Health Research Policy and Systems最新文献

{"title":"Conducting cross-sectoral collaborative research for food system transformation: learnings from a qualitative evaluation study.","authors":"Sarah Shaw, Oliver Huse, Bea Savory, Noah Cooke, Claire Thompson, Rachel Loopstra, Peter Scarborough, David Ogilvie, Steven Cummins, Martin White, Jean Adams","doi":"10.1186/s12961-026-01540-y","DOIUrl":"10.1186/s12961-026-01540-y","url":null,"abstract":"<p><strong>Background: </strong>The SALIENT consortium aimed to bring together research, government and food system stakeholders to co-design, implement and evaluate public-facing food system interventions targeting health and sustainability whilst maintaining affordability and commercial viability. A total of 40 organizations engaged with SALIENT; 8 progressed to deliver and evaluate a total of 10 interventions. We conducted an evaluation to understand how and why the SALIENT stakeholder engagement process worked for different organizations and to inform future food system intervention research.</p><p><strong>Methods: </strong>Using theory-based evaluation principles, a theory of change (ToC) was developed to describe how the SALIENT process was expected to function. A total of 38 semi-structured interviews were conducted with government partners, researchers and food system representatives. Data were thematically analysed and interpreted in relation to the ToC.</p><p><strong>Results: </strong>Findings highlighted the fragmented nature of existing health and sustainability actions across the food system, shaped by differing priorities, agendas and constraints of stakeholders. Power dynamics influenced stakeholder participation, with engagement strongest when research was aligned with core stakeholder goals and offered them tangible benefits. Whilst pragmatic co-design processes built trust and feasibility, they sometimes led to interventions with limited potential to address critical uncertainties in the evidence base. Academic processes were often perceived as misaligned with stakeholders' practical needs.</p><p><strong>Conclusions: </strong>Long-term government direction, stronger accountability, and incentives are needed to foster meaningful collaboration between researchers and food system stakeholders. Future partnerships should balance flexibility with rigour, build trust through sustained relationships, and establish strong governance, communication and evaluation processes early to generate robust, scalable evidence for meaningful food system change.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Storytelling for fostering a culture of safety in healthcare: a quasi-experimental study.","authors":"Marzieh Adel-Mehraban, Merzieh Gharehbaghi-NoveinFar, Tahmine Salehi, Shima Haghani, Ezzat Abbariki","doi":"10.1186/s12961-026-01508-y","DOIUrl":"https://doi.org/10.1186/s12961-026-01508-y","url":null,"abstract":"<p><strong>Background: </strong>Patient safety is a critical component of healthcare, emphasizing the prevention of errors and adverse events that may harm patients during medical care delivery.</p><p><strong>Objective: </strong>This study aimed to investigate the impact of storytelling training on patient safety culture amongst nurses at Firuzgar Hospital, affiliated with the Iran University of Medical Sciences, with the objective of minimizing errors in patient care.</p><p><strong>Methods: </strong>This quasi-experimental study was conducted at Firouzgar Hospital in 2023. A total of 64 nurses were randomly selected from a population of 515 and allocated into either an intervention group (n = 32) or a control group (n = 32) using a computer-generated random number sequence. The intervention group participated in six storytelling sessions, which were conducted by a nurse manager and lasted 1.5 h, over a 3-month period. The stories were derived from the hospital's own root cause analyses (RCA) and focused on specific patient safety incidents. The control group received only the routine patient safety education provided by the hospital. The safety culture of both groups was assessed using the Hospital Survey on Patient Safety Culture questionnaire (HSOPSC) (version 1) at three timepoints: (1) prior to the intervention (baseline), (2) immediately after the completion of the storytelling sessions and (3) 1 month following the final session. Data were analysed using SPSS software (version 16). Descriptive statistics, independent t-tests, analysis of variance (ANOVA) and Fisher statistical tests were used to compare groups over time.</p><p><strong>Results: </strong>The patient safety culture in the experimental group was significantly higher than that in the control group (P < 0.001). The effect size of the intervention on patient safety culture was 0.159, indicating a substantial impact, as this value exceeds the threshold of 0.08. The greatest impact was noted in the training and skills dimension (effect size = 0.185), whilst the lowest impact was observed in the staff dimension (effect size = 0.049).