The Kathmandu Declaration on Global CVD/Hypertension Research and
                        Implementation Science: A Framework to Advance Implementation Research for
                        Cardiovascular and Other Noncommunicable Diseases in Low- and Middle-Income
                        Countries

Aifah, Angela; Iwelunmor, Juliet; Akwanalo, Constantine; Allison, Jeroan J.; Amberbir, Alemayehu; Asante, Kwaku Poku; Baumann, Ana A.; Brown, Angela L.; Butler, Mark J.; Dalton, Milena; Dávila‐Román, Víctor G.; Fitzpatrick, Annette L.; Fort, Meredith; Goldberg, Robert J.; Gondwe, Austrida; Ha, Duc Anh; He, Jiang; Hosseinipour, Mina C.; Irazola, Vilma; Kamano, Jemima; Karengera, Stephen; Karmacharya, Biraj; Koju, Rajendra; Maharjan, Rashmi; Mohan, Sailesh; Mutabazi, Vincent; Mutimura, Eugene; Muula, Adamson S; Narayan, K.M. Venkat; Nguyen, Hoa Mi; Njuguna, Benson; Nyirenda, Moffat; Ogedegbe, Gbenga; Oosterhout, Joep van; Onakomaiya, Deborah; Patel, Shivani A.; Paniagua-Ávila, Alejandra; Ramírez‐Zea, Manuel; Plange‐Rhule, Jacob; Roche, Dina; Shrestha, Archana; Sharma, Hanspria; Tandon, Nikhil; Thu-Cuc, Nguyen; Vaidya, Abhinav; Vedanthan, Rajesh; Weber, Mary Beth

doi:10.1016/j.gheart.2019.05.006

Cited by 25 publications

(27 citation statements)

References 9 publications

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“…However, inequities in the delivery of healthcare are a global issue. Ongoing efforts are documenting the magnitude of these healthcare inequities, identifying interventions to improve healthcare delivery, and improving crosscountry communications for better implementation of these interventions for communities in need [84]; e.g., [85,86]. A common challenge in these efforts is finding the balance between a global response to address inequities in healthcare delivery while respecting and understanding the unique systems of care across countries.…”

Section: Considerations For Global Inequities In Healthcare Deliverymentioning

confidence: 99%

Reframing implementation science to address inequities in healthcare delivery

Baumann

Cabassa

2020

BMC Health Serv Res

265

273

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Background: Research has generated valuable knowledge in identifying, understanding, and intervening to address inequities in the delivery of healthcare, yet these inequities persist. The best available interventions, programs and policies designed to address inequities in healthcare are not being adopted in routine practice settings. Implementation science can help address this gap by studying the factors, processes, and strategies at multiple levels of a system of care that influence the uptake, use, and the sustainability of these programs for vulnerable populations. We propose that an equity lens can help integrate the fields of implementation science and research that focuses on inequities in healthcare delivery. Main text: Using Proctor et al.' (12) framework as a case study, we reframed five elements of implementation science to study inequities in healthcare. These elements include: 1) focus on reach from the very beginning; 2) design and select interventions for vulnerable populations and low-resource communities with implementation in mind; 3) implement what works and develop implementation strategies that can help reduce inequities in care; 4) develop the science of adaptations; and 5) use an equity lens for implementation outcomes. Conclusions: The goal of this paper is to continue the dialogue on how to critically infuse an equity approach in implementation studies to proactively address healthcare inequities in historically underserved populations. Our examples provide ways to operationalize how we can blend implementation science and healthcare inequities research.

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Section: Considerations For Global Inequities In Healthcare Deliverymentioning

confidence: 99%

Reframing implementation science to address inequities in healthcare delivery

Baumann

Cabassa

2020

BMC Health Serv Res

265

273

View full text Add to dashboard Cite

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“…As a branch of medical and health sciences, global health has three fundamental tasks: (1) to master the spatio-temporal patterns of a medical and/or health issue across the globe to gain a better understanding of the issue and to assess its global impact [40][41][42][43]; (2) to investigate the determinants and influential factors associated with medical and health issues that are known to have global impact [15,[40][41][42][43]; and (3) to establish evidence-based global solutions, including strategies, frameworks, governances, policies, regulations and laws [14,15,28,38,[44][45][46][47].…”

Section: The Definition Of Global Healthmentioning

confidence: 99%

“…Global solutions are also needed for many emerging health problems, including cardiovascular diseases, sedentary lifestyle, obesity, internet abuse, drug abuse, tobacco smoking, suicide, and other problems [29,44]. As described earlier, global solutions are not often a medical intervention or a procedure for individual patients but frameworks, policies, strategies, laws and regulations.…”

