Study protocol: analysis of regional lung health policies and stakeholders in Africa

Background Lung health is a critical area for research in sub-Saharan Africa. The International Multidisciplinary Programme to Address Lung Health and TB in Africa (IMPALA) is a collaborative programme that seeks to fill evidence gaps to address high-burden lung health issues in Africa. In order to generate demand for and facilitate use of IMPALA research by policy-makers and other decision-makers at the regional level, an analysis of regional lung health policies and stakeholders will be undertaken to inform a programmatic strategy for policy engagement. Methods and analysis This analysis will be conducted in three phases. The first phase will be a rapid desk review of regional lung health policies and stakeholders that seeks to understand the regional lung health policy landscape, which issues are prioritised in existing regional policy, key regional actors, and opportunities for engagement with key stakeholders. The second phase will be a rapid desk review of the scientific literature, expanding on the work in the first phase by looking at the external factors that influence regional lung health policy, the ways in which regional bodies influence policy at the national level, investments in lung health, structures for discussion and advocacy, and the role of evidence at the regional level. The third phase will involve a survey of IMPALA partners and researchers as well as interviews with key regional stakeholders to further shed light on regional policies, including policy priorities and gaps, policy implementation status and challenges, stakeholders, and platforms for engagement and promoting uptake of evidence. Discussion Health policy analysis provides insights into power dynamics and the political nature of the prioritisation of health issues, which are often overlooked. In order to ensure the uptake of new knowledge and evidence generated by IMPALA, it is important to consider these complex factors

Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle- income countries

Background Knowledge translation (KT) is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to yield beneficial outcomes for society. Effective KT requires researchers to play an active role in promoting evidence uptake. This paper presents a systematised review of evidence on low- and middle- income (LMIC) researchers’ KT capacity, practice and interventions for enhancing their KT practice (support) with the aim of identifying gaps and informing future research and interventions. Methods An electronic search for peer reviewed publications focusing on LMIC researchers’ KT capacity, practice and support across all academic fields, authored in English and from the earliest records available to February 2019, was conducted using PubMed and Scopus. Selected studies were appraised using the Mixed Methods Appraisal Tool , data pertaining to publication characteristics and study design extracted and an a priori thematic analysis of reported research findings completed. Results The search resulted in 334 screened articles of which 66 met the inclusion criteria. Most (43) of the articles presented original research findings, 22 were commentaries and 1 was a systematic review. 48 articles reported on researchers’ KT practice, 12 assessed institutional KT capacity of academic/research organisations and 9 reported on KT support for researchers. More than half (59%) of the articles focused on sub-Saharan Africa and a majority (93%) on health research. Most of the primary studies used the case study design (41%). The findings suggest that LMIC researchers rarely conduct KT and face a range of barriers at individual and institutional levels that limit their KT practice including inadequate KT knowledge and skills particularly for communicating research and interacting with research end-users, insufficient funding and inadequate institutional guidelines, structures and incentives promoting KT practice. Furthermore, the evidence-base on effective interventions for enhancing KT among LMIC researchers is insufficient and largely of weak quality. Conclusions More high-quality research on researchers’ KT capacity, practice and effective KT capacity strengthening interventions is needed. Study designs that extend beyond case studies and descriptive studies e are recommended. Furthermore, realist approaches, pragmatic trials, impact evaluations, implementation research and participatory action research are recommended for evaluating interventions

OA-03-521-21 Chronic Lung Diseases Remain Under-Prioritized in Africa Despite Their Growing Burden: Findings from a Lung Health Policy Analysis

Background: Globally, 4 million people die prematurely from CLDs (e.g. asthma and chronic obstructive pulmo- nary disease (COPD)) (Global Impact of Respiratory Disease – Second Edition, 2017). In sub-Saharan Africa (SSA), the burden of CLDs is estimated to be large and growing (Bigna and Noubiap, 2019). This study seeks to provide evidence on CLD policy and programme re- sponses, prioritised CLDs, health system approaches to address CLDs, and CLD financial investments in East Africa, focusing on Kenya and Uganda. Design/Methods: We conducted a desk review of CLD- relevant policies at regional level (East Africa) and na- tional level for Kenya and Uganda. Interviews with lung health stakeholders in Uganda and Kenya were conduct- ed to contextualise findings from the desk review. This paper fills an evidence gap on lung health policy in SSA and will inform future CLD research, policies, and pro- grammes. Results: Preliminary findings reveal no CLD-specific policies in East Africa, Kenya or Uganda and a narrow focus of lung health policies on tuberculosis. East African policies do not name CLDs however national-level policies refer to CLDs, namely COPD and asthma. The main approach to CLD control in the two countries is prevention by addressing their risk factors (e.g. tobacco exposure and poor air quality). Documentation of CLD financial investments was not available. Interviews re- vealed political will, but insufficient resources to man- age CLDs. Conclusions: We found a lack of CLD policy prioriti- zation in Kenya, Uganda, and East Africa. The narrow focus of lung health policy investments on tuberculosis calls for local evidence on CLDs’ disease burden, eco- nomic burden, and interventions to address their risk factors, as well as effective research translation initiatives to drive policy action. Given SSA’s resource-constrained context, investments must be evidence-informed to en- sure resource allocations are commensurate to the scope of the problem and proven to improve management and prevention of CLDs