Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Ethiopia

Awotiwon, Ajibola; Sword, Charlie; Eastman, Tracy; Ras, Christy Joy; Ana, Prince; Cornick, Ruth; Fairall, Lara; Bateman, Eric D.; Dube, Audry; Curran, Robyn; Udoekwere, Inemesit; Essien, Unyime-Obong; Assem, Okorie; Edu, Theresa Sylvester; Ismail, Hajia Binta; Olubajo, Olalekan; Ana, Joseph

doi:10.1136/bmjgh-2018-001108

Cited by 38 publications

(32 citation statements)

References 22 publications

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“…Research not always used to inform policy and practice decisions [48][49][50][51][52][53][54][55][56] Examples of LMIC researchers successfully getting evidence used [43,48,49] Factors influencing KT Researchers' reputation/credibility/contextual understanding [32,49,50,[57][58][59][60][61][62][63][64][65][66][67][68]127] Relevance and credibility of research evidence [32, 49, 50, 53, 54, 58, 60, 62-67, 70-72, 127] Contrasting views, demands and incentives among researchers and policy-makers in relation to research, its use, policy actor roles and policy-making [32, 49, 50, 57, 59-61, 67, 70, 73-78] Nature of policy issues (technical versus contested versus interest of policy-maker) [49, 58-62, 67, 70, 76, 79] Political context [32, 48-51, 53, 58, 59, 62, 64, 67, 80, 81, 127] Decision-makers' research background [51,55,57,65,77] Donor influence [51, 54, 55, 57-60, 70, 71, 127] International influence, e.g. WHO [54,58,59,65,67,…”

Section: Research Usementioning

confidence: 99%

“…Short window for responding to policy demands [49,50,51,57,59,67,70,77,78,80] High turnover of government officials and politicians [49,50,53,59,62,64,67,81,85,127] Unfavourable political environment [49, 50, 53, 58, 60-62, 64, 67, 68, 70, 74, 80, 81, 127] Policy implementation challenges [49,50,53,58,64,78,80,81] KT knowledge and skills of target audiences Target audiences lack knowledge/understanding and skills related to research and policy development [31, 49, 50-52, 55, 57-59, 64, 67, 68, 78, 82, 84, 86] Research availability, accessibility and relevance…”

Section: Political Contextmentioning

confidence: 99%

“…Researchers' inadequate research and KT skills [31,49,50,52,55,61,67,72,78,87,127] Researchers' fear of, or limited engagement of, media [52,67,74,77] Challenges with simplifying research findings [49,50,55,59,60,64,67,71,74] Researcher not interested in KT [48,49,[59][60][61] Research institutional support…”

Section: Political Contextmentioning

confidence: 99%

“…Timely research [48,49,58,61,64,65,71,72,85,87,127] Availability of policy-relevant research [43, 50, 57, 64-66, 71-73, 77, 80-82, 87] Researcher/target audience collaboration and networking…”

Section: Political Contextmentioning

confidence: 99%

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Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries

Murunga

Oronje

Bates

et al. 2020

Health Res Policy Sys

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Background: Knowledge translation (KT) is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to yield beneficial outcomes for society. Effective KT requires researchers to play an active role in promoting evidence uptake. This paper presents a systematised review of evidence on low-and middle-income country (LMIC) researchers' KT capacity, practice and interventions for enhancing their KT practice (support) with the aim of identifying gaps and informing future research and interventions. Methods: An electronic search for peer-reviewed publications focusing on LMIC researchers' KT capacity, practice and support across all academic fields, authored in English and from the earliest records available to February 2019, was conducted using PubMed and Scopus. Selected studies were appraised using the Mixed Methods Appraisal Tool, data pertaining to publication characteristics and study design extracted, and an a priori thematic analysis of reported research findings completed. Results: The search resulted in 334 screened articles, of which 66 met the inclusion criteria. Most (n = 43) of the articles presented original research findings, 22 were commentaries and 1 was a structured review; 47 articles reported on researchers' KT practice, 12 assessed the KT capacity of researchers or academic/research institutions and 9 reported on KT support for researchers. More than half (59%) of the articles focused on sub-Saharan Africa and the majority (91%) on health research. Most of the primary studies used the case study design (41%). The findings suggest that LMIC researchers rarely conduct KT and face a range of barriers at individual and institutional levels that limit their KT practice, including inadequate KT knowledge and skills, particularly for communicating research and interacting with research end-users, insufficient funding, and inadequate institutional guidelines, structures and incentives promoting KT practice. Furthermore, the evidence-base on effective interventions for enhancing LMIC researchers' KT practice is insufficient and largely of weak quality.

