scholarly journals Future Directions for Providing Conceptual Clarity Related to Context in Implementation; Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis"

2021 ◽  
Author(s):  
Amelia E. Van Pelt ◽  
Rinad S. Beidas
Keyword(s):  
Implementation Science ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Future Directions ◽  
Middle Income ◽  
Evidence Based Practices ◽  
Middle Income Countries ◽  
Stakeholder Perspectives ◽  
Conceptual Clarity ◽  
Country Analysis

In implementation science, contextual inquiry guides the implementation process for successful uptake of evidence-based practices. However, the conceptualization and measurement of context varies across frameworks and stakeholders. To advance implementation science, future efforts to advance the understanding of context should incorporate input from implementation stakeholders through co-creation, elicit stakeholders’ perspectives in low- and middle-income countries to generate a more comprehensive list of determinants, and refine inconsistencies in terminology to promote research synthesis. Greater conceptual clarity and generalizability in contextual inquiry will enable improved communication and collaboration, thus facilitating a shift in focus to development and evaluation of implementation strategies to improve healthcare and health outcomes.

scholarly journals Context Matters in Evidence Implementation Globally; Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis"

2021 ◽  
Author(s):  
Marie-Pierre Gagnon
Keyword(s):  
Knowledge Translation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Stakeholder Perspectives ◽  
Experience Levels ◽  
Country Analysis ◽  
Healthcare Interventions ◽  
Comprehensive Framework ◽  
Study Participants ◽  
Context Features

Context influences the effectiveness of healthcare interventions and should be considered to inform their implementation. However, context remains poorly defined in the knowledge translation (KT) literature. The paper by Squires and colleagues constitutes a valuable contribution to the field of KT as it provides the basis for a comprehensive framework to assess the influence of context on implementation success. In their study, Squires et al. identified 66 context features, grouped into 16 attributes. Their findings highlight a great convergence in the context features mentioned by stakeholders across countries, experience levels and roles in KT. Thus, the proposed framework could eventually transfer to several implementation settings. However, all study participants were from high-income countries. It would therefore be important to replicate this research in low- and middle-income countries. A common understanding of what context means is essential to assessing its influence on the implementation of healthcare interventions globally.

Implementation Science in Health Care

2017 ◽  
Author(s):  
Alison B. Hamilton ◽  
Brian S. Mittman
Keyword(s):  
Health Care ◽  
Implementation Science ◽  
Scale Up ◽  
Implementation Strategies ◽  
Future Directions ◽  
Evidence Based Practices ◽  
Implementation Processes ◽  
Naturally Occurring ◽  
Health Care Practices ◽  
Development And Evolution

Implementation science in health care comprises over 30 years of rich and varied activity that has developed, refined, and applied implementation science concepts, theories, and research approaches. This body of activity has produced valuable empirical findings and has contributed to the continued development of the broader field of implementation science. This chapter describes key stages in the development and evolution of implementation science in health care. It discusses key settings, evidence-based practices, and implementation strategies studied by health care implementation researchers and examines key challenges and future directions in the field. Continued growth in health care implementation science will require expanded attention to sustainment, scale-up, and spread of effective health care practices and attention to the study of routine, naturally-occurring implementation processes in addition to experimental evaluation of investigator-led implementation.

Implementation science of pediatric palliative care in lower-middle-income countries in Southeast Asia: An integrative review

2021 ◽  
Vol 15 (9) ◽  
pp. 2737-2740
Author(s):  
Jestoni D. Maniago ◽  
Floreliz V. Ngaya-An
Keyword(s):  
Palliative Care ◽  
Southeast Asia ◽  
Implementation Science ◽  
Implementation Process ◽  
Health Science ◽  
Integrative Review ◽  
Pediatric Palliative Care ◽  
Eligibility Criteria ◽  
Middle Income ◽  
Middle Income Countries

There is an ongoing development in the pediatric palliative care (PPC) program in Southeast Asia (SEA). However, the implementation process has not been clearly understood among lower-middle-income countries (LMICs) in this region. The purpose of this paper is to review and synthesize research about the implementation process of 7 identified LMICs in the SEA: Cambodia, Indonesia, Myanmar, Lao PDR, Philippines, Timor-Leste, and Vietnam. An integrative review utilizing Whittemore and Knafi’s five-stage process was employed. Electronic searches of CINAHL, Web of Science, ProQuest, and Google Scholar (no year restriction) were conducted. From 7,599 articles retrieved, only 11 met the eligibility criteria. Each article was appraised for methodological quality (QualSyst tool and AACODS checklist), and constant comparison methods were used. Two overarching themes emerged in this review - the gaps in PPC standards, practice framework and guidelines and the PPC challenges and implementation strategies. Understanding the implementation science of PPC among LMICs in the SEA region addresses the gap between idealism and realism. It provides reliable information in the development of strategic work plans that will improve the implementation process and promote the translation of EBIs into practice significant to the quality of pediatric patient outcomes. Keywords: adoption; innovation; health science; knowledge translation; patient care

scholarly journals Tobacco intervention research in low- and middle-income countries: lessons learned and future directions

