Implementation and evaluation of the RAISE initiative: supporting low and middle income countries to adapt and implement health systems guidelines

Article type
Authors
Fahim C1, Quinn de Launay K1, Baddeliyanage R1, Davenport-Huyer L1, Marten R2, Hadush Gebregiorgis A3, Wiysonge CS4, Puchalski-Ritchie L1, Tricco A1, Pham B1, Peer N1, Tuncalp O5, Akala O2, Langlois E6, Straus SE1
1Knowledge Translation Program, St. Michael's Hospital, Unity Health Toronto
2Alliance for Health Policy and Systems Research, World Health Organization
3World Health Organization Ethiopia
4South African Cochrane Centre
5Human Reproduction Programme World Health Organization
6WHO Partnership for Maternal, Newborn & Child Health PMNCH
Abstract
Background: There is limited evidence on how to build capacity for health policy and systems research (HPSR) implementation in low and middle income countries (LMIC). The World Health Organization’s Research to Enhance the Adaptation and Implementation of Health Systems Guidelines (RAISE) initiative aims to support six LMIC teams to adapt and implement health systems guidelines. We describe our approach to developing a Technical Support Centre (TSC) in response to RAISE teams’ needs and our plan to evaluate the impact of the TSC.

Objectives: Develop and evaluate a tailored TSC support program based on RAISE teams’ needs.

Methods: Informed by the Knowledge to Action model, the Theoretical Domains Framework, and the Consolidated Framework for Implementation Research, we conducted a needs assessment to develop the TSC activities. The needs assessment was composed of key informant interviews and surveys with RAISE participants from six LMICs (Nigeria, Ghana, Mozambique, Zambia, India, Colombia). Data were analyzed by 2 researchers using a rapid analysis approach. The TSC activities were developed in response to the identified needs.

Results: A total of 28 RAISE participants responded to the needs assessment survey and/or participated in the interviews. Participants included 6 principal investigators, 13 co-investigators, 5 research coordinators/assistants, and 4 decision makers/knowledge users. The teams requested support on: engaging and training policy-makers to support evidence-based implementation in LMIC contexts and KT theories, models and frameworks to support health system guidelines adaptation and implementation. Anticipated challenges to health system guidelines adaptation and implementation included: limited institutional resources and supports, maintaining policymaker and stakeholder engagement, delays in regulatory approvals, changes in government policies/priorities, and lack of understanding of KT and HPSR methods. In response to identified needs, the TSC activities include: an in-person, kickoff workshop on KT and HPSR methods, a webinar series iteratively tailored to team needs, online discussion boards to support collaboration, implementation support (eg: review of protocols, study materials) and coaching calls, and in-country workshops to support local capacity. A comprehensive four phase, mixed methods study design protocol was developed and registered on Open Science Framework to determine the impact of the TSC program.

Expected Impact: To advance the knowledge on capacity building to support high-quality health system guidelines adaptation and implementation in LMICs.

Stakeholder Involvement: The TSC activities were designed using an integrated KT approach and are tailored to the needs of the RAISE teams.