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Gibas KM, Ahonkhai AA, Huang A, van Wyk C, Tsiga-Ahmed FI, Musa BM, Sani MU, Audet CM, Wester CW, Aliyu MH. The V-BRCH Project: Strengthening HIV Research Capacity in Nigeria through Intensive Workshops in Implementation Science and Grant Writing. Am J Trop Med Hyg 2024; 110:534-539. [PMID: 38350133 PMCID: PMC10919197 DOI: 10.4269/ajtmh.23-0711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/20/2023] [Indexed: 02/15/2024] Open
Abstract
As persons with HIV live longer as the result of antiretroviral therapy, morbidity from HIV-associated noncommunicable diseases (NCDs) is increasing. The Vanderbilt-Nigeria Building Research Capacity in HIV and Noncommunicable Diseases program is a training platform created with the goal of training a cohort of successful Nigerian investigators to become leaders in HIV-associated NCD research. We describe survey findings from two week-long workshops in Kano, Nigeria, where trainees received instruction in implementation science and grant writing. Surveys assessed participants' self-perceived knowledge and confidence in topics taught during these workshops. Thirty-seven participants (all assistant professors) attended the implementation science workshop; 30 attended the grant-writing workshop. Response rates for the implementation science workshop were 89.2% for the preworkshop survey and 91.9% for the postworkshop survey. For the grant-writing workshop, these values were 88.2% and 85.3%, respectively. Improvement in participant knowledge and confidence was observed in every domain measured for both workshops. On average, a 101.4% increase in knowledge and a 118.0% increase in confidence was observed across measured domains among participants in the implementation science workshop. For the grant-writing workshop, there was a 68.8% increase in knowledge and a 70.3% increase in confidence observed. Participants rated the workshops and instructors as effective for both workshops. These workshops improved participants' knowledge and competence in implementation science and grant writing, and provide a model for training programs that aim to provide physician scientists with the skills needed to compete for independent funding, conduct locally relevant research, and disseminate research findings.
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Affiliation(s)
- Kevin M. Gibas
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Epidemiology & Infection Prevention, Rhode Island Hospital, Providence, Rhode Island
| | - Aima A. Ahonkhai
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alexander Huang
- Vanderbilt Institute for Global Health, Nashville, Tennessee
| | - Chelsea van Wyk
- Vanderbilt Institute for Global Health, Nashville, Tennessee
| | | | - Baba M. Musa
- Department of Medicine, Bayero University, Kano, Nigeria
| | | | | | | | - Muktar H. Aliyu
- Vanderbilt Institute for Global Health, Nashville, Tennessee
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2
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Hahka TM, Slotkowski RA, Akbar A, VanOrmer MC, Sembajwe LF, Ssekandi AM, Namaganda A, Muwonge H, Kasolo JN, Nakimuli A, Mwesigwa N, Ishimwe JA, Kalyesubula R, Kirabo A, Anderson Berry AL, Patel KP. Hypertension Related Co-Morbidities and Complications in Women of Sub-Saharan Africa: A Brief Review. Circ Res 2024; 134:459-473. [PMID: 38359096 PMCID: PMC10885774 DOI: 10.1161/circresaha.123.324077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Hypertension is the leading cause of cardiovascular disease in women, and sub-Saharan African (SSA) countries have some of the highest rates of hypertension in the world. Expanding knowledge of causes, management, and awareness of hypertension and its co-morbidities worldwide is an effective strategy to mitigate its harms, decrease morbidities and mortality, and improve individual quality of life. Hypertensive disorders of pregnancy (HDPs) are a particularly important subset of hypertension, as pregnancy is a major stress test of the cardiovascular system and can be the first instance in which cardiovascular disease is clinically apparent. In SSA, women experience a higher incidence of HDP compared with other African regions. However, the region has yet to adopt treatment and preventative strategies for HDP. This delay stems from insufficient awareness, lack of clinical screening for hypertension, and lack of prevention programs. In this brief literature review, we will address the long-term consequences of hypertension and HDP in women. We evaluate the effects of uncontrolled hypertension in SSA by including research on heart disease, stroke, kidney disease, peripheral arterial disease, and HDP. Limitations exist in the number of studies from SSA; therefore, we will use data from countries across the globe, comparing and contrasting approaches in similar and dissimilar populations. Our review highlights an urgent need to prioritize public health, clinical, and bench research to discover cost-effective preventative and treatment strategies that will improve the lives of women living with hypertension in SSA.