2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Tobacco Dependence ◽  
Lessons Learned ◽  
Future Directions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Tobacco Intervention

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).

scholarly journals Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis

The Lancet ◽  
2013 ◽  
Vol 382 (9890) ◽  
pp. 417-425 ◽  
Author(s):  
Joanne Katz ◽  
Anne CC Lee ◽  
Naoko Kozuki ◽  
Joy E Lawn ◽  
Simon Cousens ◽  
...  
Keyword(s):  
Gestational Age ◽  
Mortality Risk ◽  
Low Income ◽  
Small For Gestational Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Analysis

scholarly journals Identifying health policy and systems research priorities on multisectoral collaboration for health in low-income and middle-income countries

2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000970 ◽  
Author(s):  
Douglas Glandon ◽  
Ankita Meghani ◽  
Nasreen Jessani ◽  
Mary Qiu ◽  
Sara Bennett
Keyword(s):  
Low Income ◽  
Health Sector ◽  
Research Priorities ◽  
Implementation Strategies ◽  
Health Coverage ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Systems Research ◽  
Review Articles

IntroductionWhile efforts to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) have reinvigorated interest in multisectoral collaborations (MSCs) among the global health and development community, there remains a plethora of questions about how best to conceptualise, plan, implement, evaluate and sustain MSCs. The objective of this paper is to present research priorities on MSC for health from researchers and policymakers around the globe, with an emphasis on low-income and middle-income countries.MethodsThe authors identified 30 priority research questions from two sources: (1) 38 review articles on MSC for health, and (2) interviews and focus groups with a total of 81 policymakers, including government officials (largely from ministries of health and state/provincial departments of health, but also offices of planning, public service, social development, the prime minister and others), large multilateral or bilateral organisations, and non-governmental organisations. In a third phase, questions were refined and ranked by a diverse group of researchers from around the globe using an online voting platform.ResultsThe top-ranked questions focused predominantly on pragmatic questions, such as how best to structure, implement and sustain MSCs, as well as how to build stakeholder capacity and community partnerships. Despite substantial variation between review articles, policymakers’ reflections and online ranking by researchers, two topics emerged as research priorities for all three: (1) leadership, partnership and governance structures for MSCs; and (2) MSC implementation strategies and mechanisms. The review articles underscored the need for more guidance on appropriate study designs and methods for investigating MSCs, which may be a prerequisite for other identified research priorities.ConclusionThese findings could inform efforts within and beyond the health sector to better align research objectives and funding with the evidence needs of policymakers grappling with questions about how best to leverage MSCs to achieve UHC and the SDGs.

scholarly journals Evidence gap map of performance measurement and management in primary healthcare systems in low-income and middle-income countries

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001451 ◽  
Author(s):  
Wolfgang Munar ◽  
Birte Snilstveit ◽  
Ligia Esther Aranda ◽  
Nilakshi Biswas ◽  
Theresa Baffour ◽  
...  
Keyword(s):  
Performance Measurement ◽  
Systematic Reviews ◽  
Low Income ◽  
Primary Healthcare ◽  
Implementation Strategies ◽  
Sub Saharan Africa ◽  
Audit And Feedback ◽  
Unintended Effects ◽  
Middle Income ◽  
Middle Income Countries

IntroductionWe mapped available evidence on performance measurement and management (PMM) strategies in primary healthcare (PHC) systems of low-income and middle-income countries (LMICs). Widely used, their effectiveness remains inconclusive. This evidence gap map characterises existing research and evidence gaps.MethodsSystematic mapping of performance measurement and management research in LMICs from 2000 to mid-2018; literature searches of seven academic databases and institutional repositories of impact evaluations and systematic reviews. Using a combination of manual screening and machine learning, four reviewers appraised 38 088 titles and abstracts, and extracted metadata from 137 impact evaluations and 18 systematic reviews that met the inclusion criteria. The resulting visual representation of the evidence base was uploaded to a web-based platform.ResultsSince 2000, the number of studies has increased; the first systematic reviews were completed in 2010. Two-thirds of the studies were conducted in sub-Saharan Africa and South Asia. Randomised controlled trials were the most frequently used study design. The evidence is concentrated in two types of PMM strategies: implementation strategies (in-service training, continuing education, supervision) and performance-based financing. Major gaps exist in accountability arrangements particularly the use of audit and feedback. The least studied types of outcomes were unintended effects, harm and social equity.ConclusionsThe evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes. The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects. Future efforts at redesigning PHC systems need to be informed by evidence on the most effective approaches for using PMM strategies.

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