scholarly journals Lessons learned from descriptions and evaluations of knowledge translation platforms supporting evidence-informed policy-making in low- and middle-income countries: a systematic review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Arun C. R. Partridge ◽  
Cristián Mansilla ◽  
Harkanwal Randhawa ◽  
John N. Lavis ◽  
Fadi El-Jardali ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Policy Making ◽  
Grey Literature ◽  
Lessons Learned ◽  
Control Group ◽  
Supporting Evidence ◽  
High Turnover ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background Knowledge translation (KT) platforms are organisations, initiatives and networks that focus on supporting evidence-informed policy-making at least in part about the health-system arrangements that determine whether the right programmes, services and products get to those who need them. Many descriptions and evaluations of KT platforms in low- and middle-income countries have been produced but, to date, they have not been systematically reviewed. Methods We identified potentially relevant studies through a search of five electronic databases and a variety of approaches to identify grey literature. We used four criteria to select eligible empirical studies. We extracted data about seven characteristics of included studies and about key findings. We used explicit criteria to assess study quality. In synthesising the findings, we gave greater attention to themes that emerged from multiple studies, higher-quality studies and different contexts. Results Country was the most common jurisdictional focus of KT platforms, EVIPNet the most common name and high turnover among staff a common infrastructural feature. Evidence briefs and deliberative dialogues were the activities/outputs that were the most extensively studied and viewed as helpful, while rapid evidence services were the next most studied but only in a single jurisdiction. None of the summative evaluations used a pre–post design or a control group and, with the exception of the evaluations of the influence of briefs and dialogues on intentions to act, none of the evaluations achieved a high quality score. Conclusions A large and growing volume of research evidence suggests that KT platforms offer promise in supporting evidence-informed policy-making in low- and middle-income countries. KT platforms should consider as next steps expanding their current, relatively limited portfolio of activities and outputs, building bridges to complementary groups, and planning for evaluations that examine ‘what works’ for ‘what types of issues’ in ‘what types of contexts’.

scholarly journals Increasing Knowledge Translation Capacity in Low- and Middle-Income Countries: A Model for Implementation Research Training

2021 ◽  
Vol 2 ◽  
Author(s):  
Michael J. Penkunas ◽  
Evangelia Berdou ◽  
Shiau Y. Chong ◽  
Pascal Launois ◽  
Emma L. M. Rhule ◽  
...  
Keyword(s):  
Public Health ◽  
Knowledge Translation ◽  
Implementation Research ◽  
Research Training ◽  
Grey Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Modified Delphi ◽  
Health Expert ◽  
Low And Middle Income

Most health professionals lack the training and expertise to translate clinical innovations into actionable programs. Even though some public health expert communities understand that even widely proven solutions need to be adapted to the demands and characteristics of diverse health systems and societies to be successful, such knowledge has yet to inform routine public health approaches and practices. Therefore, it should not be a surprise that the “know-do” gap between clinical innovations and their on-the-ground application that implementation research seeks to bridge is pervasive and enduring, particularly in low- and middle-income countries. This article draws on a study of implementation research training courses to highlight the various competencies needed to translate different types of knowledge into action, many of which are not adequately addressed in existing curricula. We utilized a four-phase modified Delphi methodology that included a review of the academic and grey literature, one-on-one interviews with experts, virtual dialogue series with key stakeholders, and peer review of the synthesized results. The resulting areas in need of further development include the ability of learners to work as part of a multidisciplinary team, engage various stakeholders, and communicate research findings to decision-makers. Based on these insights, it is argued that knowledge translation in implementation research is a multi-faceted, multi-level sensemaking and communication activity that takes place throughout the research and research-to policy-processes.

