EBMAfricaNet: An innovative approach of translating and implementing evidence using freely available evidence from existing evidence networks

2019-09-13 africa evidence week blog cameroon evidence-informed decision-making informs learns
EBMAfricaNet: An innovative approach of translating and implementing evidence using freely available evidence from existing evidence networks

In June 2018 at the JBI collaboration colloquium in Antwerp, eBASE Africa initiated a bold concept of evidence implementation with iScientia Belgium to increase the use of existing guidelines through an evidence portal called EBMAfricaNet. The platform uses freely available synthesized evidence from Cochrane reviews, national guidelines (Cameroon, Nigeria and Rwanda), WHO guidelines, and DUODECIM Guidelines – with possibilities to host several other relevant guidelines. The project is supported by human resources within the Guidelines International Network Africa Community members. 

In essence, EBMAfricaNet is an ecosystem of medical information at the point-of-care which will improve access to quality healthcare especially at primary care level using an innovative approach of using freely available evidence from existing evidence networks. This ecosystem will combine clinical data (stored in an open source electronic health record) from primary care and hospital care. The platform will give access to a digital library of scientific information, and to high quality clinical practice guidelines at the point-of-care with decision support tools. This was in line with eBASE Africa’s mission of improving livelihoods for underserved populations through use of innovation and best practices especially for rural communities in Africa. This has been done with a multinational team of clinicians within GIN Africa community from Cameroon, Rwanda and Nigeria forming a community best practice.

Since November 2018, EBMAfricaNet has mobilized over 100 clinicians from Cameroon, Nigeria and Rwanda to the platform, hosted 33 guidelines for malaria, TB, HIV, hypertension, and soil transmitted helminths to the platform. The platform has an editorial team of 6 clinicians who facilitate the guidelines adaptation process. The editorial team uses a GRADE approach to develop recommendations into the evidence portal which are the 5 disease conditions with heaviest disease burden. Consumer referees are also used to develop contents including podcasts of drug information to consumers.

EBMAfricaNet will also include electronic health records and networking of clinical practices using a platform where health technologies are indexed to facilitate cross borders referrals.

This innovative approach is based on the fact that:

  1. Access to evidence-based guidelines among clinicians is still a challenge and evidence-based practice and health technology assessment are often ignored in the African setting.
  2. With low access to evidence and clinical practices operating in silos, the healthcare systems are less effective and efficient negatively affecting the quality of care and health systems performance posing a potential risk to the health-related SDGs in the region.

Relevance of EBPracticeNet Africa community of practice (CoP)

This innovative evidence translation approach of using a community of practice will be hosting the guidelines as point of care clinical decision support systems for clinicians in Africa. Currently these guidelines are being identified and formatted for the platform by clinicians in the various countries. Clinicians, nurses and even community health workers will be able to access these guidelines for their practice.

Relevance of EBPracticeNet Africa to consumers

EBPractice Net Africa provides drug information to consumers, facilitates referrals and prescriptions within the platform. The EBPracticeNet Africa platform has contributions from consumers at editorial level.

Challenges so far

Funding: The main challenge with the EBMAfricaNet community of practice is funding to fully develop the pilot and make best evidence available clinicians serving hard to reach populations. The current project has received in kind technical support from iScientia Belgium, Cochrane Belgium, and Finish Society of General Practitioners.

Access to relevant research recommendations: Access to relevant research evidence is challenging and often unavailable. The site has solicited access National guidelines, WHO guidelines, and DUODECIM guidelines. JBI has also made available access the University of Adelaide electronic library. EBMAfricaNet also enjoys freely available evidence from Cochrane collaboration and the Africa Evidence Network.

Local Capacity in evidence synthesis and translation: Local evidence synthesis and translation capacity is weak. EBMAfricaNet exploited existing skills within the GIN Africa community.

Upcoming events: eBASE will be presenting these concepts at the upcoming events. 

  1.  Cochrane Colloquium in Santiago, Chile from the 21st to the 25th October 2019. www.colloquium2019.cochrane.org
  2.  G.I.N & JBI Conference in Adelaide, Australia from the 30th of October to November 2nd 2019. www.g-i-n.net/conference/fu-g-i-n-events/adelaide-conference-2019