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Problem Many national child health guidelines In Malawi, Nigeria and South Africa are outdated and score poorly on rigorous methods and stakeholder participation. Approach In line with the World Health Organization's (WHO) emphasis on local guideline contextualization, the Global Evidence-Local Adaptation (GELA) project supported multistakeholder processes to adapt evidence-informed recommendations for child health in Malawi, Nigeria and South Africa. The GELA project team convened national steering groups, which conducted structured, iterative priority-setting exercises to identify priority topics. We identified appropriate source guidelines by systematically searching and screening available guidelines. We then matched recommendations in potential source guidelines to the relevant questions, and assessed the guidelines for timeliness and quality. Drawing on WHO's guideline process, we applied the GRADE-ADOLOPMENT process to develop contextualized recommendations from existing guidelines. If no source guideline or reviews were identified, we conducted new evidence syntheses. Local setting Malawi, Nigeria and South Africa are countries with varying health priorities and systems, all transitioning to universal health coverage. Guideline structures differ between countries, with processes largely led from national health ministries. Relevant changes National guideline groups, supported by GELA researchers and government-academic partners, developed five contextually-tailored child health recommendations. For most of these recommendations, additional evidence was required to inform contextually appropriate national decision-making. Formal capacity-building and on-the-job learning enhanced the competencies of national contributors and researchers in evidence-informed decision-making. Lessons learnt Developing context-relevant recommendations requires considerable resources and time. Further investment in strengthening local capacity is needed for sustainable national guideline development. [phrase omitted] Probleme En Afrique du Sud, au Malawi et au Nigeria, de nombreuses lignes directrices nationales relatives a la sante infantile sont obsoletes et affichent de pietres resultats en termes de rigueur des methodes et d'implication des parties prenantes. Approche S'alignant sur l'importance accordee par l'Organisation mondiale de la Sante (OMS) a la contextualisation des lignes directrices locales, le projet Global Evidence - Local Adaptation (GELA) a apporte son soutien a divers processus de collaboration multilaterale afin d'adapter des recommandations sur la sante infantile etayees par des faits en Afrique du Sud, au Malawi et au Nigeria. L'equipe du projet GELA a constitue des groupes de pilotage nationaux, charges d'effectuer des exercices iteratifs et structures de definition des priorites afin de repertorier les principaux themes. Nous avons identifie des lignes directrices de reference en procedant a une recherche et une selection parmi celles disponibles. Ensuite, nous avons compare les recommandations de ces potentielles lignes directrices de reference avec les questions pertinentes, puis nous avons evalue leur qualite et leur actualite. En nous fondant sur le processus d'elaboration de lignes directrices de l'OMS, nous avons applique la methodologie GRADEADOLOPMENT pour formuler des recommandations contextualisees a partir de lignes directrices existantes. Si aucune analyse ni ligne directrice de reference n'avait pu etre degagee, nous etablissions de nouvelles syntheses de preuves. Environnement local L'Afrique du Sud, le Malawi et le Nigeria sont des pays aux priorites et systemes de sante variables, qui operent tous trois une transition vers une couverture sanitaire universelle. Les structures des lignes directrices different d'un pays a l'autre, les processus etant generalement menes par les Ministeres nationaux de la Sante. Changements significatifs Les groupes charges d'elaborer des lignes directrices nationales, avec l'aide des chercheurs GELA et des partenaires gouvernementaux et universitaires, ont emis cinq recommandations adaptees au contexte en matiere de sante infantile. Dans la plupart des cas, la prise de decisions nationales contextualisees necessitait des preuves supplementaires. Le programme de renforcement des capacites et l'apprentissage sur le terrain ont permis d'ameliorer les competences des chercheurs et contributeurs nationaux dans les processus decisionnels etayes par des faits. Lecons tirees Mettre au point des recommandations propres a chaque contexte demande du temps et des ressources considerables. D'autres investissements dans le renforcement des capacites locales sont indispensables pour perenniser le developpement national de lignes directrices. [phrase omitted] Situacion Muchas directrices nacionales de salud infantil en Malawi, Nigeria y Sudafrica estan obsoletas y obtienen una puntuacion baja respecto a los metodos rigurosos y la participacion de las partes interesadas. Enfoque En consonancia con el enfasis de la Organizacion Mundial de la Salud (OMS) en la contextualizacion local de las directrices, el proyecto Global Evidence-Local Adaptation (GELA) apoyo procesos multisectoriales para adaptar las recomendaciones basadas en la evidencia a la salud infantil en Malawi, Nigeria y Sudafrica. El equipo del proyecto GELA convoco a grupos directivos nacionales, que realizaron ejercicios estructurados e iterativos de fijacion de prioridades para identificar los temas prioritarios. Se identificaron las