Stock-Outs of Essential Medicines Among Community Health Workers (CHWs) In Low- And Middle-Income Countries (LMICs): A Systematic Literature Review of The Extent, Reasons, And Consequences

2021 ◽  
Author(s):  
Abimbola Olaniran ◽  
Jane Briggs ◽  
Ami Pradhan ◽  
Erin Bogue ◽  
Benjamin Schreiber ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Grey Literature ◽  
Community Level ◽  
Health Centers ◽  
Essential Medicines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background: This paper explores the extent of community-level stock-out of essential medicines among Community Health Workers (CHWs) in Low- and Middle-Income Countries (LMICs) and identifies the reasons for and consequences of essential medicine stock-outs. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. Five electronic databases were searched with a prespecified strategy and the grey literature examined, January 2006 - March 2021. Papers containing information on (i) the percentage of CHWs stocked out or (ii) reasons for stock-outs along the supply chain and consequences of stock-out were included and appraised for risk of bias. Outcomes were quantitative data on the extent of stock-out, summarized using descriptive statistics, and qualitative data regarding reasons for and consequences of stock-outs, analyzed using thematic content analysis and narrative synthesis. Results: Two reviewers screened 1083 records; 78 evaluations were included. Over the last fifteen years, CHWs experienced stock-outs of essential medicines nearly one third of the time and at a significantly (p < 0.01) higher rate than the health centers to which they are affiliated (28.93% [CI 95%: 28.79 - 29.07] vs 9.17 % [CI 95%: 8.64 - 9.70], respectively). A comparison of the period 2006-2015 and 2016-2021 showed a significant (p < 0.01) increase in CHW stock-out level from 26.36% [CI 95%: 26.22 -26.50] to 48.65% [CI 95%: 48.02- 49.28] while that of health centers increased from 7.79% [95% CI: 7.16 - 8.42] to 14.28% [95% CI: 11.22- 17.34]. Distribution barriers were the most cited reasons for stock-outs. Ultimately, patients were the most affected: stock-outs resulted in out-of-pocket expenses to buy unavailable medicines, poor adherence to medicine regimes, dissatisfaction, and low service utilization. Conclusion: Community-level stock-out of essential medicines constitutes a serious threat to achieving universal health coverage and equitable improvement of health outcomes. This paper suggests stock-outs are getting worse, and that there are particular barriers at the last mile. There is an urgent need to address the health and non-health system constraints that prevent the essential medicines procured for LMICs by international and national stakeholders from reaching the people who need them the most.

scholarly journals Using pictorial action instructions to build a basic humanitarian engineering project

2019 ◽  
Vol 14 (1) ◽  
pp. 60-70
Author(s):  
Kathleen Paco Cadman ◽  
Du Feng
Keyword(s):  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Low Literacy ◽  
Engineering Project ◽  
Middle Income ◽  
Middle Income Countries ◽  
Humanitarian Engineering ◽  
Engineering Projects ◽  
Low And Middle Income

Humanitarian engineering projects mitigate environmental hazards disproportionately affecting health in low- and middle-income countries. However, widespread literacy deficits can create barriers in training low-literacy adults to construct these projects, indicating a need for literacy-adapted training materials. A randomized control trial in rural Guatemala tested the usability of pictorial action instructions, compared to demonstration-only methods, in training low-literacy adults (N = 60; n = 30 per group) to construct a solar bottle bulb. Fourteen days after the training, participants individually constructed the solar bottle bulb. The intervention group received pictorial action instructions to guide them, and the control group completed construction based on memory. Usability was evaluated by measuring the effectiveness and efficiency of construction, as well as user satisfaction and self-efficacy levels. Effectiveness and self-efficacy were significantly better among those in the intervention group compared to the control group. Considering this, the findings support the use of pictorial action instructions in training low-literacy adults to construct humanitarian engineering projects. This method may allow more individuals in rural regions of low- and middle-income countries to successfully construct their own humanitarian engineering projects in a way that is sustainable and scalable. Further research is needed to test these instructions in different settings, on a larger scale, as well as to test the long-term effects of using pictorial action instructions. 

scholarly journals Looking ahead in the COVID-19 pandemic: emerging lessons learned for sexual and reproductive health services in low- and middle-income countries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Sanni Yaya
Keyword(s):  
Reproductive Health ◽  
Service Provision ◽  
Sexual And Reproductive Health ◽  
Lessons Learned ◽  
Safe Abortion ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries ◽  
Published Evidence ◽  
Low And Middle Income

