title: Use of clinical guidelines: perspectives from clinicians in paediatric and maternity hospitals in Kabul, Afghanistan.
abstract: This study explored the perceived value, role and reported use of clinical guidelines by clinicians in urban paediatric and maternity hospital settings, and the effect of current implementation strategies on clinician attitudes, knowledge and behaviour. A total of 63 clinicians from 7 paediatric and maternity hospitals in Kabul, Afghanistan participated in structured focus groups; content analysis methodology was used for identification and analysis of key themes. Seven sets of guidelines, protocols or standards were identified (including 5 WHO-endorsed guidelines). However, most are failing to achieve high levels of use. Factors associated with guideline use included: clinician involvement in guideline development; multidisciplinary training; demonstrable results; and positive clinician perceptions regarding guideline quality and contextual appropriateness. Implementation activities should fulfil 3 major objectives: promote guideline awareness and access; stimulate motivation among clinical guideline users; and actively facilitate adherence to guidelines.
authors: Department of General Paediatrics, Royal Children's Hospital, Melbourne, Australia.
authors: H
authors: H
authors: Graham
authors: Centre for International Health, Burnet Institute, Melbourne, Australia.
authors: M
authors: M
authors: Tokhi
authors: Department of International Health, Johns Hopkins School of Public Health, Baltimore, United States of America.
authors: A
authors: A
authors: Edward
authors: Health Financing Directorate, Ministry of Public Health, Kabul, Afghanistan.
authors: A S
authors: AS
authors: Salehi
authors: Afghan Midwifery Association, Islamic Republic of Afghanistan; Centre for Midwifery, Child and Family Health, University of Technology, Sydney, Australia.
authors: S
authors: S
authors: Turkmani
authors: Centre for International Health, Burnet Institute, Melbourne, Australia.
authors: T
authors: T
authors: Duke
authors: Department of International Health, Johns Hopkins School of Public Health, Baltimore, United States of America.
authors: L
authors: L
authors: Bartlett
mesh_terms: D000346:Afghanistan; D002985:Clinical Protocols; D005260:Female; D017144:Focus Groups; D019983:Guideline Adherence; D006771:Hospitals, Maternity; D006776:Hospitals, Pediatric; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D036301:Qualitative Research