</p><p><strong>Conclusions: </strong>This study provides robust evidence that the storytelling intervention based on root cause analysis demonstrated a statistically significant and substantial positive effect on patient safety culture amongst nurses. The intervention was most effective in enhancing the \"training and skills\" dimension, suggesting its particular value in developing practical competencies. These findings support the use of narrative-based learning as an effective strategy to complement routine patient safety education.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory health research and promotion with children in Germany: a scoping review.","authors":"Janna Landwehr, Hanna Luetke Lanfer, Miriam Schierenbeck, Leonie M Heim-Scheffel","doi":"10.1186/s12961-026-01544-8","DOIUrl":"https://doi.org/10.1186/s12961-026-01544-8","url":null,"abstract":"<p><strong>Background: </strong>Participatory health research and promotion (PHR/P) emphasizes collaborative knowledge production, mutual learning, and redistribution of power between academic and non-academic actors. With children, PHR/P has gained increasing legitimacy under the United Nations Convention on the Rights of the Child, which recognizes children as rights-holders and social actors. However, little is known about how PHR/P with children is framed and enacted in Germany. This review provides the first systematic overview of PHR/P with children in Germany.</p><p><strong>Methods: </strong>We conducted a scoping review following Arksey and O'Malley's framework and PRISMA guidelines. Searches were performed in four databases in March-April 2024, supplemented by snowballing of friends' studies. Eligible studies (2000-2024) reported empirical projects in Germany (plus two projects from German-speaking Switzerland) that explicitly applied participatory approaches with children (< 18 years) and addressed health-related topics. Medical intervention studies and studies limited to clinical patient groups were excluded. Data extraction used a structured codebook adapted from the International Collaboration for Participatory Health Research and focusing on objectives, actors, research phases, and reflections. Two reviewers coded each report independently.</p><p><strong>Results: </strong>Twelve projects (23 publications) met the inclusion criteria. Most projects were situated in educational or communal contexts. Health-related objectives were consistently reported, often focusing on behavioural change. Participatory objectives were less frequent, remained implicit in several cases, and were rarely defined with children. Children typically participated alongside other adults, rarely as the sole group of non-academic actors. Participation was usually reported in operational phases (e.g. data collection), whereas involvement in conceptual phases (e.g. defining research questions, analysis, dissemination) was uncommon. Creative methods (e.g. photovoice, theater, drawing) were widely used. Reflections focused mainly on ethics, informed consent, and child protection, while sustainability, power relations, and children's perceived benefits were seldom addressed. Reporting practices were often vague, limiting systematic assessment.</p><p><strong>Discussion: </strong>PHR/P with children in Germany has gained traction but remains unevenly reported. Health-related goals dominate participatory aims, children's roles are often mediated by adults, and reflections on sustainability and power remain underdeveloped. Greater transparency in reporting participatory processes is essential to strengthen cumulative knowledge and design meaningful child-centred approaches. Trial registration N/A.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research governance in England needs improvements to ensure participant and site confidentiality in healthcare workforce research.","authors":"Justin Aunger, Jane Ferguson, Esra Alkim Karaagac, Tommer Spence, Jill Maben, Ashok Patnaik, Russell Mannion, Yingxi Zhao, Nathan Proudlove, Helen Bodenham-Chilton, Kieran Walshe","doi":"10.1186/s12961-026-01538-6","DOIUrl":"10.1186/s12961-026-01538-6","url":null,"abstract":"<p><p>Sensitive healthcare workforce research relies on credible assurances of confidentiality for participating staff and organizations. Yet, National Health Service (NHS) research governance processes can compromise these assurances even before recruitment begins, particularly through processes such as site documentation, local principal investigator (PI) requirements, research passports, and portfolio reporting. These risks are especially important for studies examining organizationally sensitive topics such as bullying, speaking up, or patient safety issues, where perceived employer awareness may reduce participation or encourage self-censorship. From March 2026, the Health Research Authority introduced reforms for staff-only studies, including streamlined site set-up, reduced site visibility, and fewer requirements for local PIs or research passports in remote studies. However, further changes are needed to better balance transparency, oversight and confidentiality. Potential improvements include dedicated pathways for sensitive organizational research, restricted-access portfolio reporting, and more centralized governance documentation. Future changes should be co-designed with researchers and NHS research and development departments to protect confidentiality and improve research productivity, while maintaining ethical standards and accountability.