Sustaining stakeholder engagement for health research during the COVID-19 pandemic: Lessons from the RESPIRE programme in Bangladesh, India, Malaysia, and Pakistan

Stakeholder engagement in healthcare research in India - A systematic review

BACKGROUND

Stakeholder engagement is increasingly crucial in healthcare research, particularly in diverse and complex settings such as India. Stakeholder engagement in health research is about collaborating with key parties such as patients, healthcare providers and policymakers to ensure the research is relevant and impactful by addressing real-world needs, thereby enhancing its quality and effect on healthcare practices.

AIM

The purpose of this study was to summarize the evidence on stakeholder engagement in healthcare research and its influence on research outcomes and healthcare policies in India.

METHODS

The evaluation was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in PubMed, SCOPUS, ProQuest, EMBASE, Web of Science, CINAHL Indian Citation Index and J-Gate, focussing on stakeholder involvement in healthcare settings in hospitals and communities in India. Various research methodologies were employed, with studies not centred on healthcare stakeholder engagement or unrelated sectors being excluded. Tools such as the Critical Appraisal Skills Programme checklist for qualitative studies and the mixed methods appraisal tool were used to evaluate the quality of the studies. Data synthesis was carried out using the descriptive/narrative synthesis approach.

RESULTS

We included 25 articles on the basis of our eligibility criteria. These articles comprised reviews, theories of change, quantitative studies, reports, mapping, commentaries, conference proceedings, qualitative studies, experience papers and mixed methods research. The review examined different types and methods of engaging stakeholders in healthcare research projects, evaluated their influence on evidence-based practice, and investigated their relevance to reaching "hard-to-reach" populations. Overcoming financial, time, knowledge and logistical barriers and gaining support from international and governmental bodies can lead to more inclusive research with a significant impact.

CONCLUSIONS

Findings suggest that stakeholder engagement contributes to more contextually relevant and ethically grounded research, though challenges related to power dynamics, resource allocation and inclusivity remain prevalent. The review concludes by providing recommendations for enhancing stakeholder engagement practices in future healthcare research in India, emphasizing the need for capacity-building and inclusive frameworks that ensure diverse voices are represented.

Improving the provision for gynaecological health care in Bangladesh using Essential Gynaecological Skills implementation package: a stakeholder-driven approach in public health facilities

Background

Gynaecological health and its related service delivery have long been neglected in Bangladesh. In response to the high burden and improvements in the provision of gynaecological health care, the Essential Gynaecological Skills (EGS) implementation package was developed. It includes comprehensive in-service training for upskilling the non-specialised health care providers and introduces the first structured data recording system for gynaecology in the outdoor of public health facilities in Bangladesh. We outline how the stakeholder engagement process was integrated into the implementation research related to this pioneering initiative.

Methods

Based on literature review, expert consultation and prior experience, we adopted the identification, sensitisation, involvement, and engagement (ISIE) framework of stakeholder engagement and process documentation. After identifying national and local level stakeholders via a power-interest mapping exercise, we sensitised them to the gaps in gynaecological health service delivery. High-power and high-interest stakeholders were involved and engaged in developing the EGS implementation package, which was then introduced in selected public health facilities and evaluated through implementation research.

Results

Acknowledging the urgent need for gynaecological health care services, the identified and sensitised stakeholders supported the development of the EGS implementation package. This resulted in the development and implementation of the EGS implementation package under the Government of Bangladesh's leadership, highlighting government ownership. These outcomes reflected the potential for scalability and sustainability of the package. However, stakeholder engagement remains a time and resource-intensive process that requires an innovative, research-backed approach with committed implementation.

Conclusions

Our experience of using the ISIE framework showcased the potential of this framework in achieving sustainability and scalability at the national level. However, further initiatives from the government can ensure nationwide scale-up, setting an example for other lower and middle-income countries.

Establishing a Digital Health Care Ecosystem in a Health Sciences University in South Africa: Protocol for a Mixed Methods Study

BACKGROUND

Comprehensive and formalized digital health care ecosystems in health sciences tertiary education in South Africa do not currently exist, but they have the potential to influence teaching and learning, research, and community engagement.

OBJECTIVE

A total of 3 key objectives underpin the study, that is, determining the health care curriculum needs and required content for the development of a formalized digital health ecosystem, determining the level of readiness of staff and students to participate in a digital health care ecosystem, and determining whether community engagement and strategic partnerships can contribute to the sustainability of a digital health care ecosystem.

METHODS

A multipronged approach will be used to address the objectives, with a mixed methods design being undertaken. The qualitative phases will be phenomenological in nature, and triangulation of information along with thematic analysis will be conducted on the collected data. Quantitative data will be collected prospectively and cross-sectionally and analyzed using descriptive analysis. Sampling will include subject experts for the Delphi technique, staff and students at the University, clinical training and education partners, and community leaders. This study has received ethical approval from the Sefako Makgatho Health Sciences University Research and Ethics Committee (SMUREC/H/260/2023:PG).

RESULTS

Data collection for the first phase will begin in January 2024 and conclude in December 2024. Phase 2 and 3 of the study will be conducted concurrently, with data collection starting in January 2025 and concluding in December 2026.

CONCLUSIONS

The establishment of a digital health care ecosystem has the potential to benefit staff, students, and communities through stakeholder collaboration, educational opportunities, research projects, and improved service delivery.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/57821.

An integrated knowledge translation (iKT) approach to advancing community-based depression care in Vietnam: lessons from an ongoing research-policy collaboration

BACKGROUND

Evidence-based mental health policies are key to supporting the expansion of community-based mental health care and are increasingly being developed in low and middle-income countries (LMICs). Despite this, research on the process of mental health policy development in LMICs is limited. Engagement between researchers and policy makers via an integrated Knowledge Translation (iKT) approach can help to facilitate the process of evidence-based policy making. This paper provides a descriptive case study of a decade-long policy and research collaboration between partners in Vietnam, Canada and Australia to advance mental health policy for community-based depression care in Vietnam.

METHODS

This descriptive case study draws on qualitative data including team meeting minutes, a focus group discussion with research team leaders, and key informant interviews with two Vietnamese policy makers. Our analysis draws on Murphy et al.'s (2021) findings and recommendations related to stakeholder engagement in global mental health research.

RESULTS

Consistent with Murphy et al.'s findings, facilitating factors across three thematic categories were identified. Related to 'the importance of understanding context', engagement between researchers and policy partners from the formative research stage provided a foundation for engagement that aligned with local priorities. The COVID-19 pandemic acted as a catalyst to further advance the prioritization of mental heath by the Government of Vietnam. 'The nature of engagement' is also important, with findings demonstrating that long-term policy engagement was facilitated by continuous funding mechanisms that have enabled trust-building and allowed the research team to respond to local priorities over time. 'Communication and dissemination' are also crucial, with the research team supporting mental health awareness-raising among policy makers and the community, including via capacity building initiatives.

CONCLUSIONS

This case study identifies factors influencing policy engagement for mental health system strengthening in an LMIC setting. Sustained engagement with policy leaders helps to ensure alignment with local priorities, thus facilitating uptake and scale-up. Funding agencies can play a crucial role in supporting mental health system development through longer term funding mechanisms. Increased research related to the policy engagement process in global mental health will further support policy development and improvement in mental health care in LMICs.