Figure 3. Steps in developing a dissemination strategy
Case study 2: A dissemination strategy for an IR Project: A case of the NIGRAAN project, Pakistan

Background: Dissemination of research findings is crucial to facilitate uptake of research findings and for translating them into action. If the dissemination is to be effective, the tools should be appropriate for the target audience, and the message should be clear and succint. Furthermore, the message must be timely. Moreover, if the health improvements are to be observed, the dissemination should go beyond just communicating by aiming to transfer new knowledge and understanding to the target audience, so that they are empowered to take the necessary actions.

Methods: NIGRAAN, a community-based implementation research (IR) project in rural Pakistan, was conducted by the Department of Community Health Sciences at the Aga Khan University (AKU) in Karachi, in collaboration with the Sindh Provincial Department of Health. Nigraan is an Urdu word meaning ‘supervisor’. This two-year IR project aimed to identify ways to strengthen structured supportive supervision of lady health workers (LHWs) by lady health supervisors (LHSs), in order to improve community case management of pneumonia and diarrhoea in children under the age of five in the Badin district of Sindh Province. Effective dissemination and knowledge translation enhances the execution process of a given IR project, as well as the use of the findings. A dissemination strategy should be developed during the planning phase of the project and should involve the relevant stakeholders. The research findings should be shared with stakeholders on a continuous basis throughout the project cycle using appropriate dissemination tools. The dissemination strategy for the NIGRAAN project was developed based on the TDR/WHO IR Toolkit dissemination framework. The relevant target audiences (community members, LHWS, LHSs, programme managers and implementers and the scientific community) were engaged at the appropriate timelines of the project lifespan.

Conclusion: A dissemination strategy was developed during the project planning phase and relevant stakeholders were actively involved. Furthermore, the dissemination tools were specific to the dissemination objectives and target audience.

Lessons: In creating a dissemination plan, researchers should consider the project goal, target audience, medium and execution plan. Developing an explicit dissemination strategy in advance guides the process of knowledge translation. Secondly, to enhance the use of the research findings, dissemination must not be an end-of-project activity but must adopt a continuous and integrated knowledge translation approach. Additionally, the multidisciplinary and collective approach used to disseminate results on an on-going basis builds the trust of stakeholders./p>

Table. NIGRAAN project dissemination strategy
Dissemination Objective Content Dissemination Tool Target audience Timeline
Creating awareness about the project among the community
  • Value of project
  • Potential benefits for the community
  • Community meetings
  • Electronic media (newspapers, radio)
Community members From outset of the project
Creating awareness among policy-makers about the project
  • General and technical overview of the project
  • Integration into existing systems/structures
  • Executive Project Management Team Meeting (EPMT)
  • Project brochure
  • Policy briefs
Policy Makers at district and provincial level At the launch of the project
Sensitization of the community about the progress of the project
  • What's happening?
  • Community response to the project
  • Field challenges and support requirements from the community
  • Local electronic media (newspapers radio)
  • LHSs' appraisal meetings
  • Community
  • Community-based organizations
Ongoing
Sensitizing the Lady Health Supervisors (LHSs) and Lady Health Workers (LHWs) about the project
  • Overview of project and intervention
  • What to expect?
  • Roles and responsibilities
  • Expectations from stakeholders
  • raining workshop
  • Formal dissemination seminars for LHSs at AKU
  • Lady Health Supervisors
  • Lady Health Workers
Intermittent
Updating policy-makers and community leaders on the progress of the project
  • Field updates (what's happening? /progress)
  • Any issues arising from within the system and/or community affecting the technical structure of the project
  • Support requirements
  • Project Support Team meetings
  • District Project Management Team meetings
Policy makers, community representatives other stakeholders with an active interest in the project Intermittent periods
Updating the funding agency about the progress of the project
  • Progress of project activities
  • Any technical issues arising
  • finances
  • Progress reports
  • Emails, telephone calls
  • World Health Organization
Yearly and end of project
Add to existing scientific knowledge
  • Process of the research
  • Research findings
  • Published articles
  • Scientific community
Ongoing basis
Inform the AKU staff on the progress Activities, successes, challenges and recommendations
  • Faculty meetings
  • Departmental presentations
  • AKU staff
Intermittent
Contribute to LHW-P curriculum Trainer's manual to improve community case management of pneumonia and diarrhoea in children under five years
  • Trainers manual
  • Lady health supervisors
After the formative phase
Source: Rabbani F et al. Improving community case management of diarrhoea and pneumonia in district Badin, Pakistan through a cluster randomised study--the NIGRAAN trial protocol. Implement Science. 2014; 9:186.
  • Case study 3: Innovative participatory health education: promoting reproductive health in post-conflict settings in Sudan

    Background: Despite efforts to improve maternal health, South Sudan has one of the highest maternal mortality ratios worldwide. The decades of war, poor infrastructure, shortage of health workers and scarcity of resources, has negatively impacted the health system in general and reproductive health specifically, as also reflected in generally poor health care-seeking behaviour. A two-year Global Health Through Education, Training and Services-funded project was conducted in the Upper Nile State, Renk County in South Sudan. Previous participatory ethnographic studies on reproductive and child health provided a better understanding of contextual issues surrounding the problem, perceptions towards maternal health and interacting dynamics influencing patient decisions. An intervention (health education) was designed targeting the entire community by addressing maternal health issues within the post-conflict context. The intervention integrated the Women Health Learning Package (WHLP) in a participatory approach involving local women, non-governmental organizations and theatrical band members.

    Results: Context-friendly materials were jointly developed and disseminated in the form of songs, drama and pictograms to promote the communities' knowledge about maternal health issues among various audiences. All materials/outputs were developed in local dialects.

    Conclusion: The effective engagement of the community in the project – right from the initial problem identification and message development – enhanced the local sense of ownership. It also culminated in the development of context-friendly educational materials to promote women's health in a post-conflict setting.

    Lessons: For a communication to be effective, innovative dissemination approaches should be adopted, community engagement is vital and the message and dissemination tools must be adapted to the local context.

    Source: Elmusharaf K. et al. Innovative Participatory Health Education (video). Available at: https://www.webmedcentral.com/View_video/225.