Cargando…

Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review

Background: The SAFE strategy (surgery for trichiasis, antibiotics for active infection, facial cleanliness and environmental improvement) is the World Health Organization (WHO) recommended guideline for the elimination of blindness by trachoma by the year 2020. Objective: While evaluations on the i...

Descripción completa

Detalles Bibliográficos
Autores principales: Maritim, Patricia, Zulu, Joseph Mumba, Jacobs, Choolwe, Chola, Mumbi, Chongwe, Gershom, Zyambo, Jessy, Halwindi, Hikabasa, Michelo, Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383623/
https://www.ncbi.nlm.nih.gov/pubmed/30773102
http://dx.doi.org/10.1080/16549716.2019.1570646
_version_ 1783396873932898304
author Maritim, Patricia
Zulu, Joseph Mumba
Jacobs, Choolwe
Chola, Mumbi
Chongwe, Gershom
Zyambo, Jessy
Halwindi, Hikabasa
Michelo, Charles
author_facet Maritim, Patricia
Zulu, Joseph Mumba
Jacobs, Choolwe
Chola, Mumbi
Chongwe, Gershom
Zyambo, Jessy
Halwindi, Hikabasa
Michelo, Charles
author_sort Maritim, Patricia
collection PubMed
description Background: The SAFE strategy (surgery for trichiasis, antibiotics for active infection, facial cleanliness and environmental improvement) is the World Health Organization (WHO) recommended guideline for the elimination of blindness by trachoma by the year 2020. Objective: While evaluations on the implementation of the SAFE strategy have been done, systematic reviews on the factors that have shaped implementation are lacking. This review sought to identify these factors. Methods: We searched PUBMED, Google Scholar, CINAHL and Cochrane Collaboration to identify studies that had implemented SAFE interventions. The Consolidated Framework for Implementation Research (CFIR) guided development of the data extraction guide and data analysis. Results: One hundred and thirty-seven studies were identified and only 10 papers fulfilled the eligibility criteria. Characteristics of the innovation – such as adaptation of the SAFE interventions to suit the setting and observability of positive health outcomes from pilots – increased local adoption. Characteristics of outer setting – which included strong multisectoral collaboration – were found to enhance implementation through the provision of resources necessary for programme activities. When community needs and resources were unaccounted for there was poor compatibility with local settings. Characteristics of the inner setting – such as poor staffing, high labour turnovers and lack of ongoing training – affected health workers’ implementation behaviour. Implementation climate within provider organisations was shaped by availability of resources. Characteristics of individuals – which included low knowledge levels – affected the acceptability of SAFE programmes; however, early adopters could be used as change agents. Finally, the use of engagement strategies tailored towards promoting community participation and stakeholder involvement during the implementation process facilitated adoption process. Conclusion: We found CFIR to be a robust framework capable of identifying different implementation determinants in low resource settings. However, there is a need for more research on the organisational, provider and implementation process related factors for trachoma as most studies focused on the outer setting.
format Online
Article
Text
id pubmed-6383623
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Taylor & Francis
record_format MEDLINE/PubMed
spelling pubmed-63836232019-02-27 Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review Maritim, Patricia Zulu, Joseph Mumba Jacobs, Choolwe Chola, Mumbi Chongwe, Gershom Zyambo, Jessy Halwindi, Hikabasa Michelo, Charles Glob Health Action Review Article Background: The SAFE strategy (surgery for trichiasis, antibiotics for active infection, facial cleanliness and environmental improvement) is the World Health Organization (WHO) recommended guideline for the elimination of blindness by trachoma by the year 2020. Objective: While evaluations on the implementation of the SAFE strategy have been done, systematic reviews on the factors that have shaped implementation are lacking. This review sought to identify these factors. Methods: We searched PUBMED, Google Scholar, CINAHL and Cochrane Collaboration to identify studies that had implemented SAFE interventions. The Consolidated Framework for Implementation Research (CFIR) guided development of the data extraction guide and data analysis. Results: One hundred and thirty-seven studies were identified and only 10 papers fulfilled the eligibility criteria. Characteristics of the innovation – such as adaptation of the SAFE interventions to suit the setting and observability of positive health outcomes from pilots – increased local adoption. Characteristics of outer setting – which included strong multisectoral collaboration – were found to enhance implementation through the provision of resources necessary for programme activities. When community needs and resources were unaccounted for there was poor compatibility with local settings. Characteristics of the inner setting – such as poor staffing, high labour turnovers and lack of ongoing training – affected health workers’ implementation behaviour. Implementation climate within provider organisations was shaped by availability of resources. Characteristics of individuals – which included low knowledge levels – affected the acceptability of SAFE programmes; however, early adopters could be used as change agents. Finally, the use of engagement strategies tailored towards promoting community participation and stakeholder involvement during the implementation process facilitated adoption process. Conclusion: We found CFIR to be a robust framework capable of identifying different implementation determinants in low resource settings. However, there is a need for more research on the organisational, provider and implementation process related factors for trachoma as most studies focused on the outer setting. Taylor & Francis 2019-02-18 /pmc/articles/PMC6383623/ /pubmed/30773102 http://dx.doi.org/10.1080/16549716.2019.1570646 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Maritim, Patricia
Zulu, Joseph Mumba
Jacobs, Choolwe
Chola, Mumbi
Chongwe, Gershom
Zyambo, Jessy
Halwindi, Hikabasa
Michelo, Charles
Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review
title Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review
title_full Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review
title_fullStr Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review
title_full_unstemmed Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review
title_short Factors shaping the implementation of the SAFE strategy for trachoma using the Consolidated Framework for Implementation Research: a systematic review
title_sort factors shaping the implementation of the safe strategy for trachoma using the consolidated framework for implementation research: a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383623/
https://www.ncbi.nlm.nih.gov/pubmed/30773102
http://dx.doi.org/10.1080/16549716.2019.1570646
work_keys_str_mv AT maritimpatricia factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT zulujosephmumba factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT jacobschoolwe factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT cholamumbi factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT chongwegershom factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT zyambojessy factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT halwindihikabasa factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview
AT michelocharles factorsshapingtheimplementationofthesafestrategyfortrachomausingtheconsolidatedframeworkforimplementationresearchasystematicreview