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Realist synthesis of co-production of services in a local authority context: what works, for whom, how and in what circumstances?","authors":"Andrew Harding, Reuben Tete Larbi, Aviel Lowndes, Paul Marshall, Adam Mars, Michaela Goodridge, Pauline Wigglesworth","doi":"10.1186/s12961-026-01522-0","DOIUrl":"https://doi.org/10.1186/s12961-026-01522-0","url":null,"abstract":"<p><strong>Background: </strong>Co-production is increasingly promoted as a means of improving the design and delivery of local authority services, yet evidence on how and why it works remains limited. This realist synthesis explored how co-production operates within complex local authority systems, identifying the circumstances and mechanisms that enable or constrain meaningful involvement of stakeholders in co-production processes and sustained change to ensure that services are co-produced with professionals and those with lived experience.</p><p><strong>Methods: </strong>Scoping searches identified key literature on co-production related to a local authority context to develop initial programme theories. Context-mechanism-outcome (CMO) configurations were constructed as \"if-then-because\" statements under four themes: equity and inclusion; collaboration and systems change; ethical and sustainable engagement and measurement and evaluation. These were refined through an analysis of 25 sources from searches across Scopus, CINAHL, Academic Search Ultimate, Web of Science and SocINDEX. Further refinement took place in two workshops with six participants with lived experience and four local authority officers. Analysis was thematic, retroductive and iterative to promote critical engagement between the research team, the literature and workshop participants.</p><p><strong>Results: </strong>Nine CMOs and an overarching programme theory illustrate how relational, structural, ethical and evaluative mechanisms interact to support authentic co-production. First, trust emerged as a central mechanism for engagement, built through culturally competent, inclusive and power-sharing practices. Second, sustainable co-production depended on visible leadership commitment, long-term investment and opportunities for skill development and emotional support. Third, ethical integrity and trauma-informed facilitation were essential for creating safe spaces where people felt respected and brave enough to share their vulnerability. Fourth, cross-sector collaboration and systems thinking enabled shared purpose and accountability across organizational boundaries. Finally, participatory and creative approaches to evaluation strengthened trust, demonstrated impact and promoted continuous learning. Concepts such as trust, power-sharing and leadership commitment operated recursively across different contexts and at varying system levels.</p><p><strong>Conclusions: </strong>Authentic co-production in local authority systems depends on aligning relational trust, ethical practice and structural support within learning cultures that value lived experience. This synthesis advances theoretical understanding and offers practical guidance for embedding equitable, sustainable collaboration into the everyday culture and governance of local authorities.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering how we define quality: insights from the co-development of an actionable definition of oral healthcare quality,mntion.","authors":"Michael Lorenz, Ziade Sarroukh, Stefan Listl","doi":"10.1186/s12961-026-01536-8","DOIUrl":"10.1186/s12961-026-01536-8","url":null,"abstract":"<p><strong>Background: </strong>The burden of oral diseases on society remains relevant as vulnerable groups lack accessibility to oral healthcare and it is expensive on a societal scale. While there is renewed political will from the UN to expand Universal Health Coverage to oral health, quality issues remain. Solving such complex systematic problems requires coherent efforts that span multiple stakeholders and sectors. The co-development of a definition of oral healthcare quality serves as a key enabler for quality improvement interventions as it facilitates collective understanding and normative directionality.</p><p><strong>Methods: </strong>As part of the EU DELIVER project, a five-step co-development process was leveraged for consenting an actionable definition for quality of oral healthcare: (1) literature screening to identify relevant themes of quality of oral healthcare; (2) compilation of a starting list from these themes; (3) World Café sessions to deliberate about themes to define quality of oral healthcare; (4) thematic analysis of information from the World Café sessions; (5) final voting and completion of the definition. The definition provides a clear foundation and normative directionality for co-developing quality indicators and targeted interventions for quality improvement. The Consolidated criteria for reporting qualitative studies (COREQ-32) were used to report the study.