Low- and middle-income countries face many common barriers to implementation of maternal health evidence products
Low- and middle-income countries face many common barriers to implementation of maternal health evidence products
复制标题
DOI：
10.1016/j.jclinepi.2016.02.017
复制
发表时间：
2016-08-01
影响因子：
7.2
通讯作者：
Straus, Sharon E.
中科院分区：
文献类型：
--
作者：
Ritchie, Lisa M. Puchalski;Khan, Sobia;Straus, Sharon E.
目标：探讨几个低收入和中等收入国家 (LMIC) 在孕产妇健康和证据实施方面面临的挑战的相似性和差异，并确定代表中低收入国家卫生保健环境中证据实施的障碍和促进因素的共同和独特主题。研究设计：定性数据的二次分析。背景：对描述作者在三大洲五个中低收入国家开展的项目的会议报告和文章进行了分析。项目的重点是确定证据产品实施的障碍和促进因素：五项世界卫生组织孕产妇保健指南，以及提高结核病治疗依从性的知识转化策略。使用主题内容分析对数据进行分析。结果：在已发现的证据实施障碍中，不同国家和临床领域存在高度共性，其中资金、物资和人力资源的缺乏最为突出。相比之下，所发现的促进因素在不同国家和证据实施产品之间存在很大差异。结论：通过确定共同障碍和需要额外关注的领域，以确保捕获独特的障碍和促进因素，这些发现为制定框架提供了一个起点，以指导评估孕产妇健康的障碍和促进因素，并可能在中低收入国家更普遍地进行证据实施。 (C) 2016 年作者。由爱思唯尔公司出版
Objectives: To explore similarities and differences in challenges to maternal health and evidence implementation in general across several low- and middle-income countries (LMICs) and to identify common and unique themes representing barriers to and facilitators of evidence implementation in LMIC health care settings.Study Design: Secondary analysis of qualitative data.Setting: Meeting reports and articles describing projects undertaken by the authors in five LMICs on three continents were analyzed. Projects focused on identifying barriers to and facilitators of implementation of evidence products: five World Health Organization maternal health guidelines, and a knowledge translation strategy to improve adherence to tuberculosis treatment. Data were analyzed using thematic content analysis.Results: Among identified barriers to evidence implementation, a high degree of commonality was found across countries and clinical areas, with lack of financial, material, and human resources most prominent. In contrast, few facilitators were identified varied substantially across countries and evidence implementation products.Conclusion: By identifying common barriers and areas requiring additional attention to ensure capture of unique barriers and facilitators, these findings provide a starting point for development of a framework to guide the assessment of barriers to and facilitators of maternal health and potentially to evidence implementation more generally in LMICs. (C) 2016 The Authors. Published by Elsevier Inc.