There is always a need to improve and bridge the gap between the production and dissemination of knowledge, whether to the public or policymakers to help facilitate informed health decisions in policy and practice. Cochrane SA manages the knowledge translation portfolio, which is solely focussed on coordinating all activities related to the above. The Knowledge Translation (KT) is intended to provide information to interested individuals of the public about a wide range of evidence-based resources. We work with researchers to develop a strategy to put knowledge into practice at clinical and policy level. The main goal of KT is to ensure that high-quality, up to date and relevant health research evidence reaches the public (patients), healthcare providers and decision-makers. By focusing on the processes through which knowledge is effectively translated into changed decision making, we play a critical role in enabling the creation and delivery of outcome-based learning experiences, and ultimately make a positive impact on people’s lives. KT addresses the issue of utilization of evidence-based research from systematic reviews and uses models which encourages the participation of both researchers and users as well as focussing on bridging research gaps. Some of the activities involved include but not limited to writing up final report summaries and newsletters on health topics, organizing KT meetings or workshops, press releases, webinars and spreading research through social media platforms such as Twitter, LinkedIn, Facebook and mass (Radio).
Theme: Bridging the Gap for Public Health Impact
Vaccine implementation research bridges vaccine development and achieving effective public health outcomes. This field investigates the practical facets of vaccine delivery to populations, ensuring equitable access and maximising their impact. One critical focus is on analysing missed opportunities for vaccination, identifying instances where eligible individuals did not receive recommended doses. Researchers and policymakers can design targeted interventions to improve coverage and safeguard vulnerable communities by addressing these gaps. Moreover, vaccine implementation research contributes to evidence-informed decision-making capacity building. Equipping healthcare systems, policymakers, and stakeholders with the tools and knowledge for informed choices about vaccine delivery strategies, distribution logistics, and communication efforts enhances the efficiency and effectiveness of vaccination programs, ultimately leading to improved public health outcomes.
Empowering Change: Cochrane South Africa's Vaccine Implementation Initiatives
At the heart of Cochrane South Africa's mission lies a resolute commitment to catalysing meaningful change in vaccine implementation. Their comprehensive research portfolio delves into the intricacies of vaccines and immunisation within Africa, with the ultimate vision of empowering decision-makers to adopt evidence-based strategies. By concentrating on the 'supply side' of immunisation, the organisation is unwavering in uncovering and addressing systemic challenges that affect vaccine accessibility and distribution across the continent. Through rigorous research and dissemination efforts, Cochrane SA is pivotal in fostering informed decision-making and advancing the overall success of immunisation initiatives in Africa.
Prominent Projects in Vaccine Implementation Research
Cochrane South Africa's dedication extends to several noteworthy projects within vaccine implementation research. One standout initiative focuses on developing innovative tools to assess and address vaccine hesitancy—the "demand side" of immunisation. Recognising the importance of understanding and mitigating hesitancy's impact on immunisation rates, researchers collaborate to create comprehensive frameworks and measurement instruments that identify contributing factors. These tools enable healthcare providers and public health agencies to tailor communication strategies and interventions, building public trust in vaccines. Another significant project involves establishing evidence-informed decision-making platforms that consolidate up-to-date research findings on vaccine implementation strategies. These platforms serve as centralised repositories of scientific knowledge, enabling policymakers to access the latest evidence for informed choices when designing and adapting vaccination programs. By empowering decision-makers with reliable information, these initiatives foster more efficient and effective vaccine delivery systems, ultimately improving global health. Cochrane South Africa stands at the forefront of an extensive vaccine implementation research initiative, generating, synthesising, and disseminating evidence-based knowledge that informs and shapes national and continental immunisation strategies with a multidisciplinary approach. This commitment seeks to provide high-quality, timely, and relevant research evidence, all while tackling the 'supply-side' dynamics of immunisation programs, particularly the structural barriers impacting vaccine access and availability across the African continent. Through these efforts, Cochrane SA endeavors to enhance the effectiveness and inclusivity of immunisation initiatives throughout the region.