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Affiliation(s)
- Taija M Hahka
- Department of Cellular and Integrative Physiology (T.M.H., A.L.A.B., K.P.P.), University of Nebraska Medical Center, Omaha, NE
- Department of Pediatrics (T.M.H., R.A.S., A.A., M.C.V., A.L.A.B.), University of Nebraska Medical Center, Omaha, NE
| | - Rebecca A Slotkowski
- Department of Pediatrics (T.M.H., R.A.S., A.A., M.C.V., A.L.A.B.), University of Nebraska Medical Center, Omaha, NE
| | - Anum Akbar
- Department of Pediatrics (T.M.H., R.A.S., A.A., M.C.V., A.L.A.B.), University of Nebraska Medical Center, Omaha, NE
| | - Matt C VanOrmer
- Department of Pediatrics (T.M.H., R.A.S., A.A., M.C.V., A.L.A.B.), University of Nebraska Medical Center, Omaha, NE
| | - Lawrence Fred Sembajwe
- Department of Medical Physiology (L.F.S., A.M.S., A. Namaganda, H.M., J.N.K., R.K.), Makerere University College of Health Sciences, Kampala, Uganda
| | - Abdul M Ssekandi
- Department of Medical Physiology (L.F.S., A.M.S., A. Namaganda, H.M., J.N.K., R.K.), Makerere University College of Health Sciences, Kampala, Uganda
| | - Agnes Namaganda
- Department of Medical Physiology (L.F.S., A.M.S., A. Namaganda, H.M., J.N.K., R.K.), Makerere University College of Health Sciences, Kampala, Uganda
| | - Haruna Muwonge
- Department of Medical Physiology (L.F.S., A.M.S., A. Namaganda, H.M., J.N.K., R.K.), Makerere University College of Health Sciences, Kampala, Uganda
| | - Josephine N Kasolo
- Department of Medical Physiology (L.F.S., A.M.S., A. Namaganda, H.M., J.N.K., R.K.), Makerere University College of Health Sciences, Kampala, Uganda
| | - Annettee Nakimuli
- Department of Obstetrics and Gynecology (A. Nakimuli), Makerere University College of Health Sciences, Kampala, Uganda
| | - Naome Mwesigwa
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN (N.M., J.A.I., A.K.)
| | - Jeanne A Ishimwe
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN (N.M., J.A.I., A.K.)
| | - Robert Kalyesubula
- Department of Medical Physiology (L.F.S., A.M.S., A. Namaganda, H.M., J.N.K., R.K.), Makerere University College of Health Sciences, Kampala, Uganda
| | - Annet Kirabo
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN (N.M., J.A.I., A.K.)
