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Comment
. 2018 Mar 21;18(1):193.
doi: 10.1186/s12913-018-3018-9.

Correspondence regarding 'Assefa Y, et al., BMC Health Services Research. 2011; 11 (1):81 and 2014; 14(1):45': The Positive-Deviance approach for translating evidence into practice to improve patient retention in HIV care

Yibeltal Assefa  1   2 , Peter S Hill  3 , Helmut Kloos  4 , Gorik Ooms  5 , Wim Van Damme  6
Affiliations
Comment

Correspondence regarding 'Assefa Y, et al., BMC Health Services Research. 2011; 11 (1):81 and 2014; 14(1):45': The Positive-Deviance approach for translating evidence into practice to improve patient retention in HIV care

Yibeltal Assefa et al. BMC Health Serv Res. .

Abstract

The purpose of this correspondence is to describe how the positive-deviance approach can be used to translate evidence into practice, based on successive studies conducted in Ethiopia. In earlier studies, it was identified that retention in antiretroviral treatment care was variable across health facilities; and, seeking compliance across facilities, a framework was developed based on the practices of those positive-deviant health facilities, where performance was noted to be markedly better. It was found that the positive deviance approach was effective in facilitating the transfer of innovative practices (using different mechanisms) from positive-deviant health facilities to negative-deviant health facilities. As a result, the variability in retention in care across health facilities narrowed over time, increasing from 83 to 96% in 2007/8 to 95-97% in 2013/14. In conclusion, the positive-deviance approach is a valuable tool to translate evidence into practice, spread good practices, and help achieving universal health coverage.

Keywords: Antiretroviral treatment; Positive deviance; Retention in care; Translating evidence into practice.

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Conflict of interest statement

Ethics approval and consent to participate

The scientific and ethical review committee of the Ethiopian Health and Nutrition Research Institute approved this study. We obtained informed verbal consent from study participants. The verbal consent was tape-recorded. We also got a letter of support from the Federal authorities to collect patient data from the health facilities.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Trend in retention in care in three negative-deviant and two positive-deviant health facilities in Ethiopia, 2005/6-2013/14
See this image and copyright information in PMC

Comment on

References

    1. Assefa Y, Kiflie A, Tesfaye D, Haile Mariam D, Kloos H, Wouters E, et al. Outcomes of antiretroviral treatment program in Ethiopia: retention of patients in care is a major challenge and varies across health facilities. BMC Health Serv Res. 2011;11(1):81. doi: 10.1186/1472-6963-11-81. - DOI - PMC - PubMed
    1. Assefa Y, Lynen L, Wouters E, Rasschaert F, Peeters K, van Damme W. How to improve patient retention in an antiretroviral treatment program in Ethiopia: a mixed-methods study. BMC Health Serv Res. 2014;14(1):45. doi: 10.1186/1472-6963-14-45. - DOI - PMC - PubMed
    1. Pascale R, Sternin J, Sternin M. The power of positive deviance: how unlikely innovators solve the world's toughest problems. Boston: Harvard Business Press; 2010.
    1. The positive deviance initiative. https://positivedeviance.org/. Accessed 15 Nov 2013.
    1. Assefa Y, van Damme W, Haile Mariam D, Kloos H. Toward universal access to HIV counseling and testing and antiretroviral treatment in Ethiopia: looking beyond HIV testing and ART initiation. AIDS Patient Care STDs. 2010;24(8) 10.1089/apc.2009.0286. - PubMed