Let’s stop dumping cookstoves in local communities. It’s time to get implementation right

Brakema, Evelyn A; Kleij, Rianne van der; Vermond, Debbie; Gemert, Frederik A van; Kirenga, Bruce

doi:10.1038/s41533-019-0160-8

Cited by 14 publications

(13 citation statements)

References 30 publications

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“…Beyond the health burden, there is a substantial socioeconomic burden of CRD in LMICs 53 . Effectiveness of previous lung health programmes is often hampered by implementation failure, further draining resource potential from already resource-limited settings and leading to poor health outcomes 11 . By demonstrating a feasible, acceptable and effective translation of an awareness programme in Uganda to two completely different settings-in Kyrgyzstan and Vietnam-we provide a potential guide for universal translation to other settings.…”

Section: Training Of Local Communiɵesmentioning

confidence: 99%

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Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

Brakema

Gemert

Williams³

et al. 2020

npj Prim. Care Respir. Med.

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Most patients with chronic respiratory disease live in low-resource settings, where evidence is scarcest. In Kyrgyzstan and Vietnam, we studied the implementation of a Ugandan programme empowering communities to take action against biomass and tobacco smoke. Together with local stakeholders, we co-created a train-the-trainer implementation design and integrated the programme into existing local health infrastructures. Feasibility and acceptability, evaluated by the modified Conceptual Framework for Implementation Fidelity, were high: we reached ~15,000 Kyrgyz and ~10,000 Vietnamese citizens within budget (~€11,000/country). The right engaged stakeholders, high compatibility with local contexts and flexibility facilitated programme success. Scores on lung health awareness questionnaires increased significantly to an excellent level among all target groups. Behaviour change was moderately successful in Vietnam and highly successful in Kyrgyzstan. We conclude that contextualising the awareness programme to diverse low-resource settings can be feasible, acceptable and effective, and increase its sustainability. This paper provides guidance to translate lung health interventions to new contexts globally.

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Section: Training Of Local Communiɵesmentioning

confidence: 99%

“…This would involve solutions such as smoking cessation and providing alternatives for cooking and heating on solid fuels in poorly ventilated homes. However, for decades, implementation of such interventions in local communities has demonstrated to be challenging [11][12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

Brakema

Gemert

Williams³

et al. 2020

npj Prim. Care Respir. Med.

Self Cite

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“…Therefore, a combination of qualitative with quantitative (mixed-method) evidence would be highly welcome; such studies are still largely unavailable. The need for more high-quality implementation evidence for LMICs has been highlighted repeatedly [25,[34][35][36][37]92]. Systematic reviews are particularly scarce.…”

Section: Ensure Compatibilitymentioning

confidence: 99%

“…In some estimates, over 60% of organisations' implementation efforts are unsuccessful [19]. Implementation success of clean cookstove programmes is often reported as strikingly low, with stove adoption rates of 4-10% [20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

“…Extrapolating the evidence from high-income countries to LMICs is inappropriate because of differences in health, economic and cultural contexts. Several calls already highlighted the need for high-quality implementation research in LMICs [ 25 , 34 – 37 ]. Therefore, in this study, we aimed to identify factors critical to the successful implementation of interventions targeting CRDs in LMICs, and to weigh their level of evidence.…”

Section: Introductionmentioning

confidence: 99%

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Implementing lung health interventions in low- and middle-income countries: a FRESH AIR systematic review and meta-synthesis

et al. 2020

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The vast majority of patients with chronic respiratory disease live in low- and middle-income countries (LMICs). Paradoxically, relevant interventions often fail to be effective particularly in these settings, as LMICs lack solid evidence on how to implement interventions successfully. Therefore, we aimed to identify factors critical to the implementation of lung health interventions in LMICs, and weight their level of evidence.This systematic review followed Cochrane methodology and PRISMA reporting standards. We searched eight databases without date- or language restrictions in July 2019, and included all relevant original, peer-reviewed articles. Two researchers independently selected articles, critically appraised them (using CASP/MetaQAT), extracted data, coded factors (following CFIR), and assigned levels of confidence in the factors (via GRADE-CERQual). We meta-synthesised levels of evidence of the factors based on their frequency and the assigned level of confidence. (PROSPERO:CRD42018088687)We included 37 articles out of 9111 screened. Studies were performed across the globe in a broad range of settings. Factors identified with a high level of evidence were 1) Understanding needs of local users, 2) ensuring Compatibility of interventions with local contexts (cultures, infrastructures), 3) identifying influential stakeholders and applying Engagement strategies, 4) ensuring adequate Access to knowledge and information, and 5) addressing Resource Availability. All implementation factors and their level of evidence were synthesised in an implementation tool.To conclude, this study identified implementation factors for lung health interventions in LMICs, weighted their level of evidence, and integrated the results into an implementation tool for practice. Policymakers, non-governmental organisations, practitioners, and researchers may use this FRESH AIR Implementation tool to develop evidence-based implementation strategies for related interventions. This could increase interventions’ implementation success, thereby optimising the use of already-scarce resources and improving health outcomes.

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Clean cooking interventions: Towards user-centred contexts of use design

Abdelnour

Pemberton-Pigott

Deichmann

2020

Energy Research & Social Science

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Let’s stop dumping cookstoves in local communities. It’s time to get implementation right

Cited by 14 publications

References 30 publications

Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

Implementing lung health interventions in low- and middle-income countries: a FRESH AIR systematic review and meta-synthesis

Clean cooking interventions: Towards user-centred contexts of use design

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