| | - Ann L Anderson Berry
- Department of Cellular and Integrative Physiology (T.M.H., A.L.A.B., K.P.P.), University of Nebraska Medical Center, Omaha, NE
- Department of Pediatrics (T.M.H., R.A.S., A.A., M.C.V., A.L.A.B.), University of Nebraska Medical Center, Omaha, NE
| | - Kaushik P Patel
- Department of Cellular and Integrative Physiology (T.M.H., A.L.A.B., K.P.P.), University of Nebraska Medical Center, Omaha, NE
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3
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Abouzeid M, Muthanna A, Nuwayhid I, El-Jardali F, Connors P, Habib RR, Akbarzadeh S, Jabbour S. Barriers to sustainable health research leadership in the Global South: Time for a Grand Bargain on localization of research leadership? Health Res Policy Syst 2022; 20:136. [PMID: 36536392 PMCID: PMC9761652 DOI: 10.1186/s12961-022-00910-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Strong Global South (GS) health research leadership, itself both dependent on and a requisite for strong health research systems, is essential to generate locally relevant research and ensure that evidence is translated into policy and practice. Strong GS health research systems and leadership are important for health development and in turn for strong health systems. However, many GS countries struggle to produce research and to improve performance on widely used research metrics measuring productivity and reflecting leadership. Drawing on literature from a rapid review, this viewpoint paper considers the barriers to GS health research leadership and proposes strategies to address these challenges. FINDINGS GS researchers and institutions face numerous barriers that undermine health research leadership potential. Barriers internal to the GS include researcher-level barriers such as insufficient mentorship, limited financial incentives and time constraints. Institutional barriers include limited availability of resources, restrictive and poorly developed research infrastructures, weak collaboration and obstructive policies and procedures. Structural barriers include political will, politicization of research and political instability. External barriers relate to the nature and extent of Global North (GN) activities and systems and include allocation and distribution of funding and resources, characteristics and focus of GN-GS research collaborations, and publication and information dissemination challenges. CONCLUSIONS Strengthening GS health research leadership requires acknowledgement of the many barriers, and adoption of mitigating measures by a range of actors at the institutional, national, regional and global levels. Particularly important are leadership capacity development integrating researcher, institutional and systems initiatives; new GN-GS partnership models emphasizing capacity exchange and shared leadership; supporting GS research communities to set, own and drive their research agendas; addressing biases against GS researchers; ensuring that GS institutions address their internal challenges; enhancing South-South collaborations; diversifying research funding flow to the GS; and learning from models that work. The time has come for a firm commitment to improving localization of research leadership, supported by adequate funding flow, to ensure strong and sustainable research systems and leadership in and from the GS. Just as the humanitarian donor and aid community adopted the Grand Bargain commitment to improve funding flow through local and national responders in times of crisis, we strongly urge the global health research community to adopt a Grand Bargain for research leadership.
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Affiliation(s)
- Marian Abouzeid
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.1021.20000 0001 0526 7079Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC Australia ,grid.1021.20000 0001 0526 7079Centre for Humanitarian Leadership, School of Humanities and Social Sciences, Deakin University, Burwood, VIC Australia
| | - Ahlam Muthanna
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Iman Nuwayhid
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Phil Connors
- grid.1021.20000 0001 0526 7079Centre for Humanitarian Leadership, School of Humanities and Social Sciences, Deakin University, Burwood, VIC Australia
| | - Rima R. Habib
- grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Shahram Akbarzadeh
- grid.1021.20000 0001 0526 7079Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC Australia
| | - Samer Jabbour
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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4
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Eboreime E, Ogwa O, Nnabude R, Aluka-Omitiran K, Banke-Thomas A, Orji N, Eluwa A, Ezeokoli A, Rotimi A, Eze LU, Offiong V, Odu U, Okonkwo R, Umeh C, Ilika F, Oreh A, Adams FN, Okpani IA, Ogundeji Y, Mbachu C, Obi FA, Badejo O. Engaging stakeholders to identify gaps and develop strategies to inform evidence use for health policymaking in Nigeria. Pan Afr Med J 2022; 43:140. [PMID: 36762150 PMCID: PMC9898774 DOI: 10.11604/pamj.2022.43.140.36754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction recent efforts to bridge the evidence-policy gap in low-and middle-income countries have seen growing interest from key audiences such as government, civil society, international organizations, private sector players, academia, and media. One of such engagement was a two-day virtual participant-driven conference (the convening) in Nigeria. The aim of the convening was to develop strategies for improving evidence use in health policy. The convening witnessed a participant blend of health policymakers, researchers, political policymakers, philanthropists, global health practitioners, program officers, students, and the media. Methods in this study, we analyzed conversations at the convening with the aim to disseminate findings to key stakeholders in Nigeria. The recordings from the convening were transcribed and analyzed inductively to identify emerging themes, which were interpreted, and inferences are drawn. Results a total of 630 people attended the convening. Participants joined from 13 countries. Participants identified poor collaboration between researchers and policymakers, poor community involvement in research and policy processes, poor funding for research, and inequalities as key factors inhibiting the use of evidence for policymaking in Nigeria. Strategies proposed to address these challenges include the use of participatory and embedded research methods, leveraging existing systems and networks, advocating for improved funding and ownership for research, and the use of context-sensitive knowledge translation strategies. Conclusion overall, better interaction among the various stakeholders will improve the evidence generation, translation, and use in Nigeria. A road map for the dissemination of findings from this conference has been developed for implementation across the strata of the health system.