Section: The Concept Of Global Solutionmentioning

confidence: 99%

“…Any HIV/AIDS studies regardless of their scope will be global as long as it contributes to the global efforts to end the HIV/AIDS epidemic by 2030 [61,62]. Lastly, an investigation of cardiovascular diseases (CVD) in a country, in Nepal for example, can be considered as global if the study is framed from a global perspective [44].…”

Section: Types Of Global Health Researchesmentioning

confidence: 99%

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What is global health? Key concepts and clarification of misperceptions

Chen

Lucero‐Prisno

et al. 2020

glob health res policy

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The call for "Working Together to Build a Community of Shared Future for Mankind" requires us to improve people's health across the globe, while global health development entails a satisfactory answer to a fundamental question: "What is global health?" To promote research, teaching, policymaking, and practice in global health, we summarize the main points on the definition of global health from the Editorial Board Meeting of Global Health Research and Policy, convened in July 2019 in Wuhan, China. The meeting functioned as a platform for free brainstorming, indepth discussion, and post-meeting synthesizing. Through the meeting, we have reached a consensus that global health can be considered as a general guiding principle, an organizing framework for thinking and action, a new branch of sciences and specialized discipline in the large family of public health and medicine. The word "global" in global health can be subjective or objective, depending on the context and setting. In addition to dual-, multicountry and global, a project or a study conducted at a local area can be global if it (1) is framed with a global perspective, (2) intends to address an issue with global impact, and/or (3) seeks global solutions to an issue, such as frameworks, strategies, policies, laws, and regulations. In this regard, global health is eventually an extension of "international health" by borrowing related knowledge, theories, technologies and methodologies from public health and medicine. Although global health is a concept that will continue to evolve, our conceptualization through group effort provides, to date, a comprehensive understanding. This report helps to inform individuals in the global health community to advance global health science and practice, and recommend to take advantage of the Belt and Road Initiative proposed by China.

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“…12,13 This gap in knowledge and application of implementation methodologies results in loss of resources (time, money, and personnel efforts) and development of unsustainable and cost-ineffective interventions in LMICs, which results in a detrimental impact on population health outcomes. [12][13][14] Moreover, the potential for implementation science to be more relevant in LMICs for developing and executing sustainable strategies that generate resources or maximize the limited resources available in these settings is essential to bridge disease prevention and management gaps in these countries. 5 In this paper, we continue the discourse from the 2018 commentary by Yapa and Bärnighausen on implementation science in resource-poor countries and communities by applying CFIR to highlight specific ways implementation science can be used to understand and advance interventions, which generate and/ or maximize resources to facilitate other health interventions in LMIC context.…”

Section: Introductionmentioning

confidence: 99%

The Role of Implementation Science in Advancing Resource Generation for Health Interventions in Low- and Middle-Income Countries

Ojo

Kabasele

Boyd

et al. 2021

Health�Serv�Insights

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Low- and middle-income countries (LMICs) bear the brunt of communicable and non-communicable diseases and experience higher mortality and poor health outcomes compared to resource-rich countries. Chronic resource deficits in LMICs impede their ability to successfully address vexing health issues. Implementation science provides researchers with an approach to develop specific interventions that can generate and/or maximize resources to facilitate the implementation of other public health interventions, in resource-constrained LMIC settings. Resources generated from these interventions could be in the form of increased health workers’ skills, task shifting to free up higher-skilled health workers, increasing laboratory capacity, and using supply chain innovations to make medications available. Pivotal to the success of such interventions is ensuring feasibility in the LMIC context. We selected and appraised three case studies of evidence-based resource-generating health interventions based in LMICs (Zambia, Zimbabwe, and Madagascar), which generated or maximized resources to facilitate ongoing health services. We used a determinant implementation framework—Consolidated Framework for Implementation Research (CFIR) to identify and map contextual factors that are reported to influence implementation feasibility in an LMIC setting. Contextual factors influencing the feasibility of these interventions included leadership engagement, local capacity building and readiness for research and implementing evidence-based practices (EBPs), infrastructural support for multilevel scale-up, and cultural and contextual adaptations. These factors highlight the importance of utilizing implementation science frameworks to evaluate, guide, and execute feasible public health interventions and projects in resource-limited settings. Within LMICs, we recommend EBPs incorporate feasible resource-generating components in health interventions to ensure improved and sustained optimal health outcomes.

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The Kathmandu Declaration on Global CVD/Hypertension Research and Implementation Science: A Framework to Advance Implementation Research for Cardiovascular and Other Noncommunicable Diseases in Low- and Middle-Income Countries

Cited by 25 publications

References 9 publications

Reframing implementation science to address inequities in healthcare delivery

Reframing implementation science to address inequities in healthcare delivery

What is global health? Key concepts and clarification of misperceptions

The Role of Implementation Science in Advancing Resource Generation for Health Interventions in Low- and Middle-Income Countries

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