Addressing the challenges of interventions in LMICs

Given the high cost and length of time involved in developing and testing new interventions, low and middle income countries (LMICs) are beginning to rely on transferring and adapting proven interventions from elsewhere.

Many governments and international organisations can be seen to promote the spread of proven evidence-based interventions. However, the practice of transferring and adapting evidence-based interventions in LMICs, whilst offering huge potential, remains an extremely complex, difficult process in a social work context.

Project aims

This interdisciplinary project aims to address these challenges through developing a new and more practical implementation framework that provides a better fit to support the transfer and adaptation of social work interventions to LMICs. An international team from Bath, Stellenbosch University in South Africa, Institute of Social Work in Tanzania and King's College London have come together to undertake the project.

During the project we aim to:

• understand how the existing knowledge about transfer and adaptation is applicable to a social work and LMICs context
• understand how the complex frameworks might be operationalised and applied in real world settings in LMICs
• learn how practitioners and the community who understand the local context can be more fully involved in implementation processes
• identify what specific practical tools would be required to support a transfer and adaptation process that is possible to replicate

Taking an interdisciplinary approach

The research team have undertaken a number of activities as part of this project.

Literature review

We carried out a literature review synthesising existing frameworks, tools and guidelines on transferring and adapting interventions from fields such as implementation science, international development and health. This included producing a draft consolidated implementation framework with clearly defined areas that require consultation and debate.

Framework review workshop

Part of the work included running a two-day international interdisciplinary workshop hosted at Bath. The workshop assessed applicability and refinement of the framework developed for the social work and LMICs context.

The attendees included qualified social workers and academics from South Africa, Tanzania and UK, two academics from Bath’s Centre for Development Studies, and academics with international expertise in transferability and adaptation frameworks from the field of international development, cultural adaptation and health.

Stakeholder engagement

We are holding two within country stakeholder workshops in Tanzania and South Africa in May 2019. Each workshop will run for two days bringing together policy-makers, researchers, practitioners and local community leaders in separate sessions. Delegates will examine the proposed framework and implementation process in relation to a concrete practical social work example, namely, Family Group Conferencing.

Through application to one intervention, findings will enable the research team to consider how such a process might differ by country, what factors are most important to adaptation and to assess needs for future practical implementation guidance and tools including improved processes for community involvement.

Review and dissemination

Following the literature review and workshops, the research team will produce a final report and international peer-reviewed publication. The report will detail learning from the process and present final implementation framework.

Positively impacting welfare needs

The project has a high likelihood of positive impact on the welfare needs of developing countries by strengthening the implementation capacity of under-resourced social work services. The project provides a stronger evidence base to improve social work practice in developing countries and build the capacity to implement more effective services that better meet the needs of the community and service providers.

We expect to see an improvement in the effectiveness and outcomes of new interventions that have been assessed and adapted for the local context. It will be possible to tailor the results of the project to other contexts and other interventions which offers similar benefits for other developing countries

Project team

• Dr Louise Brown, Reader, University of Bath
• Dr Alexandra Ziemann, King’s Improvement Science Postdoctoral Research Fellow
• Dr Marianne Strydom, Stellenbosch University
• Dr Zena Mabeyo, Institute of Social Work, Tanzania