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Affiliation(s)
- Ejemai Eboreime
- Talk Health Real Media Limited, Abuja, Nigeria,,Corresponding author: Ejemai Eboreime, Department of Psychiatry, University of Alberta, Edmonton, Canada.
| | - Oluwafunmike Ogwa
- Systems Development Initiative, Abuja, Nigeria,,Doctorkk Health International, Lagos, Nigeria
| | - Rosemary Nnabude
- Systems Development Initiative, Abuja, Nigeria,,School of Public Health, University of Alberta, Edmonton, Canada
| | - Kasarachi Aluka-Omitiran
- Systems Development Initiative, Abuja, Nigeria,,Department of Community Health Services, National Primary Health Care Development Agency, Abuja, Nigeria
| | - Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, United Kingdom,,London School of Economics and Political Science, London, United Kingdom
| | - Nneka Orji
- Systems Development Initiative, Abuja, Nigeria,,Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Achama Eluwa
- Systems Development Initiative, Abuja, Nigeria,,Health, Nutrition and Population Global Practice Unit, The World Bank, Washington DC, United States of America
| | - Adaobi Ezeokoli
- Systems Development Initiative, Abuja, Nigeria,,Harvard Kennedy School, Harvard University, Cambridge, Massachusetts, United States
| | - Aanu Rotimi
- Systems Development Initiative, Abuja, Nigeria,,Centre for Accountability and Inclusive Development, Abuja, Nigeria
| | - Laz Ude Eze
- Systems Development Initiative, Abuja, Nigeria,,Talk Health Real Media Limited, Abuja, Nigeria
| | - Vanessa Offiong
- Systems Development Initiative, Abuja, Nigeria,,As Equals, CNN International, Abuja, Nigeria
| | - Ugochi Odu
- Systems Development Initiative, Abuja, Nigeria,,Healthreach limited, Abuja, Nigeria
| | - Rita Okonkwo
- Systems Development Initiative, Abuja, Nigeria,,Institute of Human Virology Nigeria, International Research Center of Excellence, Abuja, Nigeria
| | - Chukwunonso Umeh
- Systems Development Initiative, Abuja, Nigeria,,African Youth Initiative on Population Health and Development (AfrYPoD), Abuja, Nigeria
| | - Frances Ilika
- Palladium, Health Policy Plus Project, Abuja, Nigeria
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Transfusion Service, Abuja, Nigeria
| | | | - Ikedichi Arnold Okpani
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Yewande Ogundeji
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Chinyere Mbachu
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Felix Abrahams Obi
- Systems Development Initiative, Abuja, Nigeria,,Results for Development (R4D), Nigeria Country Office, Abuja, Nigeria
| | - Okikiolu Badejo
- Systems Development Initiative, Abuja, Nigeria,,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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5
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Swahn MH, Robow Z, Balenger A, Staton CA, Kasirye R, Francis JM, Komba S, Siema P. Preventing Alcohol-Related Harm in East Africa: Stakeholder Perceptions of Readiness across Five Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14979. [PMID: 36429695 PMCID: PMC9690202 DOI: 10.3390/ijerph192214979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE While alcohol-related harm is a recognized public health priority, the capacity to address and mitigate its harm is lacking, primarily in low-income countries. Recent developments including new tools that can assess readiness for preventing alcohol-related harm, specifically in low-resource settings, can be used to determine strengths and opportunities for supporting, planning, and resource allocation. In this study, we determined the perceptions of readiness and capacity for the prevention of alcohol-related harm across East Africa among stakeholders engaged in such work. METHODS We conducted a cross-sectional survey in 2020, distributed by the East Africa Alcohol Policy Alliance to their member alliances and stakeholders across five countries in East Africa (i.e., Burundi, Kenya, Rwanda, Tanzania, and Uganda). The survey included modified measures from the Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) short form, organizational size and funding, research capacity and priorities, and perceptions related to alcohol prevention and harm both locally and in the region. Analyses were computed based on 142 persons/organizations completing the survey. RESULTS In terms of general readiness, the overall adjusted aggregate score for East Africa was 39.70% (ranging from 30.5% in Burundi to 47.0% in Kenya). Of the 10 domains assessed (on a 0-10 scale), across all countries, knowledge of alcohol prevention (8.43), institutional links and resources (6.15) and legislation, mandates and policies (5.46) received the highest scores. In contrast, measures pertaining to resources (i.e., material, human, technical, and informal) received the lowest score. CONCLUSIONS Our results demonstrate substantial variability in the readiness to address alcohol-related harm across East Africa. The highest capacity was noted for knowledge towards alcohol prevention, institutional links, and legislative mandates and policies. However, important gaps were noted in terms of attitudes towards alcohol prevention, the will to address the problem, as well as material, human, and informal resources, which need to be urgently addressed to strengthen capacity for addressing and mitigating the significant toll of alcohol-related harm in the region.
