Article type
Abstract
Background: Utilisation of research evidence has become a central requirement in healthcare. Although the notion of evidence-based practice has been widely embraced in the developed world, research shows this to be less understood and implemented within low-income settings. There is need to understand the factors underpinning the uptake of evidence based practice within these settings.
Objectives: The aim of this review was to synthesise available evidence regarding the barriers to and facilitators of research evidence utilisation in healthcare practice within low-income settings.
Methods: A qualitative systematic review of literature was undertaken between October 2016 to March 2017. Six databases (CINAHL, Ovid MEDLINE (R) 1946, ASSIA, PsychInfo, Web of Science, and EMBASE) were searched followed by hand searching of reference lists. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute (JBI-QARI). Qualitative findings were extracted using the JBI-QARI and synthesised using a pragmatic meta-aggregative approach.
Results: Nine studies were included. The review identified several factors influencing evidence utilisation in healthcare within low-income settings. The main barriers included: lack of knowledge about evidence based practice, lack of access to resources, unsupportive policies, lack of institutional/management support, negative attitudes towards evidence-based practice, and resistance to change. The main facilitators included: Collaboration with international institutions, participation of local stakeholders, staff motivation, context-based policies and guidelines, availing resources, proving trainings, and supportive policies.
Conclusions: Significant barriers challenge the utilisation of evidence in healthcare practice in low-income settings. Approaches to improving evidence utilisation in these settings should primarily focus on: building capacity through trainings; supportive institutional policies; and availing necessary resources. Limited research on this subject has been undertaken in sub-Saharan Africa and future research should target this context.
Objectives: The aim of this review was to synthesise available evidence regarding the barriers to and facilitators of research evidence utilisation in healthcare practice within low-income settings.
Methods: A qualitative systematic review of literature was undertaken between October 2016 to March 2017. Six databases (CINAHL, Ovid MEDLINE (R) 1946, ASSIA, PsychInfo, Web of Science, and EMBASE) were searched followed by hand searching of reference lists. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute (JBI-QARI). Qualitative findings were extracted using the JBI-QARI and synthesised using a pragmatic meta-aggregative approach.
Results: Nine studies were included. The review identified several factors influencing evidence utilisation in healthcare within low-income settings. The main barriers included: lack of knowledge about evidence based practice, lack of access to resources, unsupportive policies, lack of institutional/management support, negative attitudes towards evidence-based practice, and resistance to change. The main facilitators included: Collaboration with international institutions, participation of local stakeholders, staff motivation, context-based policies and guidelines, availing resources, proving trainings, and supportive policies.
Conclusions: Significant barriers challenge the utilisation of evidence in healthcare practice in low-income settings. Approaches to improving evidence utilisation in these settings should primarily focus on: building capacity through trainings; supportive institutional policies; and availing necessary resources. Limited research on this subject has been undertaken in sub-Saharan Africa and future research should target this context.