University of Adelaide, Adelaide, SA, Australia
| | - Alex Mignone
- JBI, The University of Adelaide, Adelaide, SA, Australia
| | - Craig Lockwood
- JBI, The University of Adelaide, Adelaide, SA, Australia
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Nnaji CA, Wiysonge CS, Okeibunor JC, Malinga T, Adamu AA, Tumusiime P, Karamagi H. Implementation research approaches to promoting universal health coverage in Africa: a scoping review. BMC Health Serv Res 2021; 21:414. [PMID: 33941178 PMCID: PMC8094606 DOI: 10.1186/s12913-021-06449-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/27/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of initiatives promoting the uptake of implementation research in Africa, its role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). Hence, this scoping review aimed to identify and characterise the use of implementation research initiatives for assessing UHC-related interventions or programmes in Africa. METHODS The review protocol was developed based on the methodological framework proposed by Arksey and O'Malley, as enhanced by the Joanna Briggs Institute. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). MEDLINE, Scopus and the Cochrane Library were searched. The search also included a hand search of relevant grey literature and reference lists. Literature sources involving the application of implementation research in the context of UHC in Africa were eligible for inclusion. RESULTS The database search yielded 2153 records. We identified 12 additional records from hand search of reference lists. After the removal of duplicates, we had 2051 unique records, of which 26 studies were included in the review. Implementation research was used within ten distinct UHC-related contexts, including HIV; maternal and child health; voluntary male medical circumcision; healthcare financing; immunisation; healthcare data quality; malaria diagnosis; primary healthcare quality improvement; surgery and typhoid fever control. The consolidated framework for implementation research (CFIR) was the most frequently used framework. Qualitative and mixed-methods study designs were the commonest methods used. Implementation research was mostly used to guide post-implementation evaluation of health programmes and the contextualisation of findings to improve future implementation outcomes. The most commonly reported contextual facilitators were political support, funding, sustained collaboration and effective programme leadership. Reported barriers included inadequate human and other resources; lack of incentives; perception of implementation as additional work burden; and socio-cultural barriers. CONCLUSIONS This review demonstrates that implementation research can be used to achieve UHC-related outcomes in Africa. It has identified important facilitators and barriers to the use of implementation research for promoting UHC in the region.
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Affiliation(s)
- Chukwudi A Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Joseph C Okeibunor
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Thobile Malinga
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Abdu A Adamu
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Prosper Tumusiime
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Humphrey Karamagi
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Nnaji CA, Wiysonge CS, Okeibunor J, Malinga T, Adamu AA, Tumusiime P, Karamagi H. Protocol for a scoping review of implementation research approaches to universal health coverage in Africa. BMJ Open 2021; 11:e041721. [PMID: 33589452 PMCID: PMC7887369 DOI: 10.1136/bmjopen-2020-041721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of institutions and initiatives promoting the uptake of implementation research in Africa, their role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). This review aims to extensively identify and characterise the nature, facilitators and barriers to the use of implementation research for assessing or evaluating UHC-related interventions or programmes in Africa. METHODS AND ANALYSIS This scoping review will be developed based on the methodological framework proposed by Arksey and O'Malley and enhanced by the Joanna Briggs Institute. It will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search of the following electronic databases will be conducted: Medline (via PubMed), Scopus and the Cochrane Library. Relevant grey literature and reference lists will also be searched. All publications describing the application of implementation research in the context of UHC will be considered for inclusion. Findings will be narratively synthesised and analysed using a predefined conceptual framework. Where applicable, quantitative evidence will be aggregated using summary statistics. There will be consultation of stakeholders, including UHC-oriented health professionals, programme managers, implementation researchers and policy-makers; to provide methodological, conceptual and practical insights. ETHICS AND DISSEMINATION The data used in this review will be sourced from publicly available literature; hence, this study will not require ethical approval. Findings and recommendations will be disseminated to reach a diverse audience, including UHC advocates, implementation researchers and key health system stakeholders within the African region. Additionally, findings will be disseminated through an open-access publication in a relevant peer-reviewed journal.
