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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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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. |
format | Online Article Text |
id | pubmed-6231097 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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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