Systematic reviews and knowledge translation

Bull World Health Organ. 2006 Aug;84(8):643-51. doi: 10.2471/blt.05.026658.


Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Developed Countries
  • Developing Countries
  • Global Health
  • Health Policy
  • Health Services Accessibility / organization & administration*
  • Humans
  • Immunization Programs / organization & administration
  • Information Dissemination / methods*
  • Insecticides
  • Knowledge*
  • Malaria / prevention & control
  • Review Literature as Topic*


  • Insecticides