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dc.contributor.authorShayo, Elizabeth Henry
dc.contributor.authorVåga, Bodil Bø
dc.contributor.authorMoland, Karen Marie
dc.contributor.authorKamuzora, Peter
dc.contributor.authorBlystad, Astrid
dc.identifier.citationShayo, E.H., Våga, B.B., Moland, K.M. et al. (2014) Challenges of disseminating clinical practice guidelines in a weak health system: the case of HIV and infant feeding recommendations in Tanzania. International Breastfeeding Journal 2014, 9(1)nb_NO
dc.description© 2015 Shayo et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License and originally published in the International Breastfeeding Journal. See DOI 10.1186/s13006-014-0024-nb_NO
dc.description.abstractBackground: Clinical guidelines aim to improve patient outcomes by providing recommendations on appropriate healthcare for specific clinical conditions. Scientific evidence produced over time leads to change in clinical guidelines, and a serious challenge may emerge in the process of communicating the changes to healthcare practitioners and getting new practices adopted. There is very little information on the major barriers to implementing clinical guidelines in low-income settings. Looking at how continual updates to clinical guidelines within a particular health intervention are communicated may shed light on the processes at work. The aim of this paper is to explore how the content of a series of diverging infant feeding guidelines have been communicated to managers in the Prevention of Mother to Child Transmission of HIV Programme (PMTCT) with the aim of generating knowledge about both barriers and facilitating factors in the dissemination of new and updated knowledge in clinical guidelines in the context of weak healthcare systems. Methods: A total of 22 in-depth interviews and two focus group discussions were conducted in 2011. All informants were linked to the PMTCT programme in Tanzania. The informants included managers at regional and district levels and health workers at health facility level. Results: The informants demonstrated partial and incomplete knowledge about the recommendations. There was lack of scientific reasoning behind various infant feeding recommendations. The greatest challenges to the successful communication of the infant feeding guidelines were related to slowness of communication, inaccessible jargon-ridden English language in the manuals, lack of summaries, lack of supportive supervision to make the guidelines comprehensible, and the absence of a reading culture. Conclusion: The study encountered substantial gaps in knowledge about the diverse HIV and infant feeding policies. These gaps were partly related to the challenges of communicating the clinical guidelines. There is a need for caution in assuming that important changes in guidelines for clinical practice can easily be translated to and implemented in local programme settings, not least in the context of weak healthcare systems.nb_NO
dc.publisherBioMed Centralnb_NO
dc.rightsNavngivelse 3.0 Norge*
dc.subjectclinical guidelinesnb_NO
dc.subjecthealthcare systemnb_NO
dc.subjectkliniske retningslinjernb_NO
dc.subjectcommunication challengesnb_NO
dc.titleChallenges of disseminating clinical practice guidelines in a weak health system: the case of HIV and infant feeding recommendations in Tanzanianb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.subject.nsiVDP::Medical disciplines: 700::Health sciences: 800nb_NO
dc.source.journalInternational Breastfeeding Journalnb_NO

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Navngivelse 3.0 Norge
Except where otherwise noted, this item's license is described as Navngivelse 3.0 Norge