Learning health systems: an empowering agenda for low-income and middle-income countries

Sheikh, Kabir; Agyepong, Irène Akua; Jhalani, Manoj; Ammar, Walid; Hafeez, Assad; Pyakuryal, Sushil; Abimbola, Seye; Ghaffar, Abdul; Swaminathan, Soumya

doi:10.1016/s0140-6736(19)33134-4

Cited by 37 publications

(36 citation statements)

References 10 publications

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“…This is particularly relevant to IR in LMICs where health systems are often underdeveloped and there is a lack of established approaches to collecting and using locally generated information. 2 In these contexts, researchers are needed to create locally relevant evidence-based solutions to implementation challenges in order to ensure that interventions are relevant, sustainable, and optimally delivered in order to reach the intended audience at scale.…”

Section: Discussionmentioning

confidence: 99%

“…1 The need to address implementation bottlenecks for e cacious health interventions is often greatest in low-and middle-income countries (LMICs), where health systems are underdeveloped and do not have established mechanisms to effectively collect and use locally generated information. 2 Building research capacities to identify and enact strategies for overcoming implementation challenges is increasingly important as countries strive for universal health coverage while combating the burden of infectious and non-communicable diseases at varying levels of intensity.…”

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confidence: 99%

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Implementation Research Training for Learners in Low- and Middle-income Countries: Evaluating Behavior Change After Participating in a Massive Online Open Course

Launois¹,

Maher²,

Certain³

et al. 2020

Preprint

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Background: Implementation research (IR) can play a critical role in the delivery of disease control interventions, particularly in low- and middle-income countries (LMICs). The growing demand for IR training has led to the development of a range of training programs and university courses, the majority of which can not be accessed by learners in LMICs. This article reports on the evaluation of a massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases hosted by the World Health Organization on the topic of IR with a focus on infectious diseases of poverty. This study followed Kirkpatrick’s Model to evaluate training programs with a specific focus on post-training changes in behavior.Methods: MOOC participants were invited to take part in an anonymous online survey examining their IR knowledge and how they applied it in their professional practice approximately 1-1.5 years after completing the MOOC. The survey contained 43 open-ended, multiple choice and Likert-type questions. Descriptive statistics were calculated for the quantitative data and responses to the open-ended questions were thematically coded.Results: A total of 748 MOOC participants responded to the survey. The demographic profile of the survey respondents aligned with that of the MOOC participants, with nearly 70% of respondents originating from Africa. Responses to the quantitative and open-ended survey questions revealed that respondents’ IR knowledge had improved to a large extent as a result of the MOOC, and that they used the knowledge and skills gained in their professional lives frequently. Respondents most often cited changes in their conceptual understanding of IR and understanding of the research process as substantial areas of change influenced by participating in the MOOC.Conclusions: These findings indicate that the MOOC was successful in targeting learners from LMICs, in strengthening their IR knowledge and in contributing to their ability to apply it in their professional practice. The utility of MOOCs for providing IR training to learners in LMICs, where implementation challenges are encountered often, makes this platform an ideal standalone learning tool or one that could be combined with other training formats.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Implementation Research Training for Learners in Low- and Middle-income Countries: Evaluating Behavior Change After Participating in a Massive Online Open Course

Launois¹,

Maher²,

Certain³

et al. 2020

Preprint

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“…IR has the potential to contribute in each of these learning dimensions—it is a crucial source of information about programme and policy actions, and involves stakeholder deliberations on research priorities, research processes and the utilization of research findings. Alongside, strengthening the utilization of routine health information, embedding IR into health systems is a crucial foundation stone for developing a learning health system ( Sheikh et al , 2020 ).…”

Section: Ir For the Learning Health Systemmentioning

confidence: 99%

Implementation research is crucial to countries’ efforts to strengthen learning health systems

Ghaffar

Swaminathan

Sheikh

et al. 2020

Health Policy and Planning

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“…For instance, a policy that has succeeded in one place may fail in another [ 8 ] or the results of a policy designed and implemented in a country may be quite the opposite of what was expected [ 9 ]. Therein, it has been argued that the ability to continually learn and adapt is essential — learning should then be at the heart of UHC-related policy processes [ 10 – 12 ]. Indeed, there is growing interest among global health actors towards ‘learning for UHC’.…”

Section: Introductionmentioning

confidence: 99%

“…In any case, there are probably missed opportunities — countries do not leverage the large array of learning situations that have great potential to spur their progress toward UHC. Today, too few ministries or technical departments are purposely investing in their own systemic learning capacities [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Policy learning and Universal Health Coverage in low- and middle-income countries

Kiendrébéogo

Allegri

Meessen³

2020

Health Res Policy Sys

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Learning is increasingly seen as an essential component to spur progress towards universal health coverage (UHC) in low-and middle-income countries (LMICs). However, learning remains an elusive concept, with different understandings and uses that vary from one person or organisation to another. Specifically, it appears that 'learning for UHC' is dominated by the teacher modenotably scientists and experts as 'teachers' conveying to local decision/policy-makers as 'learners' what to do. This article shows that, to meet countries' needs, it is important to acknowledge that UHC learning situations are not restricted to the most visible epistemic learning approach practiced today. This article draws on an analytical framework proposed by Dunlop and Radaelli, whereby they identified four learning modes that can emerge according to the specific characteristics of the policy process: epistemic learning, learning in the shadow of hierarchy, learning through bargaining and reflexive learning. These learning modes look relevant to help widen the learning prospects that LMICs need to advance their UHC agenda. Actually, they open up new perspectives in a research field that, until now, has appeared scattered and relatively blurry.

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Learning health systems: an empowering agenda for low-income and middle-income countries

Cited by 37 publications

References 10 publications

Implementation Research Training for Learners in Low- and Middle-income Countries: Evaluating Behavior Change After Participating in a Massive Online Open Course

Implementation Research Training for Learners in Low- and Middle-income Countries: Evaluating Behavior Change After Participating in a Massive Online Open Course

Implementation research is crucial to countries’ efforts to strengthen learning health systems

Policy learning and Universal Health Coverage in low- and middle-income countries

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