The main role of Cochrane SA is to provide training and support to Cochrane authors in countries for which it is the reference centre. In addition, Cochrane SA is involved in a number of projects which promotes evidence-based practice and policy.
Cochrane South Africa manages two clinical trial registry databases that are hosted within the South African Medical Research Council (SAMRC). The Pan African Clinical Trials Registry (PACTR) which is a regional registry of the WHO-ICTRP network was initially established as the Aids, TB, and Malaria trial Registry (ATM registry) in 2007 and relaunched in 2009 as PACTR to include registration of trials studying all diseases or conditions. PACTR is the only African primary registry in the WHO-ICTRP network. The South African National Clinical Trial Register (SANCTR) was established following a call by the South African Department of Health Minister to have clinical trials registered on a public register in 2005 and was redeveloped and hosted by the SAMRC in August 2020. The two registries collect the WHO-required datasets that provide enough information to uniquely identify each trial in a publicly accessible domain.
There is an urgent need to facilitate leadership and coordination of pandemic preparedness and response in low- and middle-income countries (LMICs). Lessons learnt from such efforts in response to the COVID-19 pandemic and outbreaks of other infectious diseases of epidemic and pandemic potential, such as Ebola virus disease, tuberculosis, and human immunodeficiency virus, need to be consolidated and developed further, especially on the African continent. This is necessary to support the rapid and seamless deployment and utilisation of available resources for contextually relevant research endeavors should another novel pathogen emerge or a previous one re-emerges.
The Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) is a global alliance of research funding organisations facilitating coordinated research on emerging infectious diseases with epidemic and pandemic potential. One of GloPID-R’s core objectives is to identify gaps and align funding with research needs, especially in LMICs. To further support this core objective, the Africa Hub secretariat will expand GloPID-R’s strategic focus on research preparedness and response on the African continent. In addition, the secretariat will map the infectious disease research funding landscape and survey funders to increase regional engagement and membership.
Over the last 15 years there has been growing recognition of the potential contribution of qualitative evidence within global health and social care decision-making. Those working in these arenas increasingly seek evidence beyond the effects of interventions, to wider questions about local norms and preferences, equity and human rights issues, acceptability and feasibility of interventions, implementation processes, and the impact of socio-political and cultural contexts. Qualitative research, and particularly reviews of qualitative evidence- or qualitative evidence synthesis (QES), are increasingly seen to offer important insights for answering this broader range of questions. Cochrane SA is currently co-ordinating a programme to build qualitative evidence synthesis (QES) as a research methodology and output, with a focus on South Africa and other African countries. The specific objectives are to:
- Build the evidence-base of qualitative evidence synthesis (QES) that are relevant to South Africa specifically and Africa more broadly and led by South African and African authors.
- Build capacity to conduct and interpret qualitative evidence synthesis (QES), particularly in South Africa and other African countries.
- Build qualitative evidence synthesis (QES) methodology, including to incorporate more critical social science theories and methods.
As part of this programme, we are conducting (or completed) a number of qualitative evidence syntheses focused on vaccination, including on the nature and drivers of vaccine hesitancy for routine childhood vaccination globally and in Africa, human papillomavirus (HPV) vaccination for adolescents globally and in Africa and for COVID-19 vaccination globally. Recently we have been involved in a QES on primary healthcare integration, and over the next 5 years we plan to further broaden the topic focus and scope of the QESes we conduct.
We are also involved in various methodological-related research, including the Cochrane qualitative Methodological Limitations Tool; or CAMELOT Project, based at the Norwegian Institute of Public Health (NIPH), where we are mapping and building tools to appraise the quality of qualitative studies included in QES. Furthermore, we are exploring how the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) might be applied to a more diverse range of QES methodologies and outputs. We have also been involved with the development of templates and guidance for conducting a Cochrane QES.
Finally, as part of our systematic review methods monthly webinars, annual symposia and collaborations with Stellenbosch University, University of Cape Town and the University of the Western Cape we facilitate various QES training lectures, workshops, short courses and Master’s module. Our aim is to expand these initiatives to other Universities in South Africa and in Africa.