Bulletin of the World Health Organization

Revisiting Lessons from the Field

The Bulletin of the World Health Organization

The Bulletin of the World Health Organization In January 2005, the Bulletin launched a new section, Lessons from the Field, (1) and we have used it to publish a number of valuable papers. These papers and the experience we gained through assessing them, in addition to the insightful comments we have received from the Bulletin’s editorial advisers, have helped us to sharpen our vision for this section. As a result, we would now like to relaunch it and provide an updated set of guidelines for potential authors, who are likely to be policy-makers and health professionals working in the field.

The importance of this section lies in its potential to capture untapped knowledge from the field and reduce the “publication gap” between knowledge produced by scientific research and that produced by practice and experience, particularly in developing country settings. We hope that this section will promote problem-solving approaches and practice-based learning as well as improve outcomes.

Context has been taken to mean “the setting in which practice takes place” (2). It is therefore crucial that Lessons from the Field papers include a proper description of their context (e.g., organizational culture, leadership and management, and resources) so that the particular lessons to be learned can be put into the correct framework and hence be of more value to readers. Papers submitted for this section should report actions taken in response to a particular public health problem in a local setting. The Bulletin is interested in your findings but, even more so, in the processes that led to them. You therefore need to describe these processes, beginning with how you became aware of the problem; building evidence and action; how you identified solutions; how you engaged partners; and the lessons that you learned. We see these as the essential elements that must be present in Lessons from the Field papers. In addition, you may wish to raise questions and debate in order to enhance learning.

We do not require you to use a prescribed structure in writing your paper. However, papers submitted to this section should have a 250-word abstract, structured under the following five headings: Problem (describe the problem), Approach (your approach to solving it), Local setting, Relevant changes (with measures, strategies and, impact), and Lessons learned. The main lessons learned should also be summarized in a box (maximum of three sentences) in the main body of the text. Papers submitted to this section must not exceed 1500 words, have no more than 15 references and no more than one Table and Figure. Specialist jargon or abbreviations should not be used. Your paper will be peer reviewed. The abstracts of accepted papers will be translated into French, Spanish and Arabic.

The main text of Lessons from the Field papers should cover the following information. First, a short background outline of the topic followed by a description of the context of the study including the resources used, sources of information and data, key players and their roles. Second, a description of the magnitude of the problem studied and how it was observed or measured. Third, an indication of who else shares this problem and what critical event triggered the need for action. Fourth, a description of how information was collected to propose the action and how this information helped to understand the problem. Fifth, the solution proposed, who took part in the decision-making, and what factors or knowledge were taken into account when proposing this solution.

In addition, you should describe what changes were made, how they were implemented, and who took part in the change process. Mention also what was observed with the proposed action and what was the impact on the specific problem, how was the impact monitored and evaluated and if this was not done why not. Discuss what was unique about the process and findings, including limitations and what can be generalized to other settings, as well as the role of chance, leadership and management in your process. Finally you should state what was learned and accomplished and what are the future steps.

The papers that were accepted and have previously been published as Lessons from the Field, including the one in this issue, (3) should therefore no longer be used as models for structure and content for this section. We will no longer be using this section for papers that could otherwise be published in the Research section of the Bulletin.

The paper should contain the following elements in this sequence:

  • Give short background on topic.
  • Describe the context: resources, sources of information and data, key players and their roles.
  • Describe the problem and its magnitude and how you observed or measured it, and indicate who else shares this problem.
  • Describe what critical event triggered the need for action.
  • Describe how you collected information to propose the action and how this information helped you understand the problem.
  • Describe what solution was proposed, who took part in proposing this solution and what factors or knowledge were taken into account when proposing this solution.
  • Describe what actual changes were made, how were they implemented, and who took part in the change process.
  • Describe what you observed with the proposed action.
  • Describe what was the impact of the action on the specific problem.
  • Did you monitor the action? How? if not, why?
  • Did you evaluate the impact of action? How? if not, why?
  • Discuss, what was unique about the process of your work and your findings, including limitations and what can be generalized to other settings.
  • Discuss the role of chance, leadership and management.
  • What did you learn and accomplish? And what are your next steps?

Acknowledgement
We thank the Bulletin’s editorial advisers for their valuable suggestions.


REFERENCES:

  • Momen H. Lessons from the Field. Bull World Health Organ 2005;83:2.
  • McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K. Getting evidence into practice: the meaning of ‘context’. J Adv Nurs, 2002;83:94-104.
  • Khan MI; Sahito SM; Khan MJ; Wassan SM; Shaikh AW; Maheshwari AK, et al. Bull World Health Organ 2006;84:72-7.

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