</p><p><strong>Results: </strong>Drawing from the breadth of the extant scientific literature and the depth of stakeholder insights from the World Café sessions, the following working definition was agreed upon: \"Quality oral healthcare refers to the contribution of healthcare to optimal oral health. This entails that care alleviates oral health inequity, is comprehensive, empowers patients, mitigates harm and encourages learning systematically, improves well-being, minimizes waste of resources and is provided at the right time. To maximize quality, care should be equitable, accessible, patient-centered, safe, effective, efficient and timely.\" The definition forms the basis for the operationalization of targeted quality improvement interventions on the practice-, community- and health systems levels.</p><p><strong>Conclusions: </strong>The definition for quality of oral healthcare is the first that was co-developed together with providers, policy-makers, and patients from various European countries. This definition provides meaningful normative direction and is highly relevant to collective problem-solving aimed at optimizing the quality of oral healthcare.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and pilot implementation of the WHO guideline on digital intervention to strengthen mental health systems in Lagos state, Nigeria.","authors":"Abiodun O Adewuya, Jibril Abdulmalik, Seye Abimbola, Olabisi E Oladipo, Asmau Dahiru, Falmata Shettima, Adedolapo Fasawe, Christine Fahim, Robert Marten, Sonam Yangchen, Sharon Straus","doi":"10.1186/s12961-026-01463-8","DOIUrl":"10.1186/s12961-026-01463-8","url":null,"abstract":"<p><strong>Background: </strong>The uptake and implementation of cost-effective interventions and programs for mental health problems are often threatened by weakened health systems (HS) in low- and middle-income countries (LMICs). Digital technologies provide concrete opportunities to tackle these HS challenges. This study aimed to adapt and conduct a pilot implementation of the \"WHO Guideline: recommendations on digital interventions for health system strengthening\" (WHO-GRDI) for mental health systems in Nigeria.</p><p><strong>Methods: </strong>The AGREE-II was used to appraise the WHO-GRDI by a team of five independent raters, and the ADAPTE framework was followed in adaptation of the WHO-GRDI to the local setting. The pilot implementation of the recommendations of the adapted WHO-GRDI was carried out within five randomly selected primary care systems. Assessment of the acceptability (using acceptability of intervention measure), appropriateness (using intervention appropriateness measure), feasibility (using feasibility of intervention measure) and perceived effectiveness of the WHO-GRDI recommendations was conducted. In addition, the stakeholders' readiness to implement change was evaluated using the Organizational Readiness for Implementing Change scale.</p><p><strong>Results: </strong>The overall assessment of the WHO-GRDI using the AGREE-II was 79.3%. The final draft of the adapted guideline has eight recommendations. During the pilot implementation, the recommendations regarding drug stock notification, health workers' supervision and communication and targeted client communication were considered quite effective (score range 80.0-92.0%), acceptable (score range 80.5-91.0%) and appropriate (score range 84.0-90.0%), and could be feasibly implemented (score range 81.0-90.0%) for mental health services in the local setting with a focus on mobile technology. However, the health workers expressed some concerns with recommendations on \"Client-to-health-provider communication\" (score range 65.6-73.4%) and \"clinical decision support\" (score range 78.0-79.0%).</p><p><strong>Conclusions: </strong>Our study detailed the process involved in the adaptation and pilot implementation of a newly released HS guideline for mental health services in a LMIC. There is a need for further research that will embrace the views and experiences of end-users of health systems guidelines to understand and contextualize the balance between generalizability and local adaptability of health systems guidelines in LMICs.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 Suppl 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting and implementing health systems guidelines: learning lessons from countries.","authors":"Seraphine Zeitouny, Christine Fahim, Abiodun Olugbenga Adewuya, Samuel Adjorlolo, Chanda Mwamba, Claudia Marcela Velez, Sharon E Straus, Robert Marten","doi":"10.1186/s12961-026-01460-x","DOIUrl":"10.1186/s12961-026-01460-x","url":null,"abstract":"","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 Suppl 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of home visit practice and perceived solutions for improvement in Ghanaian context: perspectives of healthcare professional and community informants.","authors":"Lillian Akorfa Ohene, Samuel Adjorlolo, Margaretta Gloria Chandi, Cecilia Aryeetey, Adelaide Maria Ansah-Ofei, Moses Aikins, Lydia Aziato","doi":"10.1186/s12961-026-01461-w","DOIUrl":"10.1186/s12961-026-01461-w","url":null,"abstract":"<p><strong>Background: </strong>Home visits conducted by nurses and other health professionals are pivotal in ensuring access to healthcare and social services, particularly for the poor and marginalized in Ghana. This paper presents findings from a study conducted in the first and last quarter's 2020 among health professionals and key community informants on health service delivery in a rural-urban setting in Accra, Ghana. The study's specific objectives were to (1) explore the challenges besetting home visit practices in Ghana and (2) solicit participants' perspectives on measures to improve current home visit practices.