87 The Journal of Continuing Education in the Health Professions, Vol. 26 No. 1, Winter 2006 Published online in Wiley InterScience (www.interscience.wiley.com) • DOI: 10.1002/chp.55 The Journal of Continuing Education in the Health Professions, Volume 26, pp. 87–96. Printed in the U.S.A. Copyright (c) 2006 The Alliance for Continuing Medical Education, the Society for Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education. All rights reserved. Innovations Knowledge Translation in Developing Countries Nancy Santesso, RD, MLIS, and Peter Tugwell, MD, MSc Abstract There is increasing evidence that the application of knowledge in developing countries is failing. One reason is the woeful shortage of health workers, but as this is redressed, it is also crucial that we have an evidence base of what works to minimize the “know-do gap.” The World Health Organization and other international organizations are actively building momentum to promote research to determine effective strategies for knowledge translation (KT). At this time, the evidence base for the effectiveness of those strategies is not definitive in developed countries and is relatively sparse in developing countries. It appears, however, that the effectiveness of these strategies is highly variable and dependent on the setting, and success hinges on whether the strategies have been tailored. A useful framework to provide direction for tailoring interventions is the Ottawa Model of Research Use (OMRU). Underlying OMRU is the principle that success rests with tailoring KT strategies to the salient barriers and supports found within the setting. The model recommends that barriers and supports found in the practice environment or as characteristics of potential adopters and the evidence-based innovation or research evidence be assessed and then the KT strat- egy tailored and executed. The model also recommends that whether the research has been applied and has resulted in improved health outcomes should be measured. Studies in devel- oping countries, although few, illustrate that the OMRU approach may be a valid method of tackling the challenges of KT strategies to improve health care in developing countries. Key Words: knowledge translation, research use, evidence-based medicine, developing countries, continuing education Background The World Report on Knowledge for Better Health reports that 6 million children die in developing countries every year due to causes that can be prevented by applying simple and effective interventions; that in many African countries, the average life expectancy is less than 40 years while in industrialized nations the Ms. Santesso: Knowledge Translation Specialist, Centre for Global Health, Institute of Population Health, University of Ottawa; Dr. Tugwell: Director, Centre for Global Health, and Professor of Medicine and Epidemiology and Community Medicine, Institute of Population Health, University of Ottawa, Ottawa, Ontario. Correspondence: Nancy Santesso, RD, MLIS, One Stewart Street, Room 206, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada K1N 6N5. E-mail: santesso@uottawa.ca. average life expectancy is 80 years or more; and that 1,000/100,000 women giving birth died in Kenya whereas in Japan the rate was 8/100,000. 1 These are only a few statistics—of which there are more—that clearly illustrate that the application of knowledge in developing countries is failing. Why could this be happening? The World Report on Knowledge for Better Health points to health systems that are poorly resourced and under severe pressure, and appropriate and effective interventions are not reaching those in need partly because how to effectively imple- ment and use an intervention may not be known. Globally, little money is spent on research into diseases affecting developing countries—less than 10% of health research money is spent on 90% of the world’s health problems: the “10/90 gap”—but there is also a major gap between