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Getting evidence into practice: what works in developing countries?

Kamran Siddiqi1, James Newell, Mike Robinson

  • 1Nuffield International Health and Development Centre, Institute of Health Sciences and Public Health Research, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK. hssks@leeds.ac.uk

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|May 6, 2005
PubMed
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Evidence for interventions changing health professional behavior in developing countries is limited. Audit and feedback, and tailored educational interventions show promise, but research quality needs improvement.

Area of Science:

  • Health Systems Research
  • Evidence-Based Practice
  • Developing Countries

Background:

  • Implementing evidence-based practices in developing countries is crucial for improving healthcare quality.
  • Interventions to change health professionals' behavior are key to bridging the gap between evidence and practice.

Purpose of the Study:

  • To review and analyze the effectiveness of interventions aimed at modifying health professional behavior in developing countries.
  • To identify successful strategies for translating research findings into clinical practice in resource-limited settings.

Main Methods:

  • A systematic literature review adapted from the Cochrane Effective Practice & Organization Care (EPOC) group methodology.
  • Inclusion of 44 controlled and uncontrolled trials assessing professional compliance or patient outcomes.

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  • Data extraction and appraisal using pre-defined tools.

    • Main Results:

    • Audit and feedback, when combined with other interventions, demonstrated short-term effectiveness.
    • Educational interventions were more impactful when tailored to local needs and organizational barriers.
    • Insufficient evidence exists for educational outreach, opinion leaders, mass media, and reminders; educational materials alone are ineffective.

    Conclusions:

    • Current evidence on behavior change interventions in developing countries is scarce and often compromised by weak study designs.
    • Improving research quality is essential for understanding effective strategies to enhance healthcare quality.
    • This review highlights methodological challenges for future research in health systems development.