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; Malek-Afzali, Hossein; Guang Shi; Yesudian, C. Ashok K.; Hoffman, Steven J.
June 2010
CMAJ: Canadian Medical Association Journal;6/15/2010, Vol. 182 Issue 9, pE362
Academic Journal
Background: Gaps continue to exist between research-based evidence and clinical practice. We surveyed health care providers in 10 low- and middle-income countries about their use of research-based evidence and examined factors that may facilitate or impede such use. Methods: We surveyed 1499 health care providers practising in one of four areas relevant to the Millennium Development Goals (prevention of malaria, care of women seeking contraception, care of children with diarrhea and care of patients with tuberculosis) in each of China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania. Results: The proportion of respondents who re ported that research was likely to change their clinical practice if performed and published in their own country (84.6% and 86.0% respectively) was higher than the proportion who reported the same about research and publications from their region (66.4% and 63.1%) or from high-income countries (55.8% and 55.5%). Respondents who were most likely to report that the use of research-based evidence led to changes in their practice included those who reported using clinical practice guidelines in paper format (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.03-2.28), using scientific journals from their own country in paper format (OR 1.70, 95% CI 1.26-2.28), viewing the quality of research performed in their country as above average or excellent (OR 1.93, 95% CI 1.16-3.22); trusting systematic reviews of randomized controlled trials (OR 1.59, 95% CI 1.08-2.35); and having easy access to the Internet (OR 1.90, 95% CI 1.19-3.02). Interpretation: Locally conducted or published research has played an important role in changing the professional practice of health care providers surveyed in low- and middle-income countries. Increased investments in local research, or at least in locally adapted publications of research-based evidence from other settings, are therefore needed. Although access to the Internet was viewed as a significant factor in whether research-based evidence led to concrete changes in practice, few respondents reported having easy access to the Internet. Therefore, efforts to improve Internet access in clinical settings need to be accelerated.


Related Articles

  • London's liaison psychiatry services: survey of service provision. Naidu, Smitha; Bolton, Jim; Smith, Jared // BJPsych Bulletin;2015, Vol. 39 Issue 2, p65 

    Aims and method To describe the liaison psychiatry services of all 30 general hospitals in Greater London and to determine whether services met national recommendations. The results were compared with a similar survey conducted 8 years previously to determine whether there had been significant...

  • Handling healthcare workforce planning with care: where do we stand? Lopes, Mário Amorim; Almeida, Álvaro Santos; Almada-Lobo, Bernardo // Human Resources for Health;2015, Vol. 13 Issue 1, p1 

    Background: Planning the health-care workforce required to meet the health needs of the population, while providing service levels that maximize the outcome and minimize the financial costs, is a complex task. The problem can be described as assessing the right number of people with the right...

  • An Analysis of Preventive Health Care in Pakistan. Mangi, Ahsan Ali; Rehman, Hafeez Ur; Ahmed, Imtiaz // Interdisciplinary Journal of Contemporary Research in Business;May2011, Vol. 3 Issue 1, p1238 

    Preventive health care in Pakistan has always remained a lower priority. In Health Policy 2001 although the Government had put emphasis on preventive care yet a lot of gaps exist in implementation. As a result the various indicators and targets set under Millennium Development Goals (MDGs) have...

  • What lessons can Africa learn from China's health success? Omaswa, Francis // Africa Health;Mar2012, Vol. 34 Issue 3, p7 

    In this article, the author comments on the lessons that Africa can learn from the phenomenal achievements of China's health sector. The author says that China has accomplished the Millennium Development Goals (MDGs) and boasts maternal and infant mortality rates close to those of developed...

  • Implementation strategies: recommendations for specifying and reporting. Proctor, Enola K.; Powell, Byron J.; McMillen, Curtis J.; McMillen, J Curtis // Implementation Science;2013, Vol. 8 Issue 1, p1 

    Implementation strategies have unparalleled importance in implementation science, as they constitute the 'how to' component of changing healthcare practice. Yet, implementation researchers and other stakeholders are not able to fully utilize the findings of studies focusing on implementation...

  • Unwanted Variations in the Rules of Practice. Wennberg, John E. // JAMA: Journal of the American Medical Association;3/13/91, Vol. 265 Issue 10, p1306 

    Editorial. Expresses an opinion on the rules that professional review organizations (PRO) have adopted for evaluating medical practice in the U.S. Views on the quality of the PRO guidelines; Bases of an efficient practice guidelines; Primary purpose of practice guidelines.

  • Optimizing the language and format of guidelines to improve guideline uptake. Gupta, Samir; Rai, Navjot; Bhattacharrya, Onil; Cheng, Alice Y. Y.; Connelly, Kim A.; Boulet, Louis-Philippe; Kaplan, Alan; Brouwers, Melissa C.; Kastner, Monika // CMAJ: Canadian Medical Association Journal;10/4/2016, Vol. 188 Issue 14, pE362 

    The article discusses the significance of optimizing the language and format of clinical practice guidelines to improve guideline uptake, along with tips on how to increase guideline uptake. Topics discussed include reasons why clinicians do not use guidelines, the importance of language and...

  • Ministers discuss health systems at Commonwealth meeting.  // Africa Health;Jul2014, Vol. 36 Issue 5, p12 

    The article discusses the highlights of the 2014 annual meeting of the Commonwealth Health Ministers, which centered on the theme "Commonwealth Post-2015 Health Agenda: Strengthening Health Policies and Systems" and discussed the importance of the Millennium Development Goals in the positioning...

  • At the crossroads: transforming health systems to address women's health across the life course. Bustreo, Flavia; Chestnov, Oleg; Knaul, Felicia Marie; Araujo de Carvalho, Islene; Merialdi, Mario; Temmerman, Marleen; Beard, John R. // Bulletin of the World Health Organization;Sep2013, Vol. 91 Issue 9, p622 

    The authors reflect on the transformation of health systems to address women’s health across the life course. Topics include an increase in the years of life lost (YLLs) from conditions not targeted in the United Nations (UN) Millennium Development Goals (MDGs), the health system...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics