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I blogged in November 2010 about an infection control project I was launching in Nepal. The project was voluntary and looked at modifying the Aseptic non-touch technique (ANTT) guidelines advocated by the EPIC 2 study, Pratt et al 1997, for the resource poor environment. This ANTT guideline is used as a main stay for practice in many health care trusts across the UK and has been adopted as the national guideline in Australia. I saw the huge benefit it could have if modified for resource poor countries (developing countries). As such with the support of UK based colleagues I modified the guideline for Nepal and launched it in Feb 2011. This launch was undertaken with the full support of my Nepali nursing colleagues and medical professionals on the infection control team at the hospital concerned.
In addition to the launch I attempted to do a basic audit of infection control rates in the hospital prior to the intervention and was hoping to collect audit style data post the intervention too. However after three years in country I have left and the agreement I had with the hospital to provide me with the sats has been revoked. In order to make my intervention worthwhile I am attempting to write up an article about the barriers to research in the developing world. However there is very little literature on this subject. Themes I identified informally are; Firstly perceived(perceived by the local population) lack of understanding by the outsider of the restrictions to the health care environment, financial and ideological. The second theme surrounds suspicion of the motives of the outsider and the possible exploitation of the country or individual concerned. Third is a lack of research and or evidence base generated in developing countries and thus information developed outside does not suit the different health care environment. I'm looking for research to back up these themes. Any help would be gratefully received.
I haven't found anything yet (still looking!) about cross-cultural experiences. But main barriers to research implementation in nursing are described as:
lack of implication for practice, insufficient help to apply findings, difficulty understanding research written in English (Korea, 2004) Oh EG, Oh HJ, Lee YJ; Taehan Kanho Hakhoe Chi, 2004 Aug, 34;
quality of research, organisational barriers, nurses values, awareness and skills (Spain, 2011) Moreno-Casbas T el al, J Clin Nursing 2011 Jul 20 (13 - 14);
lack of time, lack of skills and inability to find research evidence (Austria, 2011) Breimaier H et al J Clin Nursing Jun 20 (11 - 12).
Well done on addressing this important subject. Like Nicola I continue to look for papers regarding barriers to research in the developing world.
Can I recommend the HIFA2015 and CHILD2015 forums to colleagues. Many relevant and topical subjects are addressed, including many aspects of research in resource poor settings. A recent "webinar"(internet based seminar) also addressed the specific problems of publishing research in Africa. Each forum is free to join and open to all health professionals.
I look forward to hearing comments from fellow nurses overseas.
Barriers to research in the developing world, I thought that I would share my own personal barriers that I experienced. As an Indian South Africa, there are certain cultural norms and practices which have often hampered my engagement with my research colleagues. I often find myself asking questions about whether my behaviour is respectful or not. The cultural constraints faced by individuals when conducting research is a foundational issue when looking into the barriers faced by researchers in the developing world. I have also had the experience of fellow nursing colleagues from certain East African countries, whose manner in approaching gaining access to institutions hampered there research initially in South Africa. once they were understood by the institution's head from a cultural perspective they progressed in obtaining the access that they needed into an institution.
I have included an article on the moral distress of Iranian nurses in ICU.
in this sentence "the agreement I had with the hospital to provide me with the sats has been revoked", are you saying that the data was not provided to you? i did not understand "sats". is it STATS instead? We would like to help you.