scholarly journals Comparison of registered and published intervention fidelity assessment in cluster randomised trials of public health interventions in low- and middle-income countries: systematic review

Trials ◽  
2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Myriam Cielo Pérez ◽  
Nanor Minoyan ◽  
Valéry Ridde ◽  
Marie-Pierre Sylvestre ◽  
Mira Johri
Keyword(s):  
Public Health ◽  
Health Interventions ◽  
Intervention Fidelity ◽  
Randomised Trials ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cluster Randomised Trials ◽  
Cluster Randomised ◽  
Fidelity Assessment

scholarly journals The Role of Implementation Science in Advancing Resource Generation for Health Interventions in Low- and Middle-Income Countries

2021 ◽  
Vol 14 ◽  
pp. 117863292199965
Author(s):  
Temitope Ojo ◽  
Laetitia Kabasele ◽  
Bethanny Boyd ◽  
Scholastica Enechukwu ◽  
Nessa Ryan ◽  
...  
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Implementation Science ◽  
Health Workers ◽  
Contextual Factors ◽  
Health Interventions ◽  
Evidence Based ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries

Low- and middle-income countries (LMICs) bear the brunt of communicable and non-communicable diseases and experience higher mortality and poor health outcomes compared to resource-rich countries. Chronic resource deficits in LMICs impede their ability to successfully address vexing health issues. Implementation science provides researchers with an approach to develop specific interventions that can generate and/or maximize resources to facilitate the implementation of other public health interventions, in resource-constrained LMIC settings. Resources generated from these interventions could be in the form of increased health workers’ skills, task shifting to free up higher-skilled health workers, increasing laboratory capacity, and using supply chain innovations to make medications available. Pivotal to the success of such interventions is ensuring feasibility in the LMIC context. We selected and appraised three case studies of evidence-based resource-generating health interventions based in LMICs (Zambia, Zimbabwe, and Madagascar), which generated or maximized resources to facilitate ongoing health services. We used a determinant implementation framework—Consolidated Framework for Implementation Research (CFIR) to identify and map contextual factors that are reported to influence implementation feasibility in an LMIC setting. Contextual factors influencing the feasibility of these interventions included leadership engagement, local capacity building and readiness for research and implementing evidence-based practices (EBPs), infrastructural support for multilevel scale-up, and cultural and contextual adaptations. These factors highlight the importance of utilizing implementation science frameworks to evaluate, guide, and execute feasible public health interventions and projects in resource-limited settings. Within LMICs, we recommend EBPs incorporate feasible resource-generating components in health interventions to ensure improved and sustained optimal health outcomes.

scholarly journals Factors influencing the scale-up of public health interventions in low- and middle-income countries: a qualitative systematic literature review

2019 ◽  
Vol 35 (2) ◽  
pp. 219-234 ◽  
Author(s):  
Susan E Bulthuis ◽  
Maryse C Kok ◽  
Joanna Raven ◽  
Marjolein A Dieleman
Keyword(s):  
Public Health ◽  
Scale Up ◽  
Scaling Up ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Factors Influencing ◽  
Low And Middle Income ◽  
The Way

Abstract To achieve universal health coverage, the scale-up of high impact public health interventions is essential. However, scale-up is challenging and often not successful. Therefore, a systematic review was conducted to provide insights into the factors influencing the scale-up of public health interventions in low- and middle-income countries (LMICs). Two databases were searched for studies with a qualitative research component. The GRADE-CERQual approach was applied to assess the confidence in the evidence for each key review finding. A multi-level perspective on transition was applied to ensure a focus on vertical scale-up for sustainability. According to this theory, changes in the way of organizing (structure), doing (practice) and thinking (culture) need to take place to ensure the scale-up of an intervention. Among the most prominent factors influencing scale-up through changes in structure was the availability of financial, human and material resources. Inadequate supply chains were often barriers to scale-up. Advocacy activities positively influenced scale-up, and changes in the policy environment hindered or facilitated scale-up. The most outstanding factors influencing scale-up through changes in practice were the availability of a strategic plan for scale-up and the way in which training and supervision was conducted. Furthermore, collaborations such as community participation and partnerships facilitated scale-up, as well as the availability of research and monitoring and evaluation data. Factors influencing scale-up through a change in culture were less prominent in the literature. While some studies articulated the acceptability of the intervention in a given sociocultural environment, more emphasis was placed on the importance of stakeholders feeling a need for a specific intervention to facilitate its scale-up. All identified factors should be taken into account when scaling up public health interventions in LMICs. The different factors are strongly interlinked, and most of them are related to one crucial first step: the development of a scale-up strategy before scaling up.

scholarly journals Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low-income and middle-income countries (LMICs): protocol for an umbrella review

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032981
Author(s):  
Elodie Besnier ◽  
Katie Thomson ◽  
Donata Stonkute ◽  
Talal Mohammad ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Infectious Diseases ◽  
Health Inequalities ◽  
Low Income ◽  
Health Interventions ◽  
Umbrella Review ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries

