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Project Overview
Summary
Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. Efforts to strengthen evidence-based approaches to improve health in these settings are partly hindered by restricted access to the best available evidence, limited training in evidence-based practice and concerns about the relevance of existing evidence. South East Asia – Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID) was a five-year project that aimed to determine whether a multifaceted intervention designed to strengthen the capacity for research synthesis, evidence-based care and knowledge implementation improved clinical practice and led to better health outcomes for mothers and babies.
Aims and objectives
SEA-ORCHID aimed to address the following broad question: Can the health of mothers and babies in Thailand, Indonesia, the Philippines and Malaysia be improved by increasing capacity for research synthesis, implementation of effective interventions, and identification of gaps in knowledge needing further research?
Rationale
Providing access to reliable health information for workers in developing countries is potentially the single most cost effective and achievable strategy for sustainable improvement in health care. Information provision alone is not enough; we need to ensure that clinical practice changes in response to that information.
The Cochrane Collaboration has had success in the developed world in involving clinicians in the process of generating and using evidence. The intervention used in this project drew on the experience of the Cochrane Collaboration in terms of infrastructure provision, training, support and methodological development, and involved local researchers to ensure it was regionally appropriate and resulted in increased capacity within SE Asia.
Design and methods
SEA-ORCHID was a before-after study, using action research to design, tailor and implement a capacity development intervention which included skills development (training and support), network building (training fellowships and project meetings), mentoring (between-country exchanges) and resourcing (subscription to evidence based materials, travel to project meetings and relevant conferences, IT infrastructure and support).
The project comprised five phases over five years. It was conducted across seven centres; four in SE Asian and three in Australia. At each SE Asian centre a study node was established within existing hospital/university departments.
Project phases
1. Pre-study phase (2004)
2. Pre-intervention phase (2005)
3. Intervention phase (2006-2007)
4. Outcome assessment phase (2008)
5. Reporting phase (2008-2009)
Participating Centres
Thailand:
Philippines:
Malaysia:
Indonesia:
Australia: |
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Khon Kaen University
University of the Philippines
Penang Medical College
Universiti Sains Malaysia
Gadjah Mada University
University of Sydney
University of Adelaide
Monash University |
Funding
SEA-ORCHID was jointly funded by an International Collaborative Research Grant from the National Health and Medical Research Council of Australia (No. 307703) and Wellcome Trust, United Kingdom (071672/Z/03/Z).
Related Publications
SEA-ORCHID study protocol
Henderson-Smart DJ, Lumbiganon P, Festin MR, Ho JJ, Mohammad H, McDonald SJ, Green S, Crowther CA. Optimising reproductive and child health outcomes by building evidence-based research and practice in South East Asia (SEA-ORCHID): study protocol. BMC Medical Research Methodology 2007, 7:43.
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