Background: The PACK (Practical Approach to Care Kit) programme developed by the Knowledge Translation Unit (KTU) in Cape Town comprises an evidenced-based clinical practice guide covering 88 topics and an implementation strategy that aims to standardise and improve care amongst primary care health workers. To ensure applicability, it is intended for localisation to reflect local burden of disease, health-systems processes and resource constraints. In 2013, the Florianópolis municipality in Brazil began an intervention to address organisation of primary care, human resources management and scope of practice, but needed policy-aligned clinical guidance.
Objectives: To localise the PACK programme to the Florianópolis setting as part of a primary care strengthening intervention.
Methods: Over a year, the PACK programme was localised through an iterative process of adaptation and review. An in-country team received step-by-step guidance on how to localise the programme, assisted remotely by a KTU mentor. Guide localisation included detailed review of local guidelines, clinical protocols, medicine lists, and test and equipment availability. Local reviewers, clinicians and other role players were consulted. Once finalised, content was translated and guide design completed. The training programme was adapted through a similar process. Calls and visits between Brazil and South Africa occurred to review progress and plan implementation strategies.
Results: All 103 pages of the PACK Adult guide were aligned with local policies and protocols. Three new topics were added to address local health patterns and systems difficulties. Training material including training manuals, case studies and videos were adapted. Guide localisation informed local nursing protocol development and addressed system issues like referral pathways.
Conclusions: Through south-to-south mentorship, the PACK programme was successfully localised in Florianópolis, augmenting a primary care strengthening intervention. The collaboration enhanced the KTU’s mentorship package and has led to a long-term relationship between the groups with collaborative learning and research possibilities.