Browsing by Author "Kalbarczyk, Anna"

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Barriers and facilitators to knowledge translation activities within academic institutions in low- And middle-income countries
(Oxford Academic, 3/1/2021) Kalbarczyk, Anna; Rodriguez, Daniela C; Mahendradhata, Yodi; Sarker, Malabika; Seme, Assefa; Majumdar, Piyusha; Akinyemi, Oluwaseun O; Kayembe, Patrick; Alonge, Olakunle O
The barriers and facilitators of conducting knowledge translation (KT) activities are well-established but less is known about the institutional forces that drive these barriers, particularly in low-resource settings. Understanding organizational readiness has been used to assess and address such barriers but the employment of readiness assessments has largely been done in high-income countries. We conducted a qualitative study to describe the institutional needs and barriers in KT specific to academic institutions in low- and middle-income countries. We conducted a review of the grey and published literature to identify country health priorities and established barriers and facilitators for KT. Key-informant interviews (KII) were conducted to elicit perceptions of institutional readiness to conduct KT, including experiences with KT, and views on motivation and capacity building. Participants included representatives from academic institutions and Ministries of Health in six countries (Bangladesh, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria). We conducted 18 KIIs, 11 with members of academic institutions and 7 with policymakers. KIIs were analysed using a deductive and inductive coding approach. Our findings support many well-documented barriers including lack of time, skills and institutional support to conduct KT. Three additional institutional drivers emerged around soft skills and the complexity of the policy process, alignment of incentives and institutional missions, and the role of networks. Participants reflected on often-lacking soft-skills needed by researchers to engage policy makers. Continuous engagement was viewed as a challenge given competing demands for time (both researchers and policy makers) and lack of institutional incentives to conduct KT. Strong networks, both within the institution and between institutions, were described as important for conducting KT but difficult to establish and maintain. Attention to the cross-cutting themes representing barriers and facilitators for both individuals and institutions can inform the development of capacity building strategies that meet readiness needs.
Developing a framework of core competencies in implementation research for low/middle-income countries
(BMJ Journals, 2019-09) Alonge, Olakunle; Rao, Aditi; Kalbarczyk, Anna; Maher, Dermot; Gonzalez Marulanda, Edwin Rolando; Sarker, Malabika; Ibisomi, Latifat; Dako-Gyeke, Phyllis; Mahendradhata, Yodi; Launois, Pascal; Vahedi, Mahnaz
The field of implementation research (IR) is growing. However, there are no recognised IR core competencies in low/middle-income countries (LMICs), nor consistent curriculum across IR training programs globally. The goal of this effort is to develop a framework of IR core competencies for training programs in LMICs. The framework was developed using a mixed-methods approach consisting of two online surveys with IR training coordinators (n = 16) and academics (n = 89) affiliated with seven LMIC institutions, and a modified-Delphi process to evaluate the domains, competencies and proficiency levels included in the framework. The final framework comprised of 11 domains, 59 competencies and 52 sub-competencies, and emphasised competencies for modifying contexts, strengthening health systems, addressing ethical concerns, engaging stakeholders and communication especially for LMIC settings, in addition to competencies on IR theories, methods and designs. The framework highlights the interconnectedness of domains and competencies for IR and practice, and training in IR following the outlined competencies is not a linear process but circular and iterative, and starting points for training may vary widely by the project, institution and challenge being addressed. The framework established the need for a theory-based approach to identifying proficiency levels for IR competencies (ie, to determine proficiency levels for IR based on generalisable educational theories for competency-based education), and the relevance of various IR competencies for LMICs compared with highincome settings. This framework is useful for identifying and evaluating competencies and trainings, and providing direction and support for professional development in IR.
Evaluating the process of partnership and research in global health: Reflections from the STRIPE project
(BMC, 8/12/2020) Kalbarczyk, Anna; Rao, Aditi; Mahendradhata, Yodi; Majumdar, Piyusha; Decker, Ellie; Binte Anwar, Humayra; Akinyemi, Oluwaseun O.; Rahimi, Ahmad Omid; Kayembe, Patrick; Alonge, Olakunle O.