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Affiliation(s)
- Chukwudi A Nnaji
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles S Wiysonge
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Joseph Okeibunor
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Thobile Malinga
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Abdu A Adamu
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Prosper Tumusiime
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Humphrey Karamagi
- Health Systems and Services Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Pfadenhauer LM, Grath T, Delobelle P, Jessani N, Meerpohl JJ, Rohwer A, Schmidt BM, Toews I, Akiteng AR, Chapotera G, Kredo T, Levitt N, Ntawuyirushintege S, Sell K, Rehfuess EA. Mixed method evaluation of the CEBHA+ integrated knowledge translation approach: a protocol. Health Res Policy Syst 2021; 19:7. [PMID: 33461592 PMCID: PMC7813167 DOI: 10.1186/s12961-020-00675-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022] Open
Abstract
Background The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) is a research consortium concerned with the prevention, diagnosis and treatment of non-communicable diseases. CEBHA+ seeks to engage policymakers and practitioners throughout the research process in order to build lasting relationships, enhance evidence uptake, and create long-term capacity among partner institutions in Ethiopia, Malawi, Rwanda, South Africa and Uganda in collaboration with two German universities. This integrated knowledge translation (IKT) approach includes the formal development, implementation and evaluation of country specific IKT strategies. Methods We have conceptualised the CEBHA+ IKT approach as a complex intervention in a complex system. We will employ a comparative case study (CCS) design and mixed methods to facilitate an in-depth evaluation. We will use quantitative surveys, qualitative interviews, quarterly updates, and a policy document analysis to capture the process and outcomes of IKT across the African CEBHA+ partner sites. We will conduct an early stage (early 2020) and a late-stage evaluation (early 2022), triangulate the data collected with various methods at each site and subsequently compare our findings across the five sites. Discussion Evaluating a complex intervention such as the CEBHA+ IKT approach is complicated, even more so when undertaken across five diverse countries. Despite conceptual, methodological and practical challenges, our comparative case study addresses important evidence gaps: While involving decision-makers in the research process is gaining traction worldwide, we still know very little regarding (i) whether this approach really makes a difference to evidence uptake, (ii) the mechanisms that make IKT successful, and (iii) relevant differences across socio-cultural contexts. The evaluation described here is intended to provide relevant insights on all of these aspects, notably in countries in Sub-Saharan Africa, and is expected to contribute to the science of IKT overall.
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Affiliation(s)
- Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany. .,Pettenkofer School of Public Health, Munich, Germany.
| | - Tanja Grath
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - Peter Delobelle
- Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.,Department of Public Health, Vrije Universiteit Brussel, Laarbeeklaan 103, Jette, 1090, Brussels, Belgium
| | - Nasreen Jessani
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Parow, Cape Town, 7500, South Africa.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, 21205, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 86, 79110, Freiburg Im Breigau, Germany.,Cochrane Germany, Cochrane Germany Foundation, Berliner Allee 2, 79110, Freiburg im Breisgau, Germany
| | - Anke Rohwer
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Parow, Cape Town, 7500, South Africa
| | - Bey-Marrié Schmidt
- Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerburg, 7500, South Africa
| | - Ingrid Toews
- Cochrane Germany, Cochrane Germany Foundation, Berliner Allee 2, 79110, Freiburg im Breisgau, Germany
| | - Ann R Akiteng
- College of Health Sciences, Makerere University, Plot 1 Upper Mulago Hill Road, Kampala, Uganda
| | - Gertrude Chapotera
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Mahatma Gandhi Road, Private Bag 360, Blantyre, Malawi
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerburg, 7500, South Africa.,Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Naomi Levitt
- Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa
| | | | - Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
| | - Eva A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany.,Pettenkofer School of Public Health, Munich, Germany
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Spagnolo J, Gautier L, Champagne F, Leduc N, Melki W, N'Guessan K, Charfi F. Reflecting on knowledge translation strategies from global health research projects in Tunisia and the Republic of Côte d'Ivoire. Int J Public Health 2020; 65:1559-1570. [PMID: 33068122 DOI: 10.1007/s00038-020-01502-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/26/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake. METHODS To generate findings for dissemination: (1) the Republic of Côte d'Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led prevention strategy targeting Ebola virus disease; and (2) the Tunisia project used several designs to assess a mental health training's effectiveness, and a case study design to explore contextual factors that may influence anticipated outcomes. RESULTS To share findings with participants, the RCI project relied on workshops and a pamphlet, and the Tunisia project relied on a structured half-day dissemination workshop and research summary. Facilitators that may have encouraged sharing and using findings include involving champions in dissemination activities, ongoing collaboration, and developing/implementing context-specific knowledge sharing strategies. Barriers include omitting to assess strategies, limited consideration of a wider audience, and the exclusion of a knowledge translation training component. CONCLUSIONS Our experiences might be useful to contexts involved in global and public health research that wish to address the "know-do gap."
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Affiliation(s)
- Jessica Spagnolo
- School of Public Health, Université de Montréal, Montreal, Canada.
