Leonard Elizabeth, de Kock Imke, Bam Wouter
Department of Industrial Engineering, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
Department of Industrial Engineering, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
Eval Program Plann. 2020 Oct;82:101832. doi: 10.1016/j.evalprogplan.2020.101832. Epub 2020 Jun 9.
The unsuccessful implementation of health innovations occurs frequently, leading to missed opportunities where improvements could have been made on various aspects of a health system. The purpose of this study is to identify, assess and synthesise the facilitators and barriers to sustainably implementing evidence-based health innovations in a low- and middle-income country (LMIC) context. To identify the LMIC specific facilitators and barriers, a systematic literature review was conducted. 79 studies were analysed, and the implementation barriers and facilitators identified in each study were extracted. The extracted barriers and facilitators were categorised and synthesized into one of seven concepts: context, innovation, relations and networks, institutions, knowledge, actors or resources. There were no substantial variations between the frequency that each concept was identified as a facilitator or barrier to implementation. However, resources, which includes time, human, financial and physical resources, was the most frequently mentioned concept; emphasising the need to focus on the resource situation in LMICs. This study contributes to the growing literature that aims to inform health system planners and evaluators in LMICs on effectively and sustainably implementing evidence-based health innovations.
卫生创新的实施往往不成功,导致错失在卫生系统各个方面进行改进的机会。本研究的目的是识别、评估和综合在低收入和中等收入国家(LMIC)背景下可持续实施循证卫生创新的促进因素和障碍。为了确定LMIC特有的促进因素和障碍,进行了一项系统的文献综述。分析了79项研究,并提取了每项研究中确定的实施障碍和促进因素。提取的障碍和促进因素被分类并综合为七个概念之一:背景、创新、关系和网络、机构、知识、行为者或资源。每个概念被确定为实施促进因素或障碍的频率之间没有实质性差异。然而,资源,包括时间、人力、财力和物力资源,是最常被提及的概念;这强调了关注LMIC资源状况的必要性。本研究为日益增多的文献做出了贡献,这些文献旨在为LMIC的卫生系统规划者和评估者提供关于有效和可持续实施循证卫生创新的信息。
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