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Fostering Deliberation and Action in Context: An Analysis of Implementation Research among Healthcare Professionals in LMICs from a Post-Digital Perspective

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Title: Fostering Deliberation and Action in Context: An Analysis of Implementation Research among Healthcare Professionals in LMICs from a Post-Digital Perspective
Language: English
Authors: Koula Charitonos (ORCID 0000-0003-4188-196X), Allison Littlejohn (ORCID 0000-0003-1784-3365), Saraswati Dawadi (ORCID 0000-0002-6636-3969), Abhinav Vaidya, Alex Owusu-Ofori (ORCID 0000-0002-2172-8645), Fereshte Goshtasbpour (ORCID 0000-0001-6971-2936), Santosi Giri
Source: British Journal of Educational Technology. 2026 57(3):746-774.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 29
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Foreign Countries, Allied Health Occupations, Allied Health Occupations Education, Allied Health Personnel, Labor Force Development, Developing Nations, Blended Learning, Educational Technology, Technology Uses in Education, Public Health, Communicable Diseases, Program Implementation, Health Services
Geographic Terms: Nepal, Ghana
DOI: 10.1111/bjet.70044
ISSN: 0007-1013
1467-8535
Abstract: Strengthening health systems through workforce development is central to combating health crises and inequalities in some of the world's poorest countries and is a key objective for implementation research (IR). Workforce development programmes often include blended and online modalities, offering the means to reach relevant communities at scale, removing barriers in accessing lifelong learning opportunities. However, approaches that privilege issues of access, reach and scale are overlooking critical problems, such as the persistent gap between 'what one knows' and 'what one practises'. In this paper, we describe the implementation of an EdTech innovation situated within a technology-supported health workforce development programme in two distinct public health systems: Nepal and Ghana. This work focused on the challenge of antimicrobial resistance (AMR), a critical area of health practice related to the burden of bacterial infections. We report on an embedded multiple case study of a health workforce development programme across participating health facilities (n = 12; 6 in each country). Taking a postdigital positionality and using critical analysis guided by Helfrich et al.'s (2007) adapted "Framework for Complex Innovations," we examine contextual factors that facilitated or impeded implementation. We used an iterative process to collect and analyse qualitative data generated by healthcare workers (HCWs) leading implementation activities in their organisations. By bringing in the relevance of the health field perspectives on the EdTech, the analysis illustrates the impact on "implementation climate" and the fit between the innovation and the values of participants. It provides evidence of how the innovation supported HCWs in organising new spaces of action to negotiate wider work and learning arrangements and facilitate the move of knowledge into their practice, hence offering a potential pathway to address the 'know-do' gap. The paper offers a significant contribution in understanding and conducting EdTech implementation research in professional settings in complex, resource-constrained settings.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1503447
Database: ERIC
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  Data: Fostering Deliberation and Action in Context: An Analysis of Implementation Research among Healthcare Professionals in LMICs from a Post-Digital Perspective
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  Data: <searchLink fieldCode="AR" term="%22Koula+Charitonos%22">Koula Charitonos</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-4188-196X">0000-0003-4188-196X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Allison+Littlejohn%22">Allison Littlejohn</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-1784-3365">0000-0003-1784-3365</externalLink>)<br /><searchLink fieldCode="AR" term="%22Saraswati+Dawadi%22">Saraswati Dawadi</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6636-3969">0000-0002-6636-3969</externalLink>)<br /><searchLink fieldCode="AR" term="%22Abhinav+Vaidya%22">Abhinav Vaidya</searchLink><br /><searchLink fieldCode="AR" term="%22Alex+Owusu-Ofori%22">Alex Owusu-Ofori</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2172-8645">0000-0002-2172-8645</externalLink>)<br /><searchLink fieldCode="AR" term="%22Fereshte+Goshtasbpour%22">Fereshte Goshtasbpour</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6971-2936">0000-0001-6971-2936</externalLink>)<br /><searchLink fieldCode="AR" term="%22Santosi+Giri%22">Santosi Giri</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22British+Journal+of+Educational+Technology%22"><i>British Journal of Educational Technology</i></searchLink>. 2026 57(3):746-774.
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 29
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Occupations%22">Allied Health Occupations</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Occupations+Education%22">Allied Health Occupations Education</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Personnel%22">Allied Health Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Labor+Force+Development%22">Labor Force Development</searchLink><br /><searchLink fieldCode="DE" term="%22Developing+Nations%22">Developing Nations</searchLink><br /><searchLink fieldCode="DE" term="%22Blended+Learning%22">Blended Learning</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Technology%22">Educational Technology</searchLink><br /><searchLink fieldCode="DE" term="%22Technology+Uses+in+Education%22">Technology Uses in Education</searchLink><br /><searchLink fieldCode="DE" term="%22Public+Health%22">Public Health</searchLink><br /><searchLink fieldCode="DE" term="%22Communicable+Diseases%22">Communicable Diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Implementation%22">Program Implementation</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Services%22">Health Services</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Nepal%22">Nepal</searchLink><br /><searchLink fieldCode="DE" term="%22Ghana%22">Ghana</searchLink>
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  Data: 10.1111/bjet.70044
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  Data: Strengthening health systems through workforce development is central to combating health crises and inequalities in some of the world's poorest countries and is a key objective for implementation research (IR). Workforce development programmes often include blended and online modalities, offering the means to reach relevant communities at scale, removing barriers in accessing lifelong learning opportunities. However, approaches that privilege issues of access, reach and scale are overlooking critical problems, such as the persistent gap between 'what one knows' and 'what one practises'. In this paper, we describe the implementation of an EdTech innovation situated within a technology-supported health workforce development programme in two distinct public health systems: Nepal and Ghana. This work focused on the challenge of antimicrobial resistance (AMR), a critical area of health practice related to the burden of bacterial infections. We report on an embedded multiple case study of a health workforce development programme across participating health facilities (n = 12; 6 in each country). Taking a postdigital positionality and using critical analysis guided by Helfrich et al.'s (2007) adapted "Framework for Complex Innovations," we examine contextual factors that facilitated or impeded implementation. We used an iterative process to collect and analyse qualitative data generated by healthcare workers (HCWs) leading implementation activities in their organisations. By bringing in the relevance of the health field perspectives on the EdTech, the analysis illustrates the impact on "implementation climate" and the fit between the innovation and the values of participants. It provides evidence of how the innovation supported HCWs in organising new spaces of action to negotiate wider work and learning arrangements and facilitate the move of knowledge into their practice, hence offering a potential pathway to address the 'know-do' gap. The paper offers a significant contribution in understanding and conducting EdTech implementation research in professional settings in complex, resource-constrained settings.
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      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Allied Health Occupations
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      – SubjectFull: Allied Health Occupations Education
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      – SubjectFull: Blended Learning
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