Engaging stakeholders to level up COPD care in LMICs: lessons learned from the "Breathe Well" programme in Brazil, China, Georgia, and North Macedonia

Genevie Fernandes*, Siân Williams*, Peymané Adab, Nicola Gale, Corina de Jong, Jaime Correia de Sousa, K K Cheng, Chunhua Chi, Brendan G Cooper, Andrew P Dickens, Alexandra Enocson, Amanda Farley, Kate Jolly, Sue Jowett, Maka Maglakelidze, Tamaz Maghlakelidze, Sonia Martins, Alice Sitch, Aleksandra Stamenova, Katarina StavrikjRafael Stelmach, Alice Turner, Zihan Pan, Hui Pang, Jianxin Zhang, Rachel E Jordan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: Effective stakeholder engagement in health research is increasingly being recognised and promoted as an important pathway to closing the gap between knowledge production and its use in health systems. However, little is known about its process and impacts, particularly in low-and middle-income countries. This opinion piece draws on the stakeholder engagement experiences from a global health research programme on Chronic Obstructive Pulmonary Disease (COPD) led by clinician researchers in Brazil, China, Georgia and North Macedonia, and presents the process, outcomes and lessons learned.

MAIN BODY: Each country team was supported with an overarching engagement protocol and mentored to develop a tailored plan. Patient involvement in research was previously limited in all countries, requiring intensive efforts through personal communication, meetings, advisory groups and social media. Accredited training programmes were effective incentives for participation from healthcare providers; and aligning research findings with competing policy priorities enabled interest and dialogue with decision-makers. The COVID-19 pandemic severely limited possibilities for planned engagement, although remote methods were used where possible. Planned and persistent engagement contributed to shared knowledge and commitment to change, including raised patient and public awareness about COPD, improved skills and practice of healthcare providers, increased interest and support from clinical leaders, and dialogue for integrating COPD services into national policy and practice.

CONCLUSION: Stakeholder engagement enabled relevant local actors to produce and utilise knowledge for small wins such as improving day-to-day practice and for long-term goals of equitable access to COPD care. For it to be successful and sustained, stakeholder engagement needs to be valued and integrated throughout the research and knowledge generation process, complete with dedicated resources, contextualised and flexible planning, and commitment.

Original languageEnglish
Pages (from-to)66
JournalBMC Health Services Research
Issue number1
Publication statusPublished - 12 Jan 2024

Keywords / Materials (for Non-textual outputs)

  • Humans
  • Developing Countries
  • Georgia
  • Brazil
  • Republic of North Macedonia
  • Pandemics


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