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Section: Research Usementioning

confidence: 99%

Section: Political Contextmentioning

confidence: 99%

Section: Political Contextmentioning

confidence: 99%

Section: Political Contextmentioning

confidence: 99%

See 2 more Smart Citations

Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries

Murunga

Oronje

Bates

et al. 2020

Health Res Policy Sys

View full text Add to dashboard Cite

show abstract

“…The implementation and training elements of PACK Child are modelled on and complement PACK Adult [18], which was trialled and scaled up in South Africa to over 30 000 clinicians in more than 3500 clinics [21][22][23], using a systematic, educational outreach training strategy and cascade model of implementation [19]. PACK is also being implemented in Botswana [24], Brazil [25], Nigeria [26] and Ethiopia [27], is available globally through a partnership with BMJ (pack.bmj.com) and is being localised for piloting in China [17].…”

Section: The World Health Organizations' (Who) Integrated Management mentioning

confidence: 99%

Addressing the quality and scope of paediatric primary care in South Africa: Evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

Murdoch

Curran

Cornick

et al. 2020

Preprint

Self Cite

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Background: Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children in South Africa. The PACK Child intervention, comprising clinical decision support tool (guide), training strategy and health systems strengthening components, was developed to expand on WHO’s Integrated Management of Childhood Illness programme, extending care of children under 5 years to those aged 0-13 years, those with chronic conditions needing regular follow-up, integration of curative and preventive measures and routine care of the well child. In 2017-2018, PACK Child was piloted in 10 primary healthcare facilities in the Western Cape Province. Here we report findings from an investigation into the contextual features of South African primary care that shaped how clinicians delivered the PACK Child intervention within clinical consultations.Methods: Process evaluation using linguistic ethnographic methodology which provides analytical tools for investigating human behaviour, and the shifting meaning of talk and text within context. Methods included semi-structured interviews, focus groups, ethnographic observation, audio-recorded consultations and documentary analysis. Analysis focused on how mapped contextual features structured clinician-caregiver interactions. Results: Primary healthcare facilities demonstrated an institutionalised orientation to minimising risk upheld by provincial documentation, providing curative episodic care to children presenting with acute symptoms, and preventive care including immunisations, feeding and growth monitoring, all in children 5 years or younger. Children with chronic illnesses such as asthma rarely receive routine care. These contextual features constrained the ability of clinicians to use the PACK Child guide to facilitate diagnosis of long-term conditions, elicit and manage psychosocial issues, and navigate use of the guide alongside provincial documentation. Conclusion: Our findings provide evidence that PACK Child is catalysing a transition to an approach that strikes a balance between assessing and minimising risk on the day of acute presentation and a larger remit of care for children over time. However, optimising success of the intervention requires reviewing priorities for paediatric care which will facilitate enhanced skills, knowledge and deployment of clinical staff to better address acute illnesses and long-term health conditions of children of all ages, as well as complex psychosocial issues surrounding the child.

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Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

Cooper

Figueiredo

Rodríguez

et al. 2023

Clinical & Translational All

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Asthma is an important health concern in Latin America (LA) where it is associated with variable prevalence and disease burden between countries. High prevalence and morbidity have been observed in some regions, particularly marginalized urban populations. Research over the past 10 years from LA has shown that childhood disease is primarily non‐atopic. The attenuation of atopy may be explained by enhanced immune regulation induced by intense exposures to environmental factors such as childhood infections and poor environmental conditions of the urban poor. Non‐atopic symptoms are associated with environmental and lifestyle factors including poor living conditions, respiratory infections, psychosocial stress, obesity, and a diet of highly processed foods. Ancestry (particularly African) and genetic factors increase asthma risk, and some of these factors may be specific to LA settings. Asthma in LA tends to be poorly controlled and depends on access to health care and medications. There is a need to improve management and access to medication through primary health care. Future research should consider the heterogeneity of asthma to identify relevant endotypes and underlying causes. The outcome of such research will need to focus on implementable strategies relevant to populations living in resource‐poor settings where the disease burden is greatest.

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Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Ethiopia

Cited by 38 publications

References 22 publications

Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries

Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries

Addressing the quality and scope of paediatric primary care in South Africa: Evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

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