Prioritizing knowledge translation in low- and middle-income countries to support pandemic response and preparedness

AbstractThe COVID-19 pandemic has created urgent demand around the world for knowledge generation about a novel coronavirus, its transmission, and control, putting academic institutions at the frontline of politics. While many academic institutions are well poised to conduct research, there are well-documented barriers for these institutions, particularly in low- and middle-income countries (LMICs), to further conduct strategic synthesis and dissemination to promote knowledge utilization among policy-makers. These systemic barriers to knowledge translation (KT) pose significant challenges for academic institutions seeking to take advantage of unprecedented policy windows to inform evidence-based decision-making. Global health funding organizations should prioritize the support of academic institutions’ activities along the KT pathway, including both knowledge generation and strategic dissemination, to improve knowledge uptake for decision-making to improve health. Institutional capacity-building initiatives for KT have the potential to profoundly impact responses to this and future pandemics.

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Developing a tool to assess institutional readiness to conduct knowledge translation activities in low-and middle-income countries

10.21203/rs.3.rs-60192/v1 ◽

2020 ◽

Author(s):

Anna Kalbarczyk ◽

Aditi Rao ◽

Olakunle O Alonge

Keyword(s):

Knowledge Translation ◽

Future Research ◽

Academic Institutions ◽

Global Knowledge ◽

Consultation Process ◽

Middle Income ◽

Stakeholder Consultation ◽

Middle Income Countries ◽

Five Factors ◽

Low And Middle Income

Abstract Background Academic institutions are well-poised to conduct knowledge translation (KT) but face many barriers, particularly in low resource settings where the need is greatest. Assessing the readiness of academic institutions to conduct KT can help our understanding of these barriers. However, limited research has been conducted to understand influencers of readiness for KT in low- and middle-income countries (LMICs) and there are no tools for KT readiness assessment designed for LMIC contexts. This paper describes the development of a tool for assessing organizational readiness to conduct KT among academic institutions in LMICs. Methods A literature review and stakeholder consultation process was conducted to identify constructs and items relevant for assessing KT readiness in LMICs. These were face validated with LMIC stakeholders and organized into a questionnaire measured on a Likert scale. A quantitative survey was conducted and the questionnaire distributed to faculty based at 6 LMIC academic institutions, as well as members of a global knowledge-to-action thematic working group. An exploratory factor analysis (EFA) was used to identify underlying dimensions of a tool for assessing institutional readiness to conduct KT. Results A total of 111 respondents with varied KT experiences from 10 LMICs (including Bangladesh, Ethiopia, DR Congo, India, Indonesia, Nigeria) were included in the analysis. We selected five factors and 23 items, with factor loadings ranging from 0.40 to 0.77. The five factors include 1) institutional climate, 2) organization change efficacy, 3) prioritization and cosmopolitanism, 4) self-efficacy, and 5) financial resources. These five factors accounted for 69% of the total variance, with Cronbach’s alpha coefficients of 0.78, 0.73, 0.62, 0.68, and 0.52, respectively. Conclusions This study identify a tool for assessing readiness of LMIC academic institutions to conduct KT, and unique opportunities for building capacity among academic institutions for KT. The organizational focus of these factors underscores the need for strategies that address organizational systems and structures in addition to individual knowledge, skills, and tools. Future research will be conducted to understand determinants of these factors and develop a comprehensive set of capacity building strategies responsive to academic institutions in LMICs.

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The burgeoning role of global health diplomacy to alleviate suffering of cancer patients in low- and middle-income countries

International Health ◽

10.1093/inthealth/ihaa004 ◽

2020 ◽

Vol 12 (3) ◽

pp. 231-233

Author(s):

Melissa Adomako ◽

Alaei Kamiar ◽

Abdulla Alshaikh ◽

Lyndsay S Baines ◽

Desiree Benson ◽

...

Keyword(s):

Global Health ◽

Evidence Base ◽

International Affairs ◽

Global Health Diplomacy ◽

Middle Income ◽

Middle Income Countries ◽

Health Diplomacy ◽

Health Practitioners ◽

And Control ◽

Low And Middle Income

Abstract The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies.

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Contributions of academic institutions in high income countries to anesthesia and surgical care in low- and middle-income countries: are they providing what is really needed?

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-018-1258-0 ◽

2018 ◽

Vol 66 (3) ◽

pp. 255-262 ◽

Cited By ~ 2

Author(s):

Shrividya Chellam ◽

Lundeg Ganbold ◽

Anita Gadgil ◽

Sergelen Orgoi ◽

Herman Lonnee ◽

...

Keyword(s):

Surgical Care ◽

High Income ◽

Academic Institutions ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

Food and Nutrition Bulletin ◽

10.1177/0379572118774229 ◽

2018 ◽

Vol 39 (2) ◽

pp. 315-331 ◽

Cited By ~ 29

Author(s):

Saskia J. M. Osendarp ◽

Homero Martinez ◽

Greg S. Garrett ◽

Lynnette M. Neufeld ◽

Luz Maria De-Regil ◽

...

Keyword(s):

Large Scale ◽

Food System ◽

Food Fortification ◽

Micronutrient Deficiencies ◽

Middle Income ◽

Middle Income Countries ◽

Essential Components ◽

Quality Of Delivery ◽

And Control ◽

Low And Middle Income

Background: Food fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires continual monitoring, quality assurance and control, and corrective measures to ensure high compliance. Objective: To provide an overview of efficacy, effectiveness, economics of food fortification and biofortification, and status of and challenges faced by large-scale food fortification programs in low- and middle-income countries (LMIC). Methods: A literature review of PubMed publications in English from 2000 to 2017, as well as gray literature, targeting nongovernmental organizations whose work focuses on this topic, complemented by national reports and a “snowball” process of citation searching. The article describes remaining technical challenges, barriers, and evidence gap and prioritizes recommendations and next steps to further accelerate progress and potential of impact. Results: The review identifies and highlights essential components of successful programs. It also points out issues that determine poor program performance, including lack of adequate monitoring and enforcement and poor compliance with standards by industry. Conclusions: In the last 17 years, large-scale food fortification initiatives have been reaching increasingly larger segments of populations in LMIC. Large-scale food fortification and biofortification should be part of other nutrition-specific and nutrition-sensitive efforts to prevent and control micronutrient deficiencies. There are remaining technical and food system challenges, especially in relation to improving coverage and quality of delivery and measuring progress of national programs.

