Premium
Mapping Clinical Barriers and Evidence‐Based Implementation Strategies in Low‐to‐Middle Income Countries (LMICs)
Author(s) -
Whitehorn Ashley,
Fu Liang,
Porritt Kylie,
Lizarondo Lucylynn,
Stephenson Matthew,
Marin Tania,
Aye Gyi Aye,
Dell Kim,
Mig Alex,
Lockwood Craig
Publication year - 2021
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12503
Subject(s) - medicine , evidence based practice , health care , context (archaeology) , implementation research , audit , nursing , knowledge translation , low and middle income countries , medical education , knowledge management , process management , business , developing country , psychological intervention , political science , computer science , geography , alternative medicine , pathology , economic growth , accounting , archaeology , law , economics
Abstract Background Low‐to‐middle income countries (LMICs) experience a high burden of disease from both non‐communicable and communicable diseases. Addressing these public health concerns requires effective implementation strategies and localization of translation of knowledge into practice. Aim To identify and categorize barriers and strategies to evidence implementation in LMICs from published evidence implementation studies. Methods A descriptive analysis of key characteristics of evidence implementation projects completed as part of a 6‐month, multi‐phase, intensive evidence‐based clinical fellowship program, conducted in LMICs and published in the JBI Database of Systematic Reviews and Implementation Reports was undertaken. Barriers were identified and categorized to the Donabedian dimensions of care (structure, process, and outcome), and strategies were mapped to the Cochrane effective practice and organization of care taxonomy. Results A total of 60 implementation projects reporting 58 evidence‐based clinical audit topics from LMICs were published between 2010 and 2018. The projects included diverse populations and were predominantly conducted in tertiary care settings. A total of 279 barriers to implementation were identified. The most frequently identified groupings of barriers were process‐related and associated predominantly with staff knowledge. A total of 565 strategies were used across all projects, with every project incorporating more than one strategy to address barriers to implementation of evidence‐based practice; most strategies were categorized as educational meetings for healthcare workers. Linking Evidence to Action Context‐specific strategies are required for successful evidence implementation in LMICs, and a number of common barriers can be addressed using locally available, low‐cost resources. Education for healthcare workers in LMICs is an effective awareness‐raising, workplace culture, and practice‐transforming strategy for evidence implementation.