- Department of Community Health Sciences, Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les Innovations en Santé, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada.
| | - Lara Gautier
- School of Public Health, Université de Montréal, Montreal, Canada
- Department of Sociology, McGill University, Montreal, Canada
| | | | - Nicole Leduc
- School of Public Health, Université de Montréal, Montreal, Canada
| | - Wahid Melki
- Hôpital Razi, Manouba, Tunisia
- Faculty of Medicine, Université de Tunis El-Manar, Tunis, Tunisia
| | - Konan N'Guessan
- Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
- Institut National d'Hygiène Publique, Abidjan, Côte d'Ivoire
| | - Fatma Charfi
- Faculty of Medicine, Université de Tunis El-Manar, Tunis, Tunisia
- Hôpital Mongi-Slim, La Marsa, Tunisia
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Hanney SR, Kanya L, Pokhrel S, Jones TH, Boaz A. How to strengthen a health research system: WHO's review, whose literature and who is providing leadership? Health Res Policy Syst 2020; 18:72. [PMID: 32571364 PMCID: PMC7308111 DOI: 10.1186/s12961-020-00581-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/21/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health research is important for the achievement of the Sustainable Development Goals. However, there are many challenges facing health research, including securing sufficient funds, building capacity, producing research findings and using both local and global evidence, and avoiding waste. A WHO initiative addressed these challenges by developing a conceptual framework with four functions to guide the development of national health research systems. Despite some progress, more is needed before health research systems can meet their full potential of improving health systems. The WHO Regional Office for Europe commissioned an evidence synthesis of the systems-level literature. This Opinion piece considers its findings before reflecting on the vast additional literature available on the range of specific health research system functions related to the various challenges. Finally, it considers who should lead research system strengthening. MAIN TEXT The evidence synthesis identifies two main approaches for strengthening national health research systems, namely implementing comprehensive and coherent strategies and participation in partnerships. The literature describing these approaches at the systems level also provides data on ways to strengthen each of the four functions of governance, securing financing, capacity-building, and production and use of research. Countries effectively implementing strategies include England, Ireland and Rwanda, whereas West Africa experienced effective partnerships. Recommended policy approaches for system strengthening are context specific. The vast literature on each function and the ever-growing evidence-base are illustrated by considering papers in just one key journal, Health Research Policy and Systems, and analysing the contribution of two national studies. A review of the functions of the Iranian system identifies over 200 relevant and mostly national records; an analysis of the creation of the English National Institute for Health Research describes the key leadership role played by the health department. Furthermore, WHO is playing leadership roles in helping coordinate partnerships within and across health research systems that have been attempting to tackle the COVID-19 crisis. CONCLUSIONS The evidence synthesis provides a firm basis for decision-making by policy-makers and research leaders looking to strengthen national health research systems within their own national context. It identifies five crucial policy approaches - conducting situation analysis, sustaining a comprehensive strategy, engaging stakeholders, evaluating impacts on health systems, and partnership participation. The vast and ever-growing additional literature could provide further perspectives, including on crucial leadership roles for health ministries.
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Affiliation(s)
- Stephen R. Hanney
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
| | - Lucy Kanya
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Subhash Pokhrel
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
| | - Teresa H. Jones
- Health Economics Research Group, Institute of Health, Environment and Societies, Brunel University London, Uxbridge, UB8 3PH United Kingdom
| | - Annette Boaz
- Faculty of Health, Social Care and Education, a partnership between Kingston University and St George’s, University of London, London, United Kingdom
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Votruba N, Grant J, Thornicroft G. The EVITA framework for evidence-based mental health policy agenda setting in low- and middle-income countries. Health Policy Plan 2020; 35:424-439. [PMID: 32040175 PMCID: PMC7195852 DOI: 10.1093/heapol/czz179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 01/23/2023] Open
Abstract
The burden of mental illness is excessive, but many countries lack evidence-based policies to improve practice. Mental health research evidence translation into policymaking is a 'wicked problem', often failing despite a robust evidence base. In a recent systematic review, we identified a gap in frameworks on agenda setting and actionability, and pragmatic, effective tools to guide action to link research and policy are needed. Responding to this gap, we developed the new EVITA 1.1 (EVIdence To Agenda setting) conceptual framework for mental health research-policy interrelationships in low- and middle-income countries (LMICs). We (1) drafted a provisional framework (EVITA 1.0); (2) validated it for specific applicability to mental health; (3) conducted expert in-depth interviews to (a) validate components and mechanisms and (b) assess intelligibility, functionality, relevance, applicability and effectiveness. To guide interview validation, we developed a simple evaluation framework. (4) Using deductive framework analysis, we coded and identified themes and finalized the framework (EVITA 1.1). Theoretical agenda-setting elements were added, as targeting the policy agenda-setting stage was found to lead to greater policy traction. The framework was validated through expert in-depth interviews (n = 13) and revised. EVITA 1.1 consists of six core components [advocacy coalitions, (en)actors, evidence generators, external influences, intermediaries and political context] and four mechanisms (capacity, catalysts, communication/relationship/partnership building and framing). EVITA 1.1 is novel and unique because it very specifically addresses the mental health research-policy process in LMICs and includes policy agenda setting as a novel, effective mechanism. Based on a thorough methodology, and through its specific design and mechanisms, EVITA has the potential to improve the challenging process of research evidence translation into policy and practice in LMICs and to increase the engagement and capacity of mental health researchers, policy agencies/planners, think tanks, NGOs and others within the mental health research-policy interface. Next, EVITA 1.1 will be empirically tested in a case study.
