Limits...
Health systems research for policy change: lessons from the implementation of rapid assessment protocols for diabetes in low- and middle-income settings.

Beran D, Miranda JJ, Cardenas MK, Bigdeli M - Health Res Policy Syst (2015)

Bottom Line: Stage 1 led to the identification of various types of documents referring to the results.All stakeholders valued the results and the credibility of the data generated.The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization.

View Article: PubMed Central - PubMed

Affiliation: Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. david.beran@unige.ch.

ABSTRACT

Background: As many challenges exist for access to diabetes care in developing countries, the International Insulin Foundation developed a Rapid Assessment tool and implemented this approach to identify barriers to care and propose concrete recommendations for decision makers. The objective of this paper is to identify the factors that contributed to informing and influencing policymakers with regards to this work.

Methods: A documentary review comprised Stage 1. Stage 2 used an online questionnaire to gain insight from users of the Rapid Assessment results. Based on Stages 1 and 2, Stage 3 comprised in-depth interviews with a total of nine individuals (one individual each from the six participating countries; two individuals from the World Health Organization; one "Global Diabetes Advocate"). Interviews were analyzed based on a list of themes developed from Stage 2.

Results: Stage 1 led to the identification of various types of documents referring to the results. The online questionnaire had a response rate of 33%. Respondents directly involved in the assessment had a "Good" or "Very Good" appreciation of most aspects and scored these higher than those not directly involved. From the interviews, formalized methods and close collaboration between the international team and local partners were strengths. Trust and a relationship with local partners were also seen as assets. All stakeholders valued the results and the credibility of the data generated. Local partners felt that more could have been done for dissemination.

Conclusion: This study shows the importance of specific results from the different assessments. In addressing complex issues having external experts involved was seen as an advantage. The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization. Through these brokers, others gained ownership of the data. The methods used and the fact that this data was grounded in a local context also reinforced its value. Despite limitations, this study offers a unique perspective where a similar research approach was taken in six countries.

No MeSH data available.


Related in: MedlinePlus

Details of responses to online questionnaire
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4591713&req=5

Fig1: Details of responses to online questionnaire

Mentions: The questionnaire was sent to a total of 167 people, with individuals in each country where the RAPIA had been implemented representing 66 possible respondents and 85 individuals seen as international partners; international partners may have collaborated with the IIF or cited its work, but were not directly involved in a specific assessment. Figure 1 details the response to the overall questionnaire. The overall response rate was 33% (n = 55). Only nine out of the 55 respondents stated they were directly involved in the implementation of the RAPIA. Of these, two were from Kyrgyzstan, one from Mali, three from Mozambique, zero from Nicaragua, two from Vietnam, and one from Zambia. Responders who stated that they were not directly involved in the implementation of an in-country assessment (n = 36), had heard about the IIF through peer reviewed publications (53%), seen a presentation about this work (53%), read about this work but not in a peer reviewed publication (33%), or in an different way (19%), including mainly meetings and being informed about this work through colleagues as well as the IIF’s website. For those who stated they were unaware of the work of the IIF, they were asked if they knew about the work of the Trustees and Advisor to the Board of the IIF regarding access to insulin. Overall, 80% of these individuals responded positively and 86% had heard about this work from a presentation given by either of these individuals.Figure 1


Health systems research for policy change: lessons from the implementation of rapid assessment protocols for diabetes in low- and middle-income settings.

Beran D, Miranda JJ, Cardenas MK, Bigdeli M - Health Res Policy Syst (2015)

Details of responses to online questionnaire
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591713&req=5

Fig1: Details of responses to online questionnaire
Mentions: The questionnaire was sent to a total of 167 people, with individuals in each country where the RAPIA had been implemented representing 66 possible respondents and 85 individuals seen as international partners; international partners may have collaborated with the IIF or cited its work, but were not directly involved in a specific assessment. Figure 1 details the response to the overall questionnaire. The overall response rate was 33% (n = 55). Only nine out of the 55 respondents stated they were directly involved in the implementation of the RAPIA. Of these, two were from Kyrgyzstan, one from Mali, three from Mozambique, zero from Nicaragua, two from Vietnam, and one from Zambia. Responders who stated that they were not directly involved in the implementation of an in-country assessment (n = 36), had heard about the IIF through peer reviewed publications (53%), seen a presentation about this work (53%), read about this work but not in a peer reviewed publication (33%), or in an different way (19%), including mainly meetings and being informed about this work through colleagues as well as the IIF’s website. For those who stated they were unaware of the work of the IIF, they were asked if they knew about the work of the Trustees and Advisor to the Board of the IIF regarding access to insulin. Overall, 80% of these individuals responded positively and 86% had heard about this work from a presentation given by either of these individuals.Figure 1

Bottom Line: Stage 1 led to the identification of various types of documents referring to the results.All stakeholders valued the results and the credibility of the data generated.The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization.

View Article: PubMed Central - PubMed

Affiliation: Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. david.beran@unige.ch.

ABSTRACT

Background: As many challenges exist for access to diabetes care in developing countries, the International Insulin Foundation developed a Rapid Assessment tool and implemented this approach to identify barriers to care and propose concrete recommendations for decision makers. The objective of this paper is to identify the factors that contributed to informing and influencing policymakers with regards to this work.

Methods: A documentary review comprised Stage 1. Stage 2 used an online questionnaire to gain insight from users of the Rapid Assessment results. Based on Stages 1 and 2, Stage 3 comprised in-depth interviews with a total of nine individuals (one individual each from the six participating countries; two individuals from the World Health Organization; one "Global Diabetes Advocate"). Interviews were analyzed based on a list of themes developed from Stage 2.

Results: Stage 1 led to the identification of various types of documents referring to the results. The online questionnaire had a response rate of 33%. Respondents directly involved in the assessment had a "Good" or "Very Good" appreciation of most aspects and scored these higher than those not directly involved. From the interviews, formalized methods and close collaboration between the international team and local partners were strengths. Trust and a relationship with local partners were also seen as assets. All stakeholders valued the results and the credibility of the data generated. Local partners felt that more could have been done for dissemination.

Conclusion: This study shows the importance of specific results from the different assessments. In addressing complex issues having external experts involved was seen as an advantage. The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization. Through these brokers, others gained ownership of the data. The methods used and the fact that this data was grounded in a local context also reinforced its value. Despite limitations, this study offers a unique perspective where a similar research approach was taken in six countries.

No MeSH data available.


Related in: MedlinePlus