AbstractThe COVID-19 pandemic has caused widespread disruption to essential health service provision globally, including in low- and middle-income countries (LMICs). Recognising the criticality of sexual and reproductive health (SRH) services, we review the actual reported impact of the COVID-19 pandemic on SRH service provision and evidence of adaptations that have been implemented to date. Across LMICs, the available data suggests that there was a reduction in access to SRH services, including family planning (FP) counselling and contraception access, and safe abortion during the early phase of the pandemic, especially when movement restrictions were in place. However, services were quickly restored, or alternatives to service provision (adaptations) were explored in many LMICs. Cases of gender-based violence (GBV) increased, with one in two women reporting that they have or know a woman who has experienced violence since the beginning of the pandemic. As per available evidence, many adaptations that have been implemented to date have been digitised, focused on getting SRH services closer to women. Through the pandemic, several LMIC governments have provided guidelines to support SRH service delivery. In addition, non-governmental organisations working in SRH programming have played significant roles in ensuring SRH services have been sustained by implementing several interventions at different levels of scale and to varying success. Most adaptations have focused on FP, with limited attention placed on GBV. Many adaptations have been implemented based on guidance and best practices and, in many cases, leveraged evidence-based interventions. However, some adaptations appear to have simply been the sensible thing to do. Where evaluations have been carried out, many have highlighted increased outputs and efficiency following the implementation of various adaptations. However, there is limited published evidence on their effectiveness, cost, value for money, acceptability, feasibility, and sustainability. In addition, the pandemic has been viewed as a homogenous event without recognising its troughs and waves or disentangling effects of response measures such as lockdowns from the pandemic itself. As the pandemic continues, neglected SRH services like those targeting GBV need to be urgently scaled up, and those being implemented with any adaptations should be rigorously tested.

Strengthening Noncommunicable Disease Research Capacity and Chronic Disease Outcomes in Low- and Middle-Income Countries in South Asia: Implementation and Evaluation of the ASCEND Program

2019 ◽  
Vol 31 (6) ◽  
pp. 536-547
Author(s):  
Allison Byrnes ◽  
Tilahun Nigatu Haregu ◽  
Naanki Pasricha ◽  
Kavita Singh ◽  
Sathish Thirunavukkarasu ◽  
...  
Keyword(s):  
Online Learning ◽  
Communicable Disease ◽  
Research Capacity ◽  
Lessons Learned ◽  
Early Career ◽  
Noncommunicable Disease ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Low And Middle Income

This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees’ research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.

scholarly journals Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 491 ◽  
Author(s):  
Christina Oh ◽  
Emily C. Keats ◽  
Zulfiqar A. Bhutta
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Child Health ◽  
Low Birthweight ◽  
Grey Literature ◽  
Micronutrient Supplementation ◽  
Maternal Anemia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Almost two billion people are deficient in key vitamins and minerals, mostly women and children in low- and middle-income countries (LMICs). Deficiencies worsen during pregnancy due to increased energy and nutritional demands, causing adverse outcomes in mother and child, but could be mitigated by interventions like micronutrient supplementation. To our knowledge, this is the first systematic review that aimed to compile evidence from both efficacy and effectiveness trials, evaluating different supplementation interventions on maternal, birth, child health, and developmental outcomes. We evaluated randomized controlled trials and quasi-experimental studies published since 1995 in peer-reviewed and grey literature that assessed the effects of calcium, vitamin A, iron, vitamin D, and zinc supplementation compared to placebo/no treatment; iron-folic (IFA) supplementation compared to folic acid only; multiple micronutrient (MMN) supplementation compared to IFA; and lipid-based nutrient supplementation (LNS) compared to MMN supplementation. Seventy-two studies, which collectively involved 314 papers (451,723 women), were included. Meta-analyses showed improvement in several key birth outcomes, such as preterm birth, small-for-gestational age (SGA) and low birthweight with MMN supplementation, compared to IFA. MMN also improved child outcomes, including diarrhea incidence and retinol concentration, which are findings not previously reported. Across all comparisons, micronutrient supplementation had little to no effect on mortality (maternal, neonatal, perinatal, and infant) outcomes, which is consistent with other systematic reviews. IFA supplementation showed notable improvement in maternal anemia and the reduction in low birthweight, whereas LNS supplementation had no apparent effect on outcomes; further research that compares LNS and MMN supplementation could help understand differences with these commodities. For single micronutrient supplementation, improvements were noted in only a few outcomes, mainly pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D), and maternal serum zinc concentration (zinc). These findings highlight that micronutrient-specific supplementation should be tailored to specific groups or needs for maximum benefit. In addition, they further contribute to the ongoing discourse of choosing antenatal MMN over IFA as the standard of care in LMICs.