</p><p><strong>Methods: </strong>A qualitative exploratory study was adopted. The study population included community healthcare workers (public health nurses, nurses and community health officers), local community leaders and faith healers group leaders. Audio-recorded data were collected during focus group discussions and stakeholder engagements. Three qualitative analysts from the research team conducted thematic and content data analysis.</p><p><strong>Results: </strong>Barriers to home visits were identified. Thematic areas under the barriers included \"Physical Challenges, Psychological Challenges and Sociocultural practices as challenges to home visiting.\" The second significant finding was centred on multiple measures to improve home visits from health workers. The themes included \"Resources and Incentives, Safety and Security, and In-service Training.\" These significant findings were validated in the stakeholder meetings.</p><p><strong>Conclusions: </strong>Multi-factorial challenges impede the practices and reception of home visits in Ghana. Based on the findings, we recommend dedicated home visiting guidelines incorporating cultural nuances and providing salient information on service set-up, logistics, and human and financial resources to streamline home visiting practice.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 Suppl 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raising the bar: translating global guidelines to achieve local policy on cholera elimination in Zambia-a qualitative case study.","authors":"Chanda Mwamba, Tikulirekuti Banda, Mazyanga Mazaba, Victor Mukonka, Kennedy Malama, Esther Hamweemba, Mainza Syulikwa, Roma Chilengi, Anjali Sharma, Christine Fahim, Robert Marten, Sonam Yangchen, Sharon Straus","doi":"10.1186/s12961-026-01464-7","DOIUrl":"10.1186/s12961-026-01464-7","url":null,"abstract":"<p><strong>Background: </strong>The global roadmap to eliminating cholera by 2030 relies on early detection and response, vaccination in hotspots and effective partnerships. In sub-Saharan Africa, where 60% of the 2.8 million annual cases occur, cholera elimination requires a multisectoral response. To accelerate progress, improved understanding of how to translate a multisectoral approach to eliminate cholera is needed.</p><p><strong>Methods: </strong>We evaluated implementation of Zambia's Multisectoral Cholera Elimination Plan (MCEP) using six phases of Graham's Knowledge-to-Action (KTA) framework (adaption, assessing barriers, implementation, monitoring, evaluation and sustaining knowledge use). We reviewed the MCEP to assess the policy environment for supporting implementation and triangulated information from 24 key informant interviews with policy-makers and implementers, 12 in-depth interviews with cholera survivors and focus group discussions with 28 community-based neighbourhood health committee members. Thematic analysis was used to analyse the data. We present our findings under each KTA phase.</p><p><strong>Results: </strong>The MCEP prioritizes actions in hotspots, and vaccinations through a multisectoral governance and coordination structure. The appointment of a coordinator and formation of multisectoral technical working groups (TWGs) have improved dissemination, coordination and the case for additional investments in laboratory capacity, cholera vaccines and infrastructure for water, sanitation, hygiene and decentralized solid waste management. However, slow institutionalization of plans, weak coordination, inadequate funding, poor infrastructure and the coronavirus disease 2019 (COVID-19) pandemic has led to fragmented implementation. The sustainability of the MCEP is not assured without: (1) comprehensive advocacy; (2) resource mobilization (international and national budget commitment); (3) monitoring and evaluation (M&E) of progress; and (4) information synthesis and dissemination for end users.</p><p><strong>Conclusions: </strong>A multisectoral approach can help gain adequate momentum and efficiencies to eliminate cholera in Zambia, provided stakeholders are fully committed and funding is allocated to support plans. An adaptive collaborative strategy within national guidelines and policies that includes target communities is needed to support local translation, adaptation and concerted efforts to eliminate cholera.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"24 Suppl 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}