Background: Thoughtful and equitable engagement with international partners is key to successful research. STRIPE, a consortium of 8 academic and research institutions across the globe whose objective is to map, synthesize, and disseminate lessons learned from polio eradication, conducted a process evaluation of this partnership during the project’s first year which focused on knowledge mapping activities. Methods: The STRIPE consortium is led by Johns Hopkins University (JHU) in partnership with 6 universities and 1 research consultancy organization in polio free, at-risk, and endemic countries. In December 2018 JHU team members submitted written reflections on their experiences (n = 9). We held calls with each consortium member to solicit additional feedback (n = 7). To establish the partnership evaluation criteria we conducted preliminary analyses based on Blackstock’s framework evaluating participatory research. In April 2019, an in-person consortium meeting was held; one member from each institution was asked to join a process evaluation working group. This group reviewed the preliminary criteria, adding, subtracting, and combining as needed; the final evaluation criteria were applied to STRIPE’s research process and partnership and illustrative examples were provided. Results: Twelve evaluation criteria were defined and applied by each member of the consortium to their experience in the project. These included access to resources, expectation setting, organizational context, external context, quality of information, relationship building, transparency, motivation, scheduling, adaptation, communication and engagement, and capacity building. For each criteria members of the working group reflected on general and context-specific challenges and potential strategies to overcome them. Teams suggested providing more time for recruitment, training, reflection, pre-testing. and financing to alleviate resource constraints. Given the large scope of the project, competing priorities, and shifting demands the working group also suggested a minimum of one fulltime project coordinator in each setting to manage resources. Conclusion: Successful management of multi-country, multicentered implementation research requires comprehensive communication tools (which to our knowledge do not exist yet or are not readily available), expectation setting, and institutional support. Capacity building activities that address human resource needs for both individuals and their institutions should be incorporated into early project planning.
Synthesis and translation of research and innovations from polio eradication (STRIPE): Initial findings from a global mixed methods study
(BMC, 8/12/2020) Alonge, Olakunle; Neel, Abigail H.; Kalbarczyk, Anna; Peters, Michael A.; Mahendradhata, Yodi; Sarker, Malabika; Owoaje, Eme; Deressa, Wakgari; Kayembe, Patrick; Salehi, Ahmad Shah; Gupta, S. D.
Background: Lessons from polio eradication efforts and the Global Polio Eradication Initiative (GPEI) are useful for improving health service delivery and outcomes globally. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a multi-phase project which aims to map, package and disseminate knowledge from polio eradication initiatives as academic and training programs. This paper discusses initial findings from the knowledge mapping around polio eradication activities across a multi-country context. Methods: The knowledge mapping phase (January 2018 – December 2019) encompassed four research activities (scoping review, survey, key informant interviews (KIIs), health system analyses). This paper utilized a sequential mixed method design combining data from the survey and KIIs. The survey included individuals involved in polio eradication between 1988 and 2019, and described the contexts, implementation strategies, intended and unintended outcomes of polio eradication activities across levels. KIIs were conducted among a nested sample in seven countries (Afghanistan, Bangladesh, the Democratic Republic of Congo, Ethiopia, India, Indonesia, Nigeria) and at the global level to further explore these domains. Results: The survey generated 3955 unique responses, mainly sub-national actors representing experience in over 74 countries; 194 KIIs were conducted. External factors including social, political, and economic factors were the most frequently cited barriers to eradication, followed by the process of implementing activities, including program execution, planning, monitoring, and stakeholder engagement. Key informants described common strategies for addressing these barriers, e.g. generating political will, engaging communities, capacity-building in planning and measurement, and adapting delivery strategies. The polio program positively affected health systems by investing in system structures and governance, however, long-term effects have been mixed as some countries have struggled to institutionalize program assets Conclusion: Understanding the implementing context is critical for identifying threats and opportunities to global health programs. Common implementation strategies emerged across countries; however, these strategies were only effective where organizational and individual capacity were sufficient, and where strategies were appropriately tailored to the sociopolitical context. To maximize gains, readiness assessments at different levels should predate future global health programs and initiatives should consider system integration earlier to ensure program institutionalization and minimize system distortions.