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非洲卫生系统中知识转化策略、结果、促进因素和障碍的证据图谱。

Evidence map of knowledge translation strategies, outcomes, facilitators and barriers in African health systems.

机构信息

School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.

Western Cape Government Health, Cape Town, South Africa.

出版信息

Health Res Policy Syst. 2019 Feb 7;17(1):16. doi: 10.1186/s12961-019-0419-0.

Abstract

BACKGROUND

The need for research-based knowledge to inform health policy formulation and implementation is a chronic global concern impacting health systems functioning and impeding the provision of quality healthcare for all. This paper provides a systematic overview of the literature on knowledge translation (KT) strategies employed by health system researchers and policy-makers in African countries.

METHODS

Evidence mapping methodology was adapted from the social and health sciences literature and used to generate a schema of KT strategies, outcomes, facilitators and barriers. Four reference databases were searched using defined criteria. Studies were screened and a searchable database containing 62 eligible studies was compiled using Microsoft Access. Frequency and thematic analysis were used to report study characteristics and to establish the final evidence map. Focus was placed on KT in policy formulation processes in order to better manage the diversity of available literature.

RESULTS

The KT literature in African countries is widely distributed, problematically diverse and growing. Significant disparities exist between reports on KT in different countries, and there are many settings without published evidence of local KT characteristics. Commonly reported KT strategies include policy briefs, capacity-building workshops and policy dialogues. Barriers affecting researchers and policy-makers include insufficient skills and capacity to conduct KT activities, time constraints and a lack of resources. Availability of quality locally relevant research was the most reported facilitator. Limited KT outcomes reflect persisting difficulties in outcome identification and reporting.

CONCLUSION

This study has identified substantial geographical gaps in knowledge and evidenced the need to boost local research capacities on KT practices in low- and middle-income countries. Evidence mapping is also shown to be a useful approach that can assist local decision-making to enhance KT in policy and practice.

摘要

背景

需要基于研究的知识来为卫生政策的制定和实施提供信息,这是一个全球性的长期问题,影响着卫生系统的运作,并阻碍了为所有人提供优质医疗保健的服务。本文对非洲国家卫生系统研究人员和政策制定者所采用的知识转化(KT)策略的文献进行了系统综述。

方法

采用来自社会和卫生科学文献中的证据绘图方法,生成 KT 策略、结果、促进因素和障碍的示意图。使用明确的标准对四个参考数据库进行了搜索。对研究进行了筛选,并使用 Microsoft Access 编制了一个包含 62 项合格研究的可搜索数据库。使用频率和主题分析报告研究特征,并建立最终的证据图。重点放在政策制定过程中的 KT 上,以便更好地管理现有文献的多样性。

结果

非洲国家的 KT 文献分布广泛,但存在问题且多样化,并且数量还在不断增加。不同国家报告的 KT 之间存在显著差异,许多国家没有发表关于当地 KT 特征的文献。常见的 KT 策略包括政策简报、能力建设研讨会和政策对话。影响研究人员和政策制定者的障碍包括进行 KT 活动的技能和能力不足、时间限制以及资源缺乏。可用性强且与当地相关的高质量研究是最常报道的促进因素。有限的 KT 结果反映出在确定和报告结果方面仍然存在困难。

结论

本研究发现了知识方面的巨大地域差距,并证明需要加强中低收入国家在 KT 实践方面的本地研究能力。证据绘图也被证明是一种有用的方法,可以协助当地决策,以加强政策和实践中的 KT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b10/6367796/2ba3b62717ca/12961_2019_419_Fig1_HTML.jpg

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