Background: Tuberculosis (TB) is the number one infectious disease killer in the world. TB is both preventable, and curable. Since 1997, the World Health Organization’s (WHO) Global TB (GTB) Programme has released evidence-informed publications to guide member states. In their EndTB strategy, the WHO set a mandate to eradicate TB by 2035, in part by intensifying TB research and innovation. As an effort towards this goal, this project applies evidence mapping methodologies to published WHO TB recommendations, in an innovative process called “recommendation mapping” (RM). Objectives: The prime objective of RM is to allow guideline developers and key stakeholders to identify gaps and clusters of recommendations across publications, serve as an instrumental tool in the sequence of guideline development (from intelligent priority setting, to the assembly of final recommendations) and increase the accessibility of key guideline components. The secondary objective of this work is to poise guideline components for live update and refinement in a rapidly learning health system. Methods: In this mixed methods study, a methodological framework for mapping guideline components is proposed, with both a quantitative and narrative assessment of raw data and final map outputs. A qualitative analysis from the perspective of key stakeholders, policy-makers, researchers and WHO-GTB liaisons working in guideline development is also included. For the methodological piece, all publications containing WHO TB recommendations were eligible for the mapping exercise. Each recommendation was extracted according to all subdomains of their PICO backbone. Subsections of recommendations are coded using existing ontologies (SNOMED-CT, ATC, ICD-11). A centralized database containing extracted and coded recommendations was then presented in an online and interactive schematic. For the qualitative assessment of palatability of this approach within the organization, semi-structured interviews and a survey was delivered to eligible participants at two Guideline Development Group meetings for WHO tuberculosis treatment and screening guidelines. Results: The notable result of this work is the development, refinement and application of recommendation mapping methodologies. 20 WHO-GTB guidelines underwent an application of the novel recommendation methodologies proposed in this thesis to create an interactive map, and a searchable database. In-depth interviews and survey results with 21 participants (WHO GTB staff, WHO TB- guideline development group members and technical experts) pointed to concerns in the current accessibility and organization of WHO-GTB guidelines. Conclusions: Recommendation mapping may have utility in charting the terrain of recommendations, inform priority setting, and provide a scaffold for the future transition to living guidelines. / Thesis / Master of Public Health (MPH) / The World Health Organization (WHO) issues guidelines to help clinicians, policy-makers, and researchers make informed decisions in their work. Guidelines contain recommendations that can be thought of as bottom-line answers to the questions we ask the scientific literature (based on the evidence available to us today). The WHO’s Tuberculosis (TB) Department is partaking in a novel digital reorganization of their guideline recommendations using the evidence-mapping methods proposed in this thesis. This thesis uses the principles of evidence mapping to create recommendation maps that, like any map, chart the landscape in a given domain (in this case, TB recommendations). The recommendation map will help guide the WHO in setting priorities for future research and guideline development.

Background: Efficient national health research systems (NHRS) generate knowledge to improve health outcomes while accounting for local health system specificities. African NHRS have a limited capacity to generate such knowledge; and rely on global or external sources of evidence which require adaptation. However, systematic, timely and comprehensive identification of local evidence needed for adaptation is challenging. Thus, the objectives of this study are to develop a centralized database of health research from Cameroon and test its applicability for informing future research production and use. Methods: We used an evidence mapping design. From October 2018 to May 2019, we searched 10 electronic databases and hand searched the archives of non-indexed African and Cameroonian journals. We screened titles, abstracts, and full texts based on these criteria: peer reviewed journal articles; published between 1999 and 2019; in English or French; investigating health-related outcomes in Cameroon. We extracted relevant study characteristics using a pre-established guide. We developed a coding scheme to label studies and ease searches on the database. Studies were coded independently by two reviewers and discrepancies resolved by consensus. We used the database to create evidence maps and identify knowledge gaps on sexual and reproductive health (SRH) priorities. Results: We included 4384 studies. Most were open access (76.3%); published in English (79.7%); conducted in the Centre region (45%) with an observational design (71.6%). The domains with the highest frequency were medical specialties (89.0%), and diseases (80.4%). The most researched specialty, diseases and population were infectiology, infectious diseases, and children respectively. Our gap maps revealed: (1) geographic and demographic disparities in the local evidence on adolescents’ contraceptive use (2) gaps in the type of local evidence needed for contextualisation and policymaking on obstetric fistula. Conclusion: Local evidence mapping and gap analysis can contribute to improving national research production and use in decision-making. / Thesis / Master of Science (MSc) / National health research systems answer questions about individuals’ health and the health care system they use. To do this, it is important to determine what we already know, which questions have not been answered and where resources should be directed in the future. Cameroon’s health research system needs to improve its research production capacity. It needs to produce answers which can be used to improve the health of Cameroonians and the decisions which are made about their health care system. As a first step towards achieving these goals, we created a database of health research from Cameroon. We used the database to create maps of what we know and don’t know about health topics such as adolescents’ use of contraception. We also made recommendations for future research in this field. The database will be useful for researchers, students, health professionals, funders and stakeholders involved with health research in Cameroon