IntroductionDespite significant progress in the last few decades, infectious diseases remain a significant threat to children’s health in low-income and middle-income countries. Effective means of prevention and control for these diseases exist, making any differences in the burden of these diseases between population groups or countries inequitable. Yet, gaps remain in our knowledge of the effect these public health interventions have on health inequalities in children, especially in low-income and middle-income countries. This umbrella review aims to address some of these gaps by exploring which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases among children in low-income and middle-income countries.Methods and analysisAn umbrella review will be conducted to identify systematic reviews or evidence synthesis of public health interventions that reduce morbidity, mortality and/or health inequalities due to infectious diseases among children (aged under 5 years) in low-income and middle-income countries. The interventions of interest are public health interventions targeting infectious diseases or associated risk factors in children. We will search for reviews reporting health and health inequalities outcomes in and between populations. The literature search will be undertaken using the Cochrane Library, Medline, EMBASE, the CAB Global Health database, Health Evidence, the Campbell Collaboration Library of Systematic Reviews, International Initiative for Impact Evaluation Systematic review repository, Scopus, the Social Sciences Citation Index and PROSPERO. Additionally, a manual search will be performed in Google Scholar and three international organisations websites (UNICEF Office of Research—Innocenti, UNICEF, WHO) to capture grey literature. Data from the records meeting our inclusion/exclusion criteria will be collated using a narrative synthesis approach.Ethics and disseminationThis review will exclusively work with anonymous group-level information available from published reviews. No ethical approval was required.The results of the review will be submitted for publication in academic journals and presented at international public health conferences. Additionally, key findings will be summarised for dissemination to a wider policy and general public audience as part of the Centre for Global Health Inequalities Research’s policy work.PROSPERO registration numberCRD42019141673

scholarly journals Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251905
Author(s):  
Elodie Besnier ◽  
Katie Thomson ◽  
Donata Stonkute ◽  
Talal Mohammad ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Health Inequalities ◽  
Systematic Reviews ◽  
Health Interventions ◽  
Umbrella Review ◽  
Public Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disadvantaged Groups

Despite significant progress in the last few decades, infectious diseases remain a major threat to child health in low- and middle-income countries (LMICs)—particularly amongst more disadvantaged groups. It is imperative to understand the best available evidence concerning which public health interventions reduce morbidity, mortality and health inequalities in children aged under five years. To address this gap, we carried out an umbrella review (a systematic reviews of reviews) to identify evidence on the effects of public health interventions (promotion, protection, prevention) on morbidity, mortality and/or health inequalities due to infectious diseases amongst children in LMICs. Ten databases were searched for records published between 2014–2021 alongside a manual search of gray literature. Articles were quality-assessed using the Assessment of Multiple Systematic Reviews tool (AMSTAR 2). A narrative synthesis was conducted. We identified 60 systematic reviews synthesizing 453 individual primary studies. A majority of the reviews reported on preventive interventions (n = 48), with a minority on promotion (n = 17) and almost no reviews covering health protection interventions (n = 2). Effective interventions for improving child health across the whole population, as well as the most disadvantaged included communication, education and social mobilization for specific preventive services or tools, such as immunization or bed nets. For all other interventions, the effects were either unclear, unknown or detrimental, either at the overall population level or regarding health inequalities. We found few reviews reporting health inequalities information and the quality of the evidence base was generally low. Our umbrella review identified some prevention interventions that might be useful in reducing under five mortality from infectious diseases in LMICs, particularly amongst the most disadvantaged groups.

Control of Mosquito-Borne Illnesses: A Challenge to Public Health Ethics

2019 ◽  
pp. 458-471
Author(s):  
Laura Greisman ◽  
Barbara Koenig ◽  
Michele Barry
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Mosquito Control ◽  
Virus Disease ◽  
Health Interventions ◽  
Ethical Challenges ◽  
Insecticide Treated Nets ◽  
Public Health Interventions ◽  
Middle Income ◽  
Public Health Agencies

This chapter delves into the ethical issues surrounding the implementation of public health interventions for control of mosquito-borne illnesses. Emerging and reemerging mosquito-borne infections remain a public health threat worldwide, prompting public health agencies to strengthen individual and population-wide measures for mosquito control. Ethical issues surrounding surveillance activities and key public health interventions for mosquito control are discussed, including provision of insecticide-treated nets (ITNs), the spraying of aerial pesticides, and the introduction of genetically modified mosquitoes. A case study of Zika virus disease highlights specific ethical challenges surrounding the safety of insect repellent use in pregnancy and the complex issue of women’s reproductive rights arising in a fast-moving epidemic. The chapter emphasizes the need for community engagement at all levels of mosquito control interventions, and it highlights the disproportionate impact of mosquito-borne disease on the poor, calling to action the need to strengthen health systems in low- and middle-income countries.

scholarly journals COVID-19: underpowered randomised trials, or no randomised trials?

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Atle Fretheim
Keyword(s):  
Public Health ◽  
Sample Size ◽  
Systematic Reviews ◽  
Sample Size Calculation ◽  
Scientific Progress ◽  
Face Mask ◽  
Health Interventions ◽  
Randomised Trials ◽  
Public Health Interventions ◽  
Key Barrier

AbstractA recently published trial of face mask use to protect against COVID-19 demonstrated a key barrier to carrying out randomised trials in public health: the need for unattainably large sample sizes. For many public health interventions, the choice is not between sufficiently powered trials and underpowered trials, but between underpowered trials and no trials at all. Underpowered trials should be viewed as contributions to the larger body of evidence, alongside other studies of various sizes and designs, collectively assessed and synthesized in systematic reviews. Overemphasis on sample size calculation is probably more of a hindrance than a help to scientific progress.

Sign in / Sign up

Export Citation Format

Share Document