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Affiliation(s)
- Nicole Votruba
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Jonathan Grant
- Policy Institute at King’s, King’s College London, 1st Floor, Virginia Woolf Building, 22 Kingsway, London WC2B 6LE, UK
| | - Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
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Onwujekwe O, Mbachu C, Etiaba E, Ezumah N, Ezenwaka U, Arize I, Okeke C, Nwankwor C, Uzochukwu B. Impact of capacity building interventions on individual and organizational competency for HPSR in endemic disease control in Nigeria: a qualitative study. Implement Sci 2020; 15:22. [PMID: 32299484 PMCID: PMC7164165 DOI: 10.1186/s13012-020-00987-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need to build capacity for health policy and systems research (HPSR) in low- and middle-income countries has been underscored as this encompasses the processes of decision-making at all levels of the health system. This implementation research project was undertaken in Southeast Nigeria to evaluate whether the capacity-building intervention improves the capacity to produce and use research evidence for decision making in endemic disease control. METHODS Three training workshops were organized for purposively selected participants comprising "producers of evidence" such as health research scientists in three universities and "users of evidence" such as policy makers, program managers, and implementers in the public health sector. Participants also held step-down workshops in their organizations. The last workshop was used to facilitate the formation of knowledge networks comprising of both producers and users, which is a critical step for getting research into policy and practice (GRIPP). Three months after the workshops, a subset, 40, of workshop participants was selected for in-depth interviews. Information was collected on (i) perceptions of usefulness of capacity-building workshops, (ii) progress with proposed research and research uptake activities, (iii) effects of these activities on evidence-informed decision making, and (iv) constraints and enablers to implementation of proposed activities. RESULTS Most participants felt the workshops provided them with new competencies and skills in one or more of research priority setting, evidence generation, communication, and use for the control of endemic diseases. Participants were at different stages of planning and implementing their proposed research and research uptake activities, and were engaging across professional and disciplinary boundaries to ensure relevance and usefulness of outputs for decision making. Key enablers of successful implementation of activities were positive team dynamics, good balance of competencies, effective communication and engagement within teams, team leader's capacity to innovate, and personal interests such as career progress. Lack of funding, limited decision space, organizational bureaucracies, and poor infrastructure were the key constraints to the implementation of proposed activities. Lack of mentorship and continuous support from trainers delayed progress with implementing proposed activities. CONCLUSIONS The capacity-building interventions contributed to the development of a critical mass of research scientists, policy makers, and practitioners who have varying levels of competencies in HPSR for endemic disease control and would require further support in carrying out their medium and long-term goals.
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Affiliation(s)
- Obinna Onwujekwe
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Chinyere Mbachu
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria.
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria.
