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‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study

OBJECTIVE: To explore experts’ views on factors influencing national and global active case-finding (ACF) policy development and implementation, and the use of evidence in these processes. DESIGN: This is an exploratory study based on semistructured expert interviews. Framework analysis was applied....

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Autores principales: Biermann, Olivia, Atkins, Salla, Lönnroth, Knut, Caws, Maxine, Viney, Kerri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282330/
https://www.ncbi.nlm.nih.gov/pubmed/32499270
http://dx.doi.org/10.1136/bmjopen-2019-036285
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author Biermann, Olivia
Atkins, Salla
Lönnroth, Knut
Caws, Maxine
Viney, Kerri
author_facet Biermann, Olivia
Atkins, Salla
Lönnroth, Knut
Caws, Maxine
Viney, Kerri
author_sort Biermann, Olivia
collection PubMed
description OBJECTIVE: To explore experts’ views on factors influencing national and global active case-finding (ACF) policy development and implementation, and the use of evidence in these processes. DESIGN: This is an exploratory study based on semistructured expert interviews. Framework analysis was applied. PARTICIPANTS: The study involved a purposive sample of 39 experts from international, non-governmental and non-profit organisations, funders, government institutions, international societies, think tanks, universities and research institutions worldwide. RESULTS: This study highlighted the perceived need among experts for different types of evidence for ACF policy development and implementation, and for stakeholder engagement including researchers and policymakers to foster evidence use. Interviewees stressed the influence of government, donor and non-governmental stakeholders in ACF policy development. Such key stakeholders also influence ACF policy implementation, in addition to available systems and processes in a given health system, and implementers’ motivation and incentives. According to the interviewees, the World Health Organization (WHO) guidelines for systematic screening face the innate challenge of providing guidance to countries across the broad area of ACF in terms of target groups, settings and screening algorithms. The guidelines could be improved by focusing on what should be done rather than what can be done in ACF, and by providing howto examples. Leadership, integration into health systems and long-term financing are key for ACF to be sustainable. CONCLUSIONS: We provide new insights into ACF policy processes globally, particularly regarding facilitators for and barriers to ACF policy development, evidence need and use, and donor organisations’ influence. According to expert participants, national and global ACF policy development and implementation can be improved by broadening stakeholder engagement. Meanwhile, using diverse evidence to inform ACF policy development and implementation could mitigate the ‘power plays plus push’ that might otherwise disrupt and mislead these policy processes.
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spelling pubmed-72823302020-06-15 ‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study Biermann, Olivia Atkins, Salla Lönnroth, Knut Caws, Maxine Viney, Kerri BMJ Open Health Policy OBJECTIVE: To explore experts’ views on factors influencing national and global active case-finding (ACF) policy development and implementation, and the use of evidence in these processes. DESIGN: This is an exploratory study based on semistructured expert interviews. Framework analysis was applied. PARTICIPANTS: The study involved a purposive sample of 39 experts from international, non-governmental and non-profit organisations, funders, government institutions, international societies, think tanks, universities and research institutions worldwide. RESULTS: This study highlighted the perceived need among experts for different types of evidence for ACF policy development and implementation, and for stakeholder engagement including researchers and policymakers to foster evidence use. Interviewees stressed the influence of government, donor and non-governmental stakeholders in ACF policy development. Such key stakeholders also influence ACF policy implementation, in addition to available systems and processes in a given health system, and implementers’ motivation and incentives. According to the interviewees, the World Health Organization (WHO) guidelines for systematic screening face the innate challenge of providing guidance to countries across the broad area of ACF in terms of target groups, settings and screening algorithms. The guidelines could be improved by focusing on what should be done rather than what can be done in ACF, and by providing howto examples. Leadership, integration into health systems and long-term financing are key for ACF to be sustainable. CONCLUSIONS: We provide new insights into ACF policy processes globally, particularly regarding facilitators for and barriers to ACF policy development, evidence need and use, and donor organisations’ influence. According to expert participants, national and global ACF policy development and implementation can be improved by broadening stakeholder engagement. Meanwhile, using diverse evidence to inform ACF policy development and implementation could mitigate the ‘power plays plus push’ that might otherwise disrupt and mislead these policy processes. BMJ Publishing Group 2020-06-03 /pmc/articles/PMC7282330/ /pubmed/32499270 http://dx.doi.org/10.1136/bmjopen-2019-036285 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Health Policy
Biermann, Olivia
Atkins, Salla
Lönnroth, Knut
Caws, Maxine
Viney, Kerri
‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
title ‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
title_full ‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
title_fullStr ‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
title_full_unstemmed ‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
title_short ‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
title_sort ‘power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
topic Health Policy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282330/
https://www.ncbi.nlm.nih.gov/pubmed/32499270
http://dx.doi.org/10.1136/bmjopen-2019-036285
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