Bridging the gaps between research, policy and practice in low- and middle-income countries: a survey of health care providers

Guindon, G. Emmanuel; Lavis, John N.; Becerra-Posada, Francisco; Malekafzali, Hossein; Shi, Guang; Yesudian, C. A. K.; Hoffman, Steven J.; Team, Practice Study

doi:10.1503/cmaj.081165

Cited by 63 publications

(62 citation statements)

References 37 publications

(32 reference statements)

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“…The large and increasing burden of musculoskeletal disease in low-and middle-income countries is poorly documented and largely neglected by the global health community [5,8,21,37]. Injury underlies 11.2% of all disability adjusted life years as reported by the Global Burden of Disease Study 2010 [29], with musculoskeletal injury estimated to account for 70% to 80% of reported injuries in one developing country (Sierra Leone) [39].…”

Section: Introductionmentioning

confidence: 99%

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Elliott

Sonshine

Akhavan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Research addressing the burden of musculoskeletal disease in low-and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low-and middle-income countries. Purpose We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Materials Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. Results We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to This study was supported by private donations to the Institute for Global Orthopaedics and Traumatology (IGOT, San Francisco, CA, USA). No authors received payment or in-kind benefit for this study, nor are any authors members of a company that provided funding to IGOT. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the research process (26%) and institutional barriers (28%). Drivers of research discussed at least once were proportionally similar across the three domains. Some themes such as research ethics boards, technology, and literature access occurred with similar frequency as barriers to and drivers of orthopaedic surgery research. Conclusions The barriers we identified most often among East African academic orthopaedic faculty members focused on resources to accomplish research, followed by institutional barriers, and method or process ba...

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Section: Introductionmentioning

confidence: 99%

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Elliott

Sonshine

Akhavan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…In a related article, we de scribe the findings from a survey of health care providers in these countries who were practising in one of these clinical areas about their awareness of, access to and use of researchbased evidence in these clinical areas and the influence of such evidence on their professional practice. 10 The challenges associated with documenting such efforts include cross-country differences in the capacity to conduct surveys of researchers; the visibility of researchers depending on their alignment with priorities of government, development agencies, research funding agencies and industry (and hence their likelihood of being identified to participate in these surveys); and re searchers' familiarity with and attitudes toward the bridging activities asked about in these surveys.…”

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confidence: 99%

Bridging the gaps between research, policy and practice in low- and middle-income countries: a survey of researchers

Lavis¹,

Guindon²,

Cameron³

et al. 2010

Canadian Medical Association Journal

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“…11 Inevitably, the cost of delivery will limit the way in which education can be delivered. While many countries will eschew pharmaceutical company assistance, other countries may not be able to afford programmes that are not subsidised 12 -another manifestation of Tudor Hart's Inverse Care Law? 13 The efficiency of targeted education noted in the Danish study is worthy of further consideration -aiming to provide preferential access to those practitioners who most need the education.…”

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confidence: 99%

Is education at the crossroads?

Tomlins

2013

Primary Care Respiratory Journal

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Bridging the gaps between research, policy and practice in low- and middle-income countries: a survey of health care providers

Cited by 63 publications

References 37 publications

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Bridging the gaps between research, policy and practice in low- and middle-income countries: a survey of researchers

Is education at the crossroads?

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