| | - Enyi Etiaba
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Nkoli Ezumah
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Uchenna Ezenwaka
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Ifeyinwa Arize
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Chinyere Okeke
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria
| | - Chikezie Nwankwor
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Benjamin Uzochukwu
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria
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Murunga VI, Oronje RN, Bates I, Tagoe N, Pulford J. Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries. Health Res Policy Syst 2020; 18:16. [PMID: 32039738 PMCID: PMC7011245 DOI: 10.1186/s12961-019-0524-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/23/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Knowledge translation (KT) is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to yield beneficial outcomes for society. Effective KT requires researchers to play an active role in promoting evidence uptake. This paper presents a systematised review of evidence on low- and middle-income country (LMIC) researchers' KT capacity, practice and interventions for enhancing their KT practice (support) with the aim of identifying gaps and informing future research and interventions. METHODS An electronic search for peer-reviewed publications focusing on LMIC researchers' KT capacity, practice and support across all academic fields, authored in English and from the earliest records available to February 2019, was conducted using PubMed and Scopus. Selected studies were appraised using the Mixed Methods Appraisal Tool, data pertaining to publication characteristics and study design extracted, and an a priori thematic analysis of reported research findings completed. RESULTS The search resulted in 334 screened articles, of which 66 met the inclusion criteria. Most (n = 43) of the articles presented original research findings, 22 were commentaries and 1 was a structured review; 47 articles reported on researchers' KT practice, 12 assessed the KT capacity of researchers or academic/research institutions and 9 reported on KT support for researchers. More than half (59%) of the articles focused on sub-Saharan Africa and the majority (91%) on health research. Most of the primary studies used the case study design (41%). The findings suggest that LMIC researchers rarely conduct KT and face a range of barriers at individual and institutional levels that limit their KT practice, including inadequate KT knowledge and skills, particularly for communicating research and interacting with research end-users, insufficient funding, and inadequate institutional guidelines, structures and incentives promoting KT practice. Furthermore, the evidence-base on effective interventions for enhancing LMIC researchers' KT practice is insufficient and largely of weak quality. CONCLUSIONS More high-quality research on researchers' KT capacity, practice and effective KT capacity strengthening interventions is needed. Study designs that extend beyond case studies and descriptive studies are recommended, including better designed evaluation studies, e.g. use of realist approaches, pragmatic trials, impact evaluations, implementation research and participatory action research.
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Affiliation(s)
- Violet Ibukayo Murunga
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 3BX United Kingdom
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
- African Institute for Development Policy, 6th Floor, Block A, Westcom Point Bldg, Mahiga Mairu Ave Off Waiyaki Way, Westlands, Nairobi, Kenya
| | - Rose Ndakala Oronje
- African Institute for Development Policy, 6th Floor, Block A, Westcom Point Bldg, Mahiga Mairu Ave Off Waiyaki Way, Westlands, Nairobi, Kenya
| | - Imelda Bates
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
| | - Nadia Tagoe
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Office of Grants and Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justin Pulford
- Liverpool School of Tropical Medicine, Center for Capacity Research, Pembroke Place, Liverpool, L35QA United Kingdom
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Scalway T, Otmani Del Barrio M, Ramirez B. Research on vector-borne diseases: implementation of research communication strategies. Infect Dis Poverty 2019; 8:101. [PMID: 31806008 PMCID: PMC6896314 DOI: 10.1186/s40249-019-0610-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background Effective communication of research findings on vector-borne diseases in Africa is challenging for a number of reasons. Following the experiences of a number of researchers over the life of a project, this article looks for lessons that can be shared with the wider research community. Main body Between 2014 and 2017, a set of five inter-disciplinary teams from seven African countries collaborated on a project focusing on vector-borne diseases in the context of climate change. A central objective of this work was to influence policy and programming with relevant research findings. This article examines how principles of research communication, derived from the literature and current guidelines, can be applied in practice. Several challenges and lessons are highlighted, showing that research communication takes place within difficult constraints and in complex, fluid institutional and political environments. The processes of communication between policymakers and researchers including stakeholder mapping, defining research communication plans and tailoring communication products are discussed. Conclusions The article concludes that while guidelines and frameworks for research communication are helpful, they should not detract from the ability of local teams to adapt to circumstances. Of key importance are the relationships and networks of local research teams.
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Affiliation(s)
| | - Mariam Otmani Del Barrio
- Unit on Vectors, Environment and Society, The UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Bernadette Ramirez
- Unit on Vectors, Environment and Society, The UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
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Diverged Preferences towards Sustainable Development Goals? A Comparison between Academia and the Communication Industry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224577. [PMID: 31752324 PMCID: PMC6888442 DOI: 10.3390/ijerph16224577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/15/2019] [Accepted: 11/16/2019] [Indexed: 11/22/2022]
Abstract
To understand how the sustainable development goals (SDGs) are involved and cited in different fields, the current study aimed to explore the key SDGs and SDG-pairs from the viewpoints of academia and the media. The academic publications with SDG(s)-related keywords in the Scopus database and the entry videos of the “2018 SDG Lions” were collected and analyzed through content and network analysis. It was found that SDG 3 and SDG 10 shared the highest preferences in both industries, but apparent gaps happened to SDG 5. The tied frequencies of the possible SDG pairs were also examined, and SDG 3-10 was identified taking the lead in both industries. Network analysis using degree centrality as the vital parameter demonstrated that SDG 8 and SDG 5 has strong connections with several SDGs for the academia and the media, respectively. The SDG-2-6-7 combination or “water-energy-food” nexus was also found the most frequent combination of three SDGs in the academia. Overall, SDG 3 can be treated as a unifying theme when seeking to acquire evidence-based knowledge for integrated implementation of the SDGs. Important implications for policy-making of the SDGs were also discussed.
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