A health knowledge brokering intervention in a district of Burkina Faso: A qualitative retrospective implementation analysis

Abstract

Background A knowledge brokering (KB) intervention was implemented in Burkina Faso. By creating partnerships with health system actors in one district, the broker was expected to assess their knowledge needs, survey the literature to provide the most recent research evidence, produce various knowledge translation tools, and support them in using research to improve their actions. The purpose of this study was to analyze the key factors that influenced the KB project and to make recommendations for future initiatives. Methods The qualitative design involved a single case study in which the KB intervention implementation was evaluated retrospectively. Data came from interviews with the intervention team (n = 4) and with various actors involved in the intervention (n = 16). Data from formative evaluations conducted during the KB implementation and observation data from a two-month field mission were also used. Two conceptual frameworks were combined to guide the analysis: the Consolidated Framework for Implementation Research (Damschroder et al., 2009) and the Ecological Framework (Durlak & DuPre, 2008). Results Various KB activities were conducted during the first two years of implementation at the local level. The project came to an early end following vain efforts to relocate the intervention at the central level in order to further influence the policy process. Certain shortcomings in the implementation team negatively influenced the implementation: inadequate leadership, no shared vision regarding the reorientation of the intervention, challenges related to the KB role, and lack of frank communications internally. Other impediments to the intervention’s deployment included local actors' lack of decision-making authority, the unavailability of resources and of organizational incentives for involvement in the KB intervention, and contextual challenges in accessing the central level. However, the KB strategy presented several strengths: collaborative development, support provided to local partners by the broker, and training opportunities and support provided to the broker. Conclusions More attention must be paid to intervention planning, partners’ engagement, human, financial and technical resources availability, continuous development of skills and of communications within the KB team, and periodic assessment of potential obstacles related to the complexity of the system within which the intervention has been implemented. Using implementation science frameworks when developing KB strategies in the West African context should be promoted.

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'Like brushing teeth' - Implementation experiences with opt-in, at-home screening for SARS-CoV-2 among schoolchildren in Germany

“…To highlight implementation processes and experiences, results are presented along the framework of McSween-Cadieux and colleagues (Table 1) [15] which combines the Consolidated Framework for Implementation Research [16] and the Ecological Framework.…”

“…To highlight implementation processes and experiences, results are presented along the framework of McSween-Cadieux and colleagues (Table 1) [15] which combines the Consolidated Framework for Implementation Research [16] and the Ecological Framework. [17] The framework investigates factors influencing intervention implementation across six domains: intervention, individuals, support system, inner setting, outer setting, and the implementation process.…”

Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial

“…In consultation with key stakeholders in each participating country, we will develop an innovative evidence-based knowledge transfer strategy 35,36 , adapted to each context. The key ingredients of this strategy will be training, implementation and evaluation of a knowledge broker in each country who will facilitate the adaptation, dissemination and exploitation of QUALI-DEC ndings by key stakeholders (see Appendix).…”