What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science.
Background: Most low and middle income countries (LMICs) are currently not on track to reach the health-related Millennium Development Goals (MDGs). One way to accelerate progress would be through the large-scale implementation of evidence-based health tools and interventions. This study aimed to: (...
| Publicado en: | Globalization & Health Vol. 8; no. 1; pp. 11 - 12 |
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| Autor principal: | |
| Formato: | research Journal Article |
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BioMed Central
2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104390209&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104390209 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17448603 1CPG jtl: Globalization & Health issn: 17448603 maglogo: N pubinfo: dt: 2012 vid: 8 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 104390209 NLM22643120 2011777729 10.1186/1744-8603-8-11 NLM22643120 PMC3514334 104390209 ppf: 11 ppct: 1 formats: tig: atl: What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science. aug: au: Yamey, Gavin affil: Evidence to Policy initiative (E2Pi), Global Health Group, University of California San Francisco, 50 Beale St, Suite 1200, Box 1224, San Francisco, CA, 94105, USA. yameyg@globalhealth.ucsf.edu. sug: subj: Developing Countries Professional Practice, Evidence-Based Health Services Standards Health Services Needs and Demand Poverty Diffusion of Innovation Health and Welfare Planning Health Policy Health Resource Utilization Health Services Research Human Interviews Management Organizational Objectives Qualitative Studies Quality Assurance ab: Background: Most low and middle income countries (LMICs) are currently not on track to reach the health-related Millennium Development Goals (MDGs). One way to accelerate progress would be through the large-scale implementation of evidence-based health tools and interventions. This study aimed to: (a) explore the barriers that have impeded such scale-up in LMICs, and (b) lay out an "implementation research agenda"--a series of key research questions that need to be addressed in order to help overcome such barriers.Methods: Interviews were conducted with fourteen key informants, all of whom are academic leaders in the field of implementation science, who were purposively selected for their expertise in scaling up in LMICs. Interviews were transcribed by hand and manually coded to look for emerging themes related to the two study aims. Barriers to scaling up, and unanswered research questions, were organized into six categories, representing different components of the scaling up process: attributes of the intervention; attributes of the implementers; scale-up approach; attributes of the adopting community; socio-political, fiscal, and cultural context; and research context.Results: Factors impeding the success of scale-up that emerged from the key informant interviews, and which are areas for future investigation, include: complexity of the intervention and lack of technical consensus; limited human resource, leadership, management, and health systems capacity; poor application of proven diffusion techniques; lack of engagement of local implementers and of the adopting community; and inadequate integration of research into scale-up efforts.Conclusions: Key steps in expanding the evidence base on implementation in LMICs include studying how to: simplify interventions; train "scale-up leaders" and health workers dedicated to scale-up; reach and engage communities; match the best delivery strategy to the specific health problem and context; and raise the low profile of implementation science. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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