Engaging Stakeholders, from Inception and Throughout the Study, is Good Research Practice to Promote use of Findings

Exploratory factor analysis of constructs used for investigating research uptake for public healthcare practice and policy in a resource-limited setting, South Africa

BACKGROUND

Low-resource settings are often less capable of responding to and implementing available quality research evidence for public healthcare practice and policy development due to various factors. In most low-resource settings, limited empirical evidence is available to help deal with localised factors that contribute to low public health research uptake, particularly from the perspective of key research stakeholders.

METHODS

Although the study initially employed a two-phase exploratory sequential approach, this paper focuses on the results generated from a quantitative approach. Considering the determining factors that affect research uptake in the context of low-resource settings, a measuring instrument was developed and its reliability and validity were assessed using an exploratory factor analysis approach.

RESULTS

A total of 212 respondents, according to their job roles and titles, were identified as researchers, front-line workers, programme managers, and directors/senior managers of higher learning institutions, indicating that the three constructs applied in the questionnaire, namely (1) individual factors, (2) organisational factors, and (3) research characteristics, demonstrated relatively high reliability with a Cronbach's alpha of greater than 0.791.

CONCLUSION

The study concludes that the instrument can potentially be used to measure factors that affect research uptake in low-resource settings.

Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review

BACKGROUND

An estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review.

METHODS

The scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question.

RESULTS

A total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms.

CONCLUSION

Important barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.

Gaps, Challenges, and Opportunities for Global Health Leadership Training

Background

Global Health Leadership (GHL) programs are essential for training emerging health care professionals to be effective leaders. Synthesizing knowledge acquired through experience implementing GHL programs can inform future recommendations for GHL.

Objective

To describe the lessons learned, highlighting gaps, challenges and opportunities, during implementation of two GHL capacity building programs, namely the Afya Bora Consortium Fellowship in Global Health Leadership and the Sustaining Technical and Analytic Resources (STAR) fellowship and internship program for global health professionals.

Methods

A mixed methods case-comparison study was conducted, using qualitative data (expert opinion) collected from the Program Directors in order to understand the experiences of the two GHL programs. A structured response guide was used to assess the overall experience in GHL program implementation, operational challenges and reported gaps. Afya Bora and STAR have been implemented for 8 and 2.5 years respectively. Thus, the analysis reflects a snapshot of the two programs at different stages.

Findings

The results reflect knowledge gained through extensive experience in implementing the two GHL programs. Afya Bora has trained 188 multi-disciplinary fellows, and 100% of the African fellows are engaged in leadership positions in government departments and non-governmental organizations (NGOs) in their countries. STAR has placed 147 participants (89 fellows and 58 interns) in more than 25 countries globally. Both programs were successful in strengthening south-south and north-south collaborations for a common goal of improving global health. Implementation of both fellowships identified room for improvement in operational procedures and financing of the programs, and highlighted knowledge and skills gaps, as well as challenges in sustainability of the training programs.

Conclusions

Afya Bora and STAR have had significant impact and have contributed to changing the leadership landscape in global health. Future GHL programs should address sustainability in terms of financing, delivery modalities and domestic integration of knowledge.

Documenting HIV research-utilization activities, outputs and outcomes: examples and lessons learned from Project SOAR

The importance of using research findings to inform policy and program decisions is well recognized, but the literature on measuring research utilization activities is scarce. As funding to support some areas of research wanes or remains stagnant, the need to document the value of investing in research by its’ effect on improved programs and policies becomes increasingly necessary. We present the experience of Project SOAR, a six-year USAID-funded project focusing on HIV/AIDS-related implementation research, to demonstrate measurement of research utilization. We follow the project’s research-utilization logic model, including inputs, activities, outputs, and outcomes. We present tools the project developed and examples from project studies and discuss what works, remaining challenges and how to overcome them, and lessons learned. We then make recommendations for incorporating research-utilization activities and measurement in implementation-research studies.

When the Best Pandemic Models are the Simplest

As the coronavirus pandemic spreads across the globe, people are debating policies to mitigate its severity. Many complex, highly detailed models have been developed to help policy setters make better decisions. However, the basis of these models is unlikely to be understood by non-experts. We describe the advantages of simple models for COVID-19. We say a model is "simple" if its only parameter is the rate of contact between people in the population. This contact rate can vary over time, depending on choices by policy setters. Such models can be understood by a broad audience, and thus can be helpful in explaining the policy decisions to the public. They can be used to evaluate the outcomes of different policies. However, simple models have a disadvantage when dealing with inhomogeneous populations. To augment the power of a simple model to evaluate complicated situations, we add what we call "satellite" equations that do not change the original model. For example, with the help of a satellite equation, one could know what his/her chance is of remaining uninfected through the end of an epidemic. Satellite equations can model the effects of the epidemic on high-risk individuals, death rates, and nursing homes and other isolated populations. To compare simple models with complex models, we introduce our "slightly complex" Model J. We find the conclusions of simple and complex models can be quite similar. However, for each added complexity, a modeler may have to choose additional parameter values describing who will infect whom under what conditions, choices for which there is often little rationale but that can have big impacts on predictions. Our simulations suggest that the added complexity offers little predictive advantage.

An Ethics-based Approach to Research in Global Health: A Call to Action for Pharmacists

As opportunities and interests in international partnerships and research continue to grow in pharmacy, so, too, does the likelihood of encountering ethical challenges. We posit that the chance of encountering an ethical challenge in global health is almost inevitable. This commentary serves as an introduction to a series of four papers highlighting ethical issues in global health research for pharmacists. The authors draw on core ethical principles to guide collaborative global research in working to advance the health of people and populations worldwide.