Background: healthcare in Africa is guided by medical manuals, which are not adapted to local practice, often outdated and may not be evidence-based. Access to evidence-based recommendation is still a challenge to clinicians. Evidence-based practice and health technology assessment are closely related but often ignored in the African setting. With low access to evidence, poorly assessed health technologies and clinical practices operating in silos, the healthcare systems are less effective and efficient than they should be. This has a negative effect on the quality of care and health systems' performance, posing a potential risk to the health-related sustainable development goals in the region.
Objectives: to create a community of best practice of clinicians using best available evidence to guide clinical practice in rural communities in Africa.
Methods: we set up a community of practice consisting of an editorial team selected across Africa using Guidelines International Network (GIN)-Africa community network, Joanna Briggs Africa Clinical Fellowship, and Cochrane Nigeria. We set up an online platform where recommendations from systematic reviews were indexed within a knowledge translation portal at www.ebmafrica.net. We developed a cloud-based platform for electronic health records, and networking clinical practices wanting to join the community of practice. The editorial team uses a GRADE approach to develop recommendations into the evidence portal. We developed guidelines for five disease conditions with the heaviest disease burden (malaria, HIV, tuberculosis, soil-transmitted helminths and hypertension). We used national guidelines, World Health Organization (WHO) Guidelines and Duodecim Cochrane-based guidelines. We worked with partners from Cochrane Belgium, University of Ghent and Cochrane Nigeria. We also worked with a Cochrane-affiliated consumer organization, CAMCOSO, to referee recommendations before uploading to the portal.
Results: we developed contextualized guidelines for malaria for four countries (Rwanda, Nigeria, Cameroon, and Ghana). We uploaded four WHO recommendations and 4000 Duodecim guidelines into the portal. We networked 11 health facilities in Bali and 12 health facilities in Calabar districts within the community of best practices.
Conclusions: setting up a web-based platform with stored electronic patient records as well as WHO, foreign and national clinical treatment guidelines will improve healthcare practice and health outcomes of patients.
Patient or healthcare consumer involvement: patients were involved in developing recommendations for the evidence portal.