In navigation, dead reckoning is the process of calculating your current position by using a previously determined position (or fix) and then moving forward. The same can be said of how we navigate progress: we cannot chart a new course until we have determined where we are and how we got there.1 It is time for bravery and courage. It is time to move forward. As Theodore Roosevelt once said, it is time to dare greatly.1
So, where are we? Health indicators across Africa related to attainment of the Millennium Development Goal (MDGs) targets continue to lag behind global averages, despite some mediocre improvements.2 Despite increased investment in programs and frameworks to accelerate the coverage of healthcare interventions, progress remains slow.3 Additionally, the limited supply of relevant evidence, the poor quality of the evidence, the untimely provision of evidence, and the lack of skills and capacity to lead knowledge translation (KT) processes are all challenges that have been well documented in the literature.3
That is not to say that there has been a lack of effort or that there is a lack of hope. While the increasing interconnectedness of the world we live in today may make us more vulnerable to public health emergencies, it also holds us in great stead for strong collaborative efforts to develop robust, context appropriate evidence to inform policy and practice. Fortunately, we are seeing more of this occur and there are now groups across the globe seeking to strengthen the evidence base for healthcare in low income regions. As we move closer to the Global Evidence Summit in Cape Town this year, I am mindful of the importance of collaboration to achieve the significant change required.
I am proud that the Joanna Briggs Institute and Joanna Briggs Collaboration, along with other international groups like the Cochrane Collaboration, the Campbell Collaboration, the Guidelines International Network and the International Society of Evidence Based Healthcare, continue to make this work a priority, and to undertake to work together to increase capacity around synthesis, transfer and implementation initiatives in an endeavor to improve health outcomes for those less fortunate than ourselves, and in ways that are collaborative, respectful and empowering. Initiatives such as the Global Evidence Summit and Global Evidence Synthesis Initiative are a testimony of that commitment.
This issue of the JBI Database of Systematic Reviews and Implementation Reports includes three editorials that highlight both the potential impact and real challenge that implementation of evidence in policy and practice can have in African settings. Okwen refers to the “complex symphony of an evidence ecosystem that requires innovative approaches from evidence generation to evidence implementation”.4(p.2227) This beautifully crafted sentiment is echoed by Bayuo in his editorial related to evidence utilization in Ghana as he describes the parallel “worlds” within which the desire and practice of evidence based healthcare live, given the significant contextual challenges faced by those working in the African context.5
These insightful editorials are accompanied by a range of pragmatic articles6-10 related to the synthesis and implementation of a range of evidence that once again highlight the unique needs and challenges of health professionals in Africa and other low income countries, and the inimitable contexts within which it needs to be considered and utilized.
Despite these challenges I believe that, internationally, we are rising strong. Increasingly we are finding new and creative ways to work collaboratively, cooperatively, collectively, and with common vision and commitment to drive the evidence based healthcare agenda forward in developing regions. I am confident that the narrative is indeed changing and changing for the better.
1. Brown B. Rising Strong: how the ability to reset transforms the way we live, love, parent and lead, Random House, New York, USA, 2017.
2. World Health Organization. World Health Statistics 2015. Geneva; 2015.
3. Nabyonga-Orem J, Dovlo D, Kwamie A, Nadege A, Guangya W, Kirigia JM. Policy dialogue to improve health outcomes in low income countries: what are the issues and way forward? BMC Health Serv Res
2016; (Suppl 4):217.
4. Okwen PM. Evidence implementation in lower- and middle-income countries: where the recipe is incomplete’. JBI Database System Rev Implement Rep
2017; 15 9:2227–2228.
5. Bayuo J. “Worlds apart”: the case of evidence utilization in Ghanaian health facilities. JBI Database Sys Rev Implement Rep
2017; 15 9:2225–2226.
6. Aviisah MK, Norman ID, Enuameh Y. Facilitators and barriers to modern contraception use among reproductive-aged women living in sub-Saharan Africa: a qualitative systematic review protocol. JBI Database Sys Rev Implement Rep
2017; 15 9:2229–2233.
7. Enuameh YAK, Adjei G, Mahama E, Gyan T, Koku E. Effectiveness of population based risk reduction programs in reducing risky sexual behavior among young people in low- and middle-income countries: a systematic review protocol. JBI Database Sys Rev Implement Rep
2017; 15 9:2242–2248.
8. Garoma DA, Abraha YG, Gebrie SA, Deribe FM, Tefera MH, Morankar S. Impact of conditional cash transfers on child nutritional outcomes among sub-Saharan Africa countries: a systematic review protocol. JBI Database Sys Rev Implement Rep
2017; 15 9:2295–2299.
9. Sugiharto S, Stephenson M, Hsu Y-Y, Fajriyah NN. Diabetes self-management education training for community health center nurses in Indonesia: a best practice implementation project. JBI Database Sys Rev Implement Rep
2017; 15 9:2390–2397.
10. Bayuo J, Munn Z, Campbell J. Assessment and management of burn pain at the Komfo Anokye Teaching Hospital: a best practice implementation project. JBI Database Sys Rev Implement Rep
2017; 15 9:2398–2418.