Insights into Global Health Practice from the Agile Software Development Movement

David Flood, Anita Chary, Kirsten Austad, Anne Kraemer Diaz, Pablo García, Boris Martinez, Waleska López Canú, Peter Rohloff, David Flood, Anita Chary, Kirsten Austad, Anne Kraemer Diaz, Pablo García, Boris Martinez, Waleska López Canú, Peter Rohloff

Abstract

Global health practitioners may feel frustration that current models of global health research, delivery, and implementation are overly focused on specific interventions, slow to provide health services in the field, and relatively ill-equipped to adapt to local contexts. Adapting design principles from the agile software development movement, we propose an analogous approach to designing global health programs that emphasizes tight integration between research and implementation, early involvement of ground-level health workers and program beneficiaries, and rapid cycles of iterative program improvement. Using examples from our own fieldwork, we illustrate the potential of 'agile global health' and reflect on the limitations, trade-offs, and implications of this approach.

Keywords: global health; implementation science; interventions; local; program design.

References

    1. Glasgow RE, Vinson C, Chambers D, Khoury MJ, Kaplan RM, Hunter C. National institutes of health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012;102:1274–81.
    1. Madon T, Hofman KJ, Kupfer L, Glass RI. Public health. Implementation science. Science. 2007;318:1728–9.
    1. Sanders D, Haines A. Implementation research is needed to achieve international health goals. PLoS Med. 2006;3:e186.
    1. Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: what it is and how to do it. BMJ. 2013;347:f6753.
    1. Manifesto for agile software development. 2001. Available from: [cited 29 January 2016]
    1. Meyer B. Agile! The good, the hype and the ugly. Zurich, Switzerland: Springer International; 2014.
    1. Raghu A, Praveen D, Peiris D, Tarassenko L, Clifford G. Engineering a mobile health tool for resource-poor settings to assess and manage cardiovascular disease risk: SMARThealth study. BMC Med Inform Decis Mak. 2015;15:36.
    1. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10:53.
    1. Rycroft-Malone J, Bucknall T. Oxford, United Kingdom:: Wiley-Blackwell; 2010. Models and frameworks for implementing evidence-based practice: linking evidence to action.
    1. Nerur S, Mahapatra R, Mangalaraj G. Challenges of migrating to agile methodologies. Comm ACM. 2005;48:72–8.
    1. Peters DH, Nhan TT, Adam T. Implementation research in health: a practical guide. Alliance for Health Policy and Systems Research and World Health Organization. 2013. Available from: [cited 29 January 2016]
    1. Field B, Booth A, Ilott I, Gerrish K. Using the knowledge to action framework in practice: a citation analysis and systematic review. Implement Sci. 2014;9:172.
    1. Flood D, Rohloff PJ. “This disease is for those who can afford it”: diabetes in indigenous Maya communities. In: Chary A, Rohloff P, editors. Privatization and the new medical pluralism: shifting healthcare landscapes in Maya Guatemala. Lantham, Maryland:: Lexington Books; 2015. pp. 53–70.
    1. Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff (Millwood) 2009;28:75–85.
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, part 2. JAMA. 2002;288:1909–14.
    1. Chary A, Greiner M, Bowers C, Rohloff P. Determining adult type 2 diabetes-related health care needs in an indigenous population from rural Guatemala: a mixed-methods preliminary study. BMC Health Serv Res. 2012;12:476.
    1. Greiner M, Melvin C, Ajsivinac J, Hernandez R, Otzoy R, Hehn E, et al. Salud del corazón: raxnaqil ri k'uxaj. Santiago Sacatepéquez, Guatemala: Wuqu’ Kawoq, Instituto de Nutrición de Central América y Panamá, Asociación Guatemalteca para la Prevención de Enfermedades del Corazón. 2012.
    1. Greiner M. Diabetes focus groups with health promoters. Santiago Sacatepéquez, Guatemala:: Wuqu’ Kawoq ∣ Maya Health Alli; 2011. unpublished internal report.
    1. Steinsbekk A, Rygg LO, Lisulo M, Rise MB, Fretheim A. Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC Health Serv Res. 2012;12:213.
    1. Qi L, Liu Q, Qi X, Wu N, Tang W, Xiong H. Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. BMC Public Health. 2015;15:471.
    1. Norris SL, Chowdhury FM, Van Le K, Horsley T, Brownstein JN, Zhang X, et al. Effectiveness of community health workers in the care of persons with diabetes. Diabet Med. 2006;23:544–56.
    1. Gill GV, Yudkin JS, Keen H, Beran D. The insulin dilemma in resource-limited countries. A way forward? Diabetologia. 2011;54:19–24.
    1. Beran D. Improving access to insulin: what can be done? Diabetes Manag. 2010;1:67–76.
    1. Gherman A, Veresiu IA, Sassu RA, Schnur JB, Scheckner BL, Montgomery GH. Psychological insulin resistance: a critical review of the literature. Pract Diabetes Int. 2011;28:125–8d.
    1. Walley J. How to get research into practice: first get practice into research. Bull World Health Organ. 2007;85:424.
    1. Tindana PO, Singh JA, Tracy CS, Upshur RE, Daar AS, Singer PA, et al. Grand challenges in global health: community engagement in research in developing countries. PLoS Med. 2007;4:e273.
    1. Kamanda A, Embleton L, Ayuku D, Atwoli L, Gisore P, Ayaya S, et al. Harnessing the power of the grassroots to conduct public health research in sub-Saharan Africa: a case study from western Kenya in the adaptation of community-based participatory research (CBPR) approaches. BMC Public Health. 2013;13:91.
    1. Cacari-Stone L, Wallerstein N, Garcia AP, Minkler M. The promise of community-based participatory research for health equity: a conceptual model for bridging evidence with policy. Am J Public Health. 2014;104:1615–23.
    1. Zachariah R, Ford N, Maher D, Bissell K, Van den Bergh R, van den Boogaard W, et al. Is operational research delivering the goods? The journey to success in low-income countries. Lancet Infect Dis. 2012;12:415–21.

Source: PubMed

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