Sydney Breneol1,2, Janet A Curran3,4, Robert Marten5, Kirti Minocha1, Catie Johnson1,2, Helen Wong1,6, Etienne V Langlois7, Lori Wozney8, C Marcela Vélez9, Christine Cassidy1,2, Sanjay Juvekar10, Melissa Rothfus11, Lydia Aziato12, Lisa Keeping-Burke13, Samuel Adjorlolo14, Daniel F Patiño-Lugo9. 1. School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada. 2. Strengthening Transitions in Care Lab, IWK Health Centre, 8th Floor Children's Site, 5850/5980 University Ave, Halifax, NS, B3K 6R8, Canada. 3. School of Nursing, Faculty of Health, Dalhousie University, Halifax, Canada. jacuran@dal.ca. 4. Strengthening Transitions in Care Lab, IWK Health Centre, 8th Floor Children's Site, 5850/5980 University Ave, Halifax, NS, B3K 6R8, Canada. jacuran@dal.ca. 5. Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. 6. Faculty of Health, Dalhousie University, Halifax, Canada. 7. Partnership for Maternal, Newborn & Child Health (PMNCH), World Health Organization, Geneva, Switzerland. 8. Nova Scotia Health Authority Policy and Planning, Dartmouth, Canada. 9. Facultad de Medicina, Universidad de Antioquia, Medellín, Antioquia, Colombia. 10. Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India. 11. W.K. Kellogg Health Science Library, Dalhousie University, Halifax, Canada. 12. School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana. 13. Department of Nursing & Health Sciences, University of New Brunswick, St. John, Canada. 14. Department of Mental Health Nursing, University of Ghana, Legon, Accra, Ghana.
Abstract
BACKGROUND: Evidence-based health system guidelines are pivotal tools to help outline the important financial, policy and service components recommended to achieve a sustainable and resilient health system. However, not all guidelines are readily translatable into practice and/or policy without effective and tailored implementation and adaptation techniques. This scoping review mapped the evidence related to the adaptation and implementation of health system guidelines in low- and middle-income countries. METHODS: We conducted a scoping review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was implemented in MEDLINE (Ovid), Embase, CINAHL, LILACS (VHL Regional Portal), and Web of Science databases in late August 2020. We also searched sources of grey literature and reference lists of potentially relevant reviews. All findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS: A total of 41 studies were included in the final set of papers. Common strategies were identified for adapting and implementing health system guidelines, related barriers and enablers, and indicators of success. The most common types of implementation strategies included education, clinical supervision, training and the formation of advisory groups. A paucity of reported information was also identified related to adaptation initiatives. Barriers to and enablers of implementation and adaptation were reported across studies, including the need for financial sustainability. Common approaches to evaluation were identified and included outcomes of interest at both the patient and health system level. CONCLUSIONS: The findings from this review suggest several themes in the literature and identify a need for future research to strengthen the evidence base for improving the implementation and adaptation of health system guidelines in low- and middle-income countries. The findings can serve as a future resource for researchers seeking to evaluate implementation and adaptation of health system guidelines. Our findings also suggest that more effort may be required across research, policy and practice sectors to support the adaptation and implementation of health system guidelines to local contexts and health system arrangements in low- and middle-income countries.
BACKGROUND: Evidence-based health system guidelines are pivotal tools to help outline the important financial, policy and service components recommended to achieve a sustainable and resilient health system. However, not all guidelines are readily translatable into practice and/or policy without effective and tailored implementation and adaptation techniques. This scoping review mapped the evidence related to the adaptation and implementation of health system guidelines in low- and middle-income countries. METHODS: We conducted a scoping review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was implemented in MEDLINE (Ovid), Embase, CINAHL, LILACS (VHL Regional Portal), and Web of Science databases in late August 2020. We also searched sources of grey literature and reference lists of potentially relevant reviews. All findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS: A total of 41 studies were included in the final set of papers. Common strategies were identified for adapting and implementing health system guidelines, related barriers and enablers, and indicators of success. The most common types of implementation strategies included education, clinical supervision, training and the formation of advisory groups. A paucity of reported information was also identified related to adaptation initiatives. Barriers to and enablers of implementation and adaptation were reported across studies, including the need for financial sustainability. Common approaches to evaluation were identified and included outcomes of interest at both the patient and health system level. CONCLUSIONS: The findings from this review suggest several themes in the literature and identify a need for future research to strengthen the evidence base for improving the implementation and adaptation of health system guidelines in low- and middle-income countries. The findings can serve as a future resource for researchers seeking to evaluate implementation and adaptation of health system guidelines. Our findings also suggest that more effort may be required across research, policy and practice sectors to support the adaptation and implementation of health system guidelines to local contexts and health system arrangements in low- and middle-income countries.
Authors: Maria Cecilia Dedios; Alexo Esperato; Luz Maria De-Regil; Juan Pablo Peña-Rosas; Susan L Norris Journal: Implement Sci Date: 2017-03-21 Impact factor: 7.327
Authors: Christine Kihembo; Ben Masiira; Lydia Nakiire; Edson Katushabe; Nasan Natseri; Immaculate Nabukenya; Innocent Komakech; Charles Lukoya Okot; Francis Adatu; Issa Makumbi; Miriam Nanyunja; Solomon Fisseha Woldetsadik; Patrick Tusiime; Peter Nsubuga; Ibrahima Soce Fall; Alemu Wondimagegnehu Journal: BMC Public Health Date: 2018-07-13 Impact factor: 3.295