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Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries

Developing a health system intervention that helps to improve primary care in a low-income and middle-income country (LMIC) is a considerable challenge; finding ways to spread that intervention to other LMICs is another. The Practical Approach to Care Kit (PACK) programme is a complex health system...

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Autores principales: Cornick, Ruth, Wattrus, Camilla, Eastman, Tracy, Ras, Christy Joy, Awotiwon, Ajibola, Anderson, Lauren, Bateman, Eric, Zepeda, Jorge, Zwarenstein, Merrick, Doherty, Tanya, Fairall, Lara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231097/
https://www.ncbi.nlm.nih.gov/pubmed/30483416
http://dx.doi.org/10.1136/bmjgh-2018-001088
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author Cornick, Ruth
Wattrus, Camilla
Eastman, Tracy
Ras, Christy Joy
Awotiwon, Ajibola
Anderson, Lauren
Bateman, Eric
Zepeda, Jorge
Zwarenstein, Merrick
Doherty, Tanya
Fairall, Lara
author_facet Cornick, Ruth
Wattrus, Camilla
Eastman, Tracy
Ras, Christy Joy
Awotiwon, Ajibola
Anderson, Lauren
Bateman, Eric
Zepeda, Jorge
Zwarenstein, Merrick
Doherty, Tanya
Fairall, Lara
author_sort Cornick, Ruth
collection PubMed
description Developing a health system intervention that helps to improve primary care in a low-income and middle-income country (LMIC) is a considerable challenge; finding ways to spread that intervention to other LMICs is another. The Practical Approach to Care Kit (PACK) programme is a complex health system intervention that has been developed and adopted as policy in South Africa to improve and standardise primary care delivery. We have successfully spread PACK to several other LMICs, including Botswana, Brazil, Nigeria and Ethiopia. This paper describes our experiences of localising and implementing PACK in these countries, and our evolving mentorship model of localisation that entails our unit providing mentorship support to an in-country team to ensure that the programme is tailored to local resource constraints, burden of disease and on-the-ground realities. The iterative nature of the model’s development meant that with each country experience, we could refine both the mentorship package and the programme itself with lessons from one country applied to the next—a ‘learning health system’ with global reach. While not yet formally evaluated, we appear to have created a feasible model for taking our health system intervention across more borders.
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spelling pubmed-62310972018-11-27 Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries Cornick, Ruth Wattrus, Camilla Eastman, Tracy Ras, Christy Joy Awotiwon, Ajibola Anderson, Lauren Bateman, Eric Zepeda, Jorge Zwarenstein, Merrick Doherty, Tanya Fairall, Lara BMJ Glob Health Practice Developing a health system intervention that helps to improve primary care in a low-income and middle-income country (LMIC) is a considerable challenge; finding ways to spread that intervention to other LMICs is another. The Practical Approach to Care Kit (PACK) programme is a complex health system intervention that has been developed and adopted as policy in South Africa to improve and standardise primary care delivery. We have successfully spread PACK to several other LMICs, including Botswana, Brazil, Nigeria and Ethiopia. This paper describes our experiences of localising and implementing PACK in these countries, and our evolving mentorship model of localisation that entails our unit providing mentorship support to an in-country team to ensure that the programme is tailored to local resource constraints, burden of disease and on-the-ground realities. The iterative nature of the model’s development meant that with each country experience, we could refine both the mentorship package and the programme itself with lessons from one country applied to the next—a ‘learning health system’ with global reach. While not yet formally evaluated, we appear to have created a feasible model for taking our health system intervention across more borders. BMJ Publishing Group 2018-10-26 /pmc/articles/PMC6231097/ /pubmed/30483416 http://dx.doi.org/10.1136/bmjgh-2018-001088 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Practice
Cornick, Ruth
Wattrus, Camilla
Eastman, Tracy
Ras, Christy Joy
Awotiwon, Ajibola
Anderson, Lauren
Bateman, Eric
Zepeda, Jorge
Zwarenstein, Merrick
Doherty, Tanya
Fairall, Lara
Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries
title Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries
title_full Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries
title_fullStr Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries
title_full_unstemmed Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries
title_short Crossing borders: the PACK experience of spreading a complex health system intervention across low-income and middle-income countries
title_sort crossing borders: the pack experience of spreading a complex health system intervention across low-income and middle-income countries
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231097/
https://www.ncbi.nlm.nih.gov/pubmed/30483416
http://dx.doi.org/10.1136/bmjgh-2018-001088
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