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  1. Wilber Sabiiti1,
  2. Nyanda E Ntinginya2,
  3. Elizabeth Fb Msoka4,
  4. Fred Orina3,
  5. Ivan Mwebaza5,
  6. Simeon Mwanyonga2,
  7. Barbara Miheso3,
  8. Erica Sanga2,
  9. Aliphonce Liyoyo4,
  10. Helen Meme3,
  11. Blandina T Mmbaga4,
  12. Ewan Chirnside1,
  13. Moses Joloba5,
  14. Evans Amukoye3,
  15. Alphonse Okwera5,
  16. Gibson S Kibiki6,
  17. Stephen H Gillespie1,
  18. Wilber Mwebaza5,
  19. Nyanda E Msoka4
  1. 1University of St Andrews, Edinbrugh, UK
  2. 2NIMR-Mbeya Medical Research Centre, Dar es Salam, Tanzania
  3. 3Kenya Medical Research Institute, Nairobi, Kenya
  4. 4Kilimanjaro Clinical Research Institute, Tanzania
  5. 5Makerere University, Kampala, Uganda
  6. 6East African Health Research Commission, Bujumbura, Burundi


Background Billions of dollars are spent on research globally every year, yet little is translated to public use through policy and/or commercialisation. For the few research findings that make it to policy, evidence in most LMICs shows they hardly see the light of implementation. Our EDCTP-funded TWENDE consortium used implementation of tuberculosis (TB) molecular diagnostics as a model to investigate the barriers, and opportunities to unlock them in order to maximise uptake of health research innovations into policy and practice.

Methods Mixed methods approach including surveys, audits, in-depth interviews and focus group discussions (FGDs), policymaker dialogues to unravel the bottlenecks and how to overcome them.

Results 1119 respondents representing from Uganda, Kenya and Tanzania participated in the study. 19% were district/county health officers, 12% healthcare audits, 58% one-on-one interviews and FGDs with healthcare practitioners, community leaders, TB patients and survivors, and care givers, and 11% policymaker workshops. Barriers: government poverty, family/individual poverty, incompatibility of technologies to existing infrastructure, low awareness and socio-cultural beliefs in the community were found. Stigma at community and healthcare levels was rife. Consequently, TB diagnostics were underimplemented and underutilised. Xpert MTB/RIF test was fully utilised in ∼10% of healthcare facilities (conducting 8 tests per day) whilst Line probe assay was implemented in less than 1% of the facilities.

Conclusion Based on our findings, we believe overcoming the barriers presents the opportunity to maximise research impact of public healthcare. This could be achieved through sustained public and practitioners’ sensitisation to remove stigma to increase demand and utilisation of services; early interaction of researchers and policymakers to increase sense of ownership and acceptability of research innovations; early communication between developers and end-users to align the tools with the needs and existing infrastructure capacity; and increased affordability of innovations through socioeconomic empowerment programmes.

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