scholarly journals A systematic review of employment outcomes from youth skills training programmes in agriculture in low- and middle-income countries

Nature Food ◽  
2020 ◽  
Vol 1 (10) ◽  
pp. 605-619 ◽  
Author(s):  
W. H. Eugenie Maïga ◽  
Mohamed Porgo ◽  
Pam Zahonogo ◽  
Cocou Jaurès Amegnaglo ◽  
Doubahan Adeline Coulibaly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Skills Training ◽  
Urban Migration ◽  
Youth Engagement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Positive Effects ◽  
Training Programmes ◽  
Low And Middle Income

Abstract Engagement of youth in agriculture in low- and middle-income countries may offer opportunities to curb underemployment, urban migration, disillusionment of youth and social unrest, as well as to lift individuals and communities from poverty and hunger. Lack of education or skills training has been cited as a challenge to engage youth in the sector. Here we systematically interrogate the literature for the evaluation of skills training programmes for youth in low- and middle-income countries. Sixteen studies—nine quantitative, four qualitative and three mixed methods—from the research and grey literature documented the effects of programmes on outcomes relating to youth engagement, including job creation, income, productivity and entrepreneurship in agriculture. Although we find that skills training programmes report positive effects on our chosen outcomes, like previous systematic reviews we find the topic to chronically lack evaluation. Given the interest that donors and policymakers have in youth engagement in agriculture, our systematic review uncovers a gap in the knowledge of their effectiveness.

scholarly journals Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 531
Author(s):  
Zohra S Lassi ◽  
Zahra A Padhani ◽  
Amna Rabbani ◽  
Fahad Rind ◽  
Rehana A. Salam ◽  
...  
Keyword(s):  
Birth Weight ◽  
Obesity Prevention ◽  
Data Extraction ◽  
Child Outcomes ◽  
Grey Literature ◽  
Food Distribution ◽  
Dietary Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Optimal nutrition plays a crucial role in pregnancy. Maternal malnutrition is a risk factor for maternal, fetal, and neonatal complications and is more prevalent in low and middle-income countries (LMICs). This review aims to study the effectiveness of antenatal macronutrient nutritional interventions on maternal, neonatal, and child outcomes. We searched the CENTRAL, PubMed, Embase, and other databases for randomized controlled trials and quasi-experimental designs on healthy pregnant women in LMICs. We also searched grey literature and reports from Google Scholar, Web of Science, and websites of different organizations. Title/abstract screening, full-text screening, and data extraction filtered 15 studies for inclusion. Balanced energy protein (BEP) supplementation (n = 8) studies showed a reduced incidence of perinatal mortality, stillbirths, low birth weight (LBW) infants, small for gestational age (SGA) babies and increased birth weight. Food distribution programs (FDPs) (n =5) witnessed reduced rates of SGA, stunting, wasting, and increased birth weight and birth length. Studies on intervention for obesity prevention (n = 2) showed reductions in birth weight. Other findings were statistically insignificant. Subgroup analyses were conducted to study the effectiveness of supplementation between regions, location, the timing of supplementation and nutritional status; however, there were a limited number of studies in each subgroup. Data from our review supports the antenatal supplementation of BEP and FDP for the prevention of adverse maternal, neonatal, and child outcomes that can be utilized for future policymaking. However, more research is required before recommending obesity prevention programs.

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