Evidence implementation in low- and middle-income countries through the JBI Clinical Fellowship Program

Article type
Authors
Okwen P1, Dangol B2, Bayuo J3, Jelly I4, Kebaya L1, Sugiharto S1, Baniya M5, Hajibrahim S6, Pyar K1, Htay M1, Moola S7, McAuthor A7, Munn Z7
1Effective Basic Services Africa
2Patan Hospital, Patan Academy of Health Sciences
3Department of Nursing, Faculty of Health and Medical Sciences, Presbyterian University College; Burns Intensive Care Unit, Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi- Ghana
4Afya Research Africa; A Joanna Briggs Institute Center of Excellence
5Spinal Injury Rehabilitation Center, Project of Spinal Injury Sangh Nepal
6Research center for Evidence based medicine, Tabriz University of Medical Sciences
7Joanna Briggs Institute, Adelaide
Abstract
Background: Research evidence is becoming available to different settings, including low- and middle-income countries (LMIC). However, getting research evidence into practice still remains a challenge. LMIC settings are quite challenging to conduct research and to translate the evidence mostly due to access, capacity and cost.

Objectives: The main goal of this study is to analyse the barriers and coping strategies while getting research into practice in LMIC.

Methods:10 clinical fellows were recruited from 6 LMICs between January and November 2016 by the Joanna Briggs Institute Clinical Fellowship Program. They were trained on JBI Practical Application of Evidence System (PACES) and the Getting Research into Practice (GRiP) frameworks. Data were extracted from the implementation reports of each fellow and were analysed.

Results:Ten projects were completed in 8 LMIC countries in Africa and Asia including the Middle East. The projects included 4 communicable diseases (Malaria, Tuberculosis, UTI, Chronic Rhinosinusitis), 2 non-communicable diseases (Diabetes, Cancers), 2 traumatic conditions (Burns and Spinal Cord Injury) and 1 practice and organisation of care (Neonatal resuscitation). Forty-nine barriers to best practice were identified, with some being common.Two behaviour-change techniques were used and twenty health outcomes were improved. Overall compliance with best practice improved from 31% (R: 0-71) to 90% (R: 64-100).

Conclusions: The JBI PACES and GRiP approach is effective in getting research into practice in LMICs and therefore promotes the use of evidence to improve standard of care and treatment.