Original Research Evaluation of implementation of evidence-based public health training in sub-Saharan Africa

Anke C. Rohwer, Nasreen S. Jessani, Nyanyiwe M. Mbeye, Bonny E. Balugaba, Ann R. Akiteng, David Tumusiime, Seleman Ntawuyirushintege, Kiya Kedir, Rawleigh Howe, Solange Durao, Ingrid Toews, Jacob Burns

Journal of Public Health in Africa | Vol 15, No 1 | a576 | | © 2024 Anke C. Rohwer, Nasreen S. Jessani, Nyanyiwe M. Mbeye, Bonny E. Balugaba, Ann R. Akiteng, David Tumusiime, Seleman Ntawuyirushintege, Kiya Kedir, Rawleigh Howe, Solange Durao, Ingrid Toews, Jacob Burns | This work is licensed under CC Attribution 4.0
Submitted: 03 May 2024 | Published: 30 August 2024

About the author(s) Anke C. Rohwer, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Nasreen S. Jessani, Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and Institute of Development Studies, Brighton, United Kingdom
Nyanyiwe M. Mbeye, Department of Community and Environmental Health, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
Bonny E. Balugaba, Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
Ann R. Akiteng, College of Health Sciences, Makerere University, Kampala, Uganda
David Tumusiime, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
Seleman Ntawuyirushintege, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
Kiya Kedir, Armauer Hansen Research Institute, Non-Communicable Disease Ministry of Health, Addis Ababa, Ethiopia
Rawleigh Howe, Armauer Hansen Research Institute, Non-Communicable Disease Ministry of Health, Addis Ababa, Ethiopia
Solange Durao, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
Ingrid Toews, Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
Jacob Burns, Institute for Medical Information Processing, Biometry, and Epidemiology, LMU Munich, Munich, Germany

Abstract

Background: The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) developed and offered a course on evidence-based public health (EBPH) in five sub-Saharan African (SSA) countries to enhance individual and institutional capacity.

Aim: This study aims to assess, compare and learn from implementing the CEBHA+ EBPH course using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and Practical, Robust, Implementation and Sustainability Model (PRISM).

Setting: This study involved CEHBA+ partner universities in five countries in SSA.

Methods: We developed a framework that draws on signalling questions for RE-AIM and PRISM dimensions. Country teams reflected on, discussed and mapped unique experiences. Using this framework, we then elicited common themes across countries and distilled country-specific experiences through virtual discussions.

Results: Across countries, 130 public health practitioners, researchers and students completed the course (Reach). The course increased EBPH knowledge and skills and the capacity to teach EBPH and resulted in immediate opportunities for applying skills (Effectiveness). Hybrid offering in two countries presented challenges regarding Internet connectivity and hybrid discussions. Facilitators had previous training in teaching EBPH. While learning material was the same across countries, the content was adapted to represent local public health priorities (Implementation, Adoption). Course materials have informed other related training leading to spin-offs (Maintenance). Institutionalisation is dependent on external funding.

Conclusion: Strengthening EBPH capacity across contexts is feasible. Curricula containing both core and contextualised elements create an authentic learning environment. Formal evaluations should be embedded within capacity-strengthening initiatives.

Contribution: This is the first study evaluating EBPH training in SSA using an implementation science lens, offering learning about context-relevant adaptations that assist with plans for sustainability and scale.

Keywords

evidence-based public health; RE-AIM framework; PRISM; evidence-informed decision-making; capacity building; Africa

Sustainable Development Goal

Goal 3: Good health and well-being

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