Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
Health Systems Research and Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
BMJ Open. 2021 Jun 30;11(6):e045123. doi: 10.1136/bmjopen-2020-045123.
Embedding researchers within health systems results in more socially relevant research and more effective uptake of evidence into policy and practice. However, the practice of embedded health service research remains poorly understood. We explored and assessed the development of embedded participatory approaches to health service research by a health research team in Kenya highlighting the different ways multiple stakeholders were engaged in a neonatal research study.
We conducted semistructured qualitative interviews with key stakeholders. Data were analysed thematically using both inductive and deductive approaches.
Over recent years, the Health Services Unit within the Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme in Nairobi Kenya, has been working closely with organisations and technical stakeholders including, but not limited to, medical and nursing schools, frontline health workers, senior paediatricians, policymakers and county officials, in developing and conducting embedded health research. This involves researchers embedding themselves in the contexts in which they carry out their research (mainly in county hospitals, local universities and other training institutions), creating and sustaining social networks. Researchers collaboratively worked with stakeholders to identify clinical, operational and behavioural issues related to routine service delivery, formulating and exploring research questions to bring change in practice PARTICIPANTS: We purposively selected 14 relevant stakeholders spanning policy, training institutions, healthcare workers, regulatory councils and professional associations.
The value of embeddedness is highlighted through the description of a recently completed project, Health Services that Deliver for Newborns (HSD-N). We describe how the HSD-N research process contributed to and further strengthened a collaborative research platform and illustrating this project's role in identifying and generating ideas about how to tackle health service delivery problems CONCLUSIONS: We conclude with a discussion about the experiences, challenges and lessons learned regarding engaging stakeholders in the coproduction of research.
将研究人员嵌入卫生系统中会产生更具社会相关性的研究,并更有效地将证据纳入政策和实践中。然而,嵌入式卫生服务研究的实践仍未被充分理解。我们探讨并评估了肯尼亚一个卫生研究团队采用嵌入式参与式方法进行卫生服务研究的发展情况,重点介绍了多种利益相关者参与新生儿研究的不同方式。
我们对主要利益相关者进行了半结构式定性访谈。使用归纳和演绎方法对数据进行了主题分析。
近年来,肯尼亚内罗毕的肯尼亚医学研究所(KEMRI)-惠康信托基金会研究计划中的卫生服务股与组织和技术利益相关者(包括但不限于医学和护理学校、一线卫生工作者、高级儿科医生、政策制定者和县级官员)密切合作,开展和进行嵌入式卫生研究。这涉及到研究人员将自己嵌入到他们开展研究的背景中(主要在县级医院、当地大学和其他培训机构),建立和维持社会网络。研究人员与利益相关者合作,共同确定与常规服务提供相关的临床、运营和行为问题,制定和探索研究问题,以实现实践中的变革。
我们有针对性地选择了 14 名利益相关者,涵盖政策、培训机构、医疗保健工作者、监管委员会和专业协会。
通过描述最近完成的一个项目“为新生儿提供的卫生服务”(HSD-N),突出了嵌入式的价值。我们描述了 HSD-N 研究过程如何促进和进一步加强了一个协作研究平台,并说明了该项目在确定和提出如何解决卫生服务提供问题的想法方面的作用。
我们讨论了在共同制定研究方面,参与利益相关者的经验、挑战和教训。