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Strengthening national vaccine decision-making: Assessing the impact of SIVAC Initiative support on national immunisation technical advisory group (NITAG) functionality in 77 low and middle-income countries

Vaccine ◽

10.1016/j.vaccine.2018.11.070 ◽

2019 ◽

Vol 37 (3) ◽

pp. 430-434 ◽

Cited By ~ 3

Author(s):

Kevin van Zandvoort ◽

Natasha Howard ◽

Sandra Mounier-Jack ◽

Mark Jit

Keyword(s):

Decision Making ◽

Advisory Group ◽

Middle Income ◽

National Immunisation ◽

Middle Income Countries ◽

Technical Advisory Group ◽

Vaccine Decision Making ◽

The Impact ◽

Low And Middle Income

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2031. Impact of Education and Antibiotic Guidelines on Dispensing Antibiotics with Community Pharmacists in a Low- and Middle-Income Country

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1711 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S682-S682

Author(s):

Smitha Gudipati ◽

Deepak Bajracharya ◽

Lenjana Jimee ◽

Gina Maki ◽

Marcus Zervos ◽

...

Keyword(s):

Community Pharmacists ◽

Antibiotic Use ◽

Educational Assessment ◽

The Body ◽

Control Groups ◽

Post Intervention ◽

Middle Income ◽

Middle Income Countries ◽

And Control ◽

Low And Middle Income

Abstract Background Non-prescription use of antibiotics in low- and middle-income countries has contributed to significant antimicrobial resistance (AMR). Henry Ford Health System has partnered with multinational organizations in Nepal to address the need for increasing awareness of AMR and implementation of effective antimicrobial stewardship. This partnership confirmed the importance of increasing knowledge and awareness regarding AMR and antibiotic use to community pharmacists. The present pilot study assessed if outpatient antibiotic dispensing guidelines given to community pharmacists could result in a reduction of unneeded antibiotic use. Methods Nine community pharmacies from Kathmandu were selected of which two were used as controls. Seven pharmacists were educated on the appropriate use of antibiotics, and outpatient dispensing before and after guidelines at all pharmacies were evaluated. The pharmacists were given guidelines on antibiotic use and duration needed for common bacterial infections encountered. Controls were not given guidelines. At baseline and post-intervention (1 week), pill counts were performed of the top six antibiotics that were dispensed by the pharmacist. Pharmacists were requested to keep a log of how many antibiotics were dispensed for one week. The pharmacists also were requested to fill out a post-intervention educational assessment to evaluate retention. Results Pill count pre-intervention was 15,856 and 1512 and post-intervention was 11,168 and 1,440 in the intervention and control groups respectively (Table 1). A post-intervention educational assessment revealed that both the intervention and control groups believed antibiotics can treat viruses (57% vs. 50%) and that antibiotics do not kill good bacteria that protect the body from infection (57% vs. 50%) (Table 2). Conclusion There was no difference in the dispensing of antibiotics between pre- and post-intervention. The findings of this study show significant room for improvement in continuing education about antibiotic use in outpatient pharmacies. Further studies are needed to target outpatient antibiotic dispensing with education and identifying economic or other incentives in hopes of reducing the burden of AMR in low- and middle-income countries. Disclosures All authors: No reported disclosures.

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Antibiotic Use in Low and Middle-Income Countries and the Challenges of Antimicrobial Resistance in Surgery

Antibiotics ◽

10.3390/antibiotics9080497 ◽

2020 ◽

Vol 9 (8) ◽

pp. 497

Author(s):

Massimo Sartelli ◽

Timothy C. Hardcastle ◽

Fausto Catena ◽

Alain Chichom-Mefire ◽

Federico Coccolini ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Prevention And Control ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Antibiotic Prescribing ◽

Prescribing Practices ◽

Middle Income ◽

Middle Income Countries ◽

And Control ◽

Low And Middle Income

Antimicrobial resistance (AMR) is a phenomenon resulting from the natural evolution of microbes. Nonetheless, human activities accelerate the pace at which microorganisms develop and spread resistance. AMR is a complex and multidimensional problem, threatening not only human and animal health, but also regional, national, and global security, and the economy. Inappropriate use of antibiotics, and poor infection prevention and control strategies are contributing to the emergence and dissemination of AMR. All healthcare providers play an important role in preventing the occurrence and spread of AMR. The organization of healthcare systems, availability of diagnostic testing and appropriate antibiotics, infection prevention and control practices, along with prescribing practices (such as over-the-counter availability of antibiotics) differs markedly between high-income countries and low and middle-income countries (LMICs). These differences may affect the implementation of antibiotic prescribing practices in these settings. The strategy to reduce the global burden of AMR includes, among other aspects, an in-depth modification of the use of existing and future antibiotics in all aspects of medical practice. The Global Alliance for Infections in Surgery has instituted an interdisciplinary working group including healthcare professionals from different countries with different backgrounds to assess the need for implementing education and increasing awareness about correct antibiotic prescribing practices across the surgical pathways. This article discusses aspects specific to LMICs, where pre-existing factors make surgeons’ compliance with best practices even more important.

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