directrices fuente apropiadas mediante la busqueda sistematica y el analisis de las directrices disponibles. A continuacion, se compararon las recomendaciones de las posibles directrices fuente con las preguntas pertinentes y se evaluo la oportunidad y la calidad de las directrices. A partir del proceso de elaboracion de directrices de la OMS, se aplico el proceso GRADE-ADOLOPMENT para desarrollar recomendaciones contextualizadas partiendo de las directrices existentes. Si no se identificaba ninguna directriz o revision fuente, se realizaban nuevas sintesis de la evidencia. Marco regional Malawi, Nigeria y Sudafrica son paises con prioridades y sistemas sanitarios diversos, todos ellos en transicion hacia la cobertura sanitaria universal. Las estructuras de las directrices difieren de un pais a otro, y los procesos se dirigen en gran medida desde los ministerios de sanidad nacionales. Cambios importantes Los grupos nacionales de directrices, apoyados por investigadores del GELA y socios gubernamentales y academicos, elaboraron cinco recomendaciones de salud infantil adaptadas a cada contexto. Para la mayoria de estas recomendaciones, se necesitaron pruebas adicionales para fundamentar una toma de decisiones nacional adecuada al contexto. La capacitacion formal y el aprendizaje en el lugar de trabajo mejoraron las competencias de los colaboradores e investigadores nacionales en la toma de decisiones basada en evidencias. Lecciones aprendidas La elaboracion de recomendaciones adaptadas al contexto requiere recursos y tiempo considerables. Se necesita una mayor inversion en el fortalecimiento de la capacidad local para el desarrollo sostenible de directrices nacionales., Introduction Implementation of evidence-informed health guidelines tailored to the health system contexts of low- and middle-income countries is needed to improve health outcomes. Evidence-informed health guidelines are documents containing clinical, [...]

A considerable proportion of quantitative research remains unpublished once completed. Little research has documented non-dissemination and dissemination bias in qualitative research. This study aimed to generate evidence on the extent of non-dissemination in qualitative research. We followed a cohort of qualitative studies presented as conference abstracts to ascertain their subsequent publication status. We searched for subsequent full publication in MEDLINE, in the Cumulative Index to Nursing & Allied Health Literature and in Google Scholar. We matched abstracts to subsequent publications according to authors, method of data collection and phenomenon of interest. Fisher's exact test was calculated to examine associations between study characteristics and publication. Factors potentially associated with time to publication were evaluated with Cox regression analysis. For 91 of 270 included abstracts (33.70%; 95% CI 28.09%-39.68%), no full publication was identified. Factors that were found to be associated with subsequent full publication were oral presentation (OR 4.62; 95% CI 2.43-8.94) and university affiliation (OR 1.96; 95% CI 1.05-3.66). Compared to oral presentations, studies presented as posters took longer time to reach full publication (hazard ratio 0.35, 95% CI 0.21-0.58). This study shows that it was not possible to retrieve a full publication for over one-third of abstracts. Our findings suggest that where this non-dissemination is systematic, it may lead to distortions of the qualitative evidence-base for decision-making through dissemination bias. Our findings are congruent with those of other studies. Further research might investigate non-dissemination of qualitative studies in other disciplines to consolidate our findings.

The aim of this study was to provide guidance to improve the completeness and clarity of meta-ethnography reporting. Evidence-based policy and practice require robust evidence syntheses which can further understanding of people's experiences and associated social processes. Meta-ethnography is a rigorous seven-phase qualitative evidence synthesis methodology, developed by Noblit and Hare. Meta-ethnography is used widely in health research, but reporting is often poor quality and this discourages trust in and use of its findings. Meta-ethnography reporting guidance is needed to improve reporting quality. The eMERGe study used a rigorous mixed-methods design and evidence-based methods to develop the novel reporting guidance and explanatory notes. The study, conducted from 2015 to 2017, comprised of: (1) a methodological systematic review of guidance for meta-ethnography conduct and reporting; (2) a review and audit of published meta-ethnographies to identify good practice principles; (3) international, multidisciplinary consensus-building processes to agree guidance content; (4) innovative development of the guidance and explanatory notes. Recommendations and good practice for all seven phases of meta-ethnography conduct and reporting were newly identified leading to 19 reporting criteria and accompanying detailed guidance. The bespoke eMERGe Reporting Guidance, which incorporates new methodological developments and advances the methodology, can help researchers to report the important aspects of meta-ethnography. Use of the guidance should raise reporting quality. Better reporting could make assessments of confidence in the findings more robust and increase use of meta-ethnography outputs to improve practice, policy and service user outcomes in health and other fields. This is the first tailored reporting guideline for meta-ethnography.