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026 What organisational resources have to be considered when adapting guidelines in the context of Low and Middle Income Countries (LMIC)? The Argentinean experience
  1. M Esandi1,2,
  2. M De Luca1,
  3. Z Ortiz1
  1. 1National Academy of Medicine, Ciudad Autónoma de Buenos Aires, Argentina
  2. 2National Southern University, Bahía Blanca, Argentina


Background Adapting guidelines in resource-constraints countries represents a great challenge. Availability of organisational resources has to be considered before implementing this methodology.

Objectives a) To compare the availability of different organisational resources during seven guidelines adaptation initiatives facilitated by the National Academy of Medicine (Argentina) between 2005 and 2013; b) to analyse the relevance of each type of resource category for adapting guidelines in the context of LMIC.

Methods 7 guidelines adaptation initiatives facilitated by the NAM since 2005 and 2013 are described. Organisational resources were categorised in 4 categories: organisational culture, human resources, economic resources, and condition resources (or states) within the organisation. Conservation of resources (COR) theory was used as the theoretical basis for analysing the relevance of each type of resource for the guideline adaptation process.

Results Four of the 7 initiatives completed the whole process and produced an evidence-based guideline; 1 was interrupted and 2 are still ongoing although 1 of them shows a considerable delay. Among all organisational resource categories, culture and human resource were perceived as the most critical, particularly in what respects to the availability in the guideline developer group of change agents (i.e. internal and external facilitation); disposition to change and motivation and an appropriate mix of skills including leadership, communication, team work, technical competences.

Discussion Guidelines adapting in resource-constraint countries is not easy, although possible if different critical organisational resources are provided from the outset of the process.

Implications for Guideline Developers/Users A minimum organisational resource threshold is necessary for guarantying guidelines adaptation in the context of LMIC.

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