Published: 09-06-2020 15:27 | Updated: 11-06-2020 16:24

Insights into the development and implementation of community-based tuberculosis screening policies

Good health policies have the potential to positively impact people’s lives and reduce inequalities. Even though the aim is to base health policies on science, research evidence is only one of many factors impacting their development and implementation. Politics, culture, money and available health care staff often shape health policies and how they are put into practice.

“Making good policies or improving them requires a solid understanding of the context, including the prevailing influencing factors (facilitators and barriers) – otherwise we may tap in the dark and waste the often already limited resources on trial and error. With this study, we aimed to understand these influences, specifically on the development and implementation of policies on community-based tuberculosis screening”, says Olivia Biermann, PhD student and first author of the publication.

“Diving into experts’ perspectives on the development and implementation of community-based screening policies, we learned more about the important role that governments, non-governmental organizations and especially donors play in developing such policies. These findings are particularly valuable as we hardly knew anything about the development processes of these policies from the literature. While the need for more evidence on this type of screening was clear from the beginning, this study shows that many different types of evidence are needed – from randomized controlled trials to implementation research.”

“Our findings are not only relevant for community-based tuberculosis screening policies, but also for policies on COVID-19 where “power plays” and “push” from different stakeholders may be disruptive and misleading, e.g. thinking of COVID-19-related school closure policies. Instead, it is important a) to stick to the evidence as much as possible and b) engage key stakeholders who are involved in or affected by the policy response. These approaches may lead to better, more equitable policies for people’s health.”


“Power plays plus push”: Experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study. Biermann O, Atkins S, Lönnroth K, Caws M, Viney K. BMJ Open; 2020;10:e036285. doi:10.1136/bmjopen-2019-036285.”


Olivia Biermann Postdoctoral Researcher