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Affiliation(s)
- Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Zakaria Robow
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Adelaide Balenger
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Catherine A. Staton
- Department of Emergency Medicine, Duke Global Health Institute, Duke University, Durham, NC 27710, USA
| | - Rogers Kasirye
- Uganda Youth Development Link, Kampala P.O. Box 12659, Uganda
| | - Joel M. Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Sophia Komba
- East Africa Alcohol Policy Alliance, Dar es Salam, Tanzania
| | - Patterson Siema
- African Population and Health Research Center, Nairobi 00100, Kenya
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6
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Ahinkorah BO, Kang M, Perry L, Brooks F. Prevention of Adolescent Pregnancy in Anglophone Sub-Saharan Africa: A Scoping Review of National Policies. Int J Health Policy Manag 2022; 11:726-739. [PMID: 33059426 PMCID: PMC9309907 DOI: 10.34172/ijhpm.2020.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite the existence of preventive policies across sub-Saharan Africa, countries within the sub-region lead global rankings for rates of adolescent pregnancy. The aim of this scoping review was to identify and review national policies on the prevention of adolescent pregnancy in Anglophone sub-Saharan Africa. METHODS Relevant policies were identified from searches of national government websites and the search engine Google. Recognised screening and data extraction processes were used; data were subjected to content analysis using a published Framework for Evaluating Program and Policy Design on Adolescent Reproductive Health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines was used in reporting the review. RESULTS In line with the inclusion criteria that guided the selection of relevant policies in this study, 17 of 75 national policies were suitable for the analysis. All were backed by political recognition, were government and public initiatives, acknowledged a range of determinants of adolescent pregnancy and allocated human resources to policy activities. Few specified financial resourcing. Most policies acknowledged the importance of coordination and collaboration among public and private actors. All policies had objectives that addressed adolescent pregnancy but none were measurable or included timeframes. Provision of comprehensive sexuality education and adolescent reproductive health services were the most common recommendations. Monitoring and evaluation plans were present in all the policies. However, youth involvement in policy formulation, and plans for implementation, monitoring and evaluation was scarce. CONCLUSION Overall, national policy strengths were seen in relation to their political recognition, and all aspects of policy formulation. Policy implementation strengths and weaknesses were identified, the latter in relation to clear descriptions of financial resources. Importantly, the absence of measurable and time-bound objectives or formal evaluation of policy effectiveness confounds demonstration of what has been delivered and achieved. Youth involvement was notably absent in many policies. For future policy-setting, governments and policy-makers should make efforts to engage young people in policy development and to be transparent, realistic and address the necessary financial resourcing. They should set quantifiable policy objectives that provide a basis for assessing the adoption, uptake and effectiveness of policies in relation to measurable objectives.
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Affiliation(s)
| | - Melissa Kang
- School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Fiona Brooks
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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7
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Faye SLB, Krumkamp R, Doumbia S, Tounkara M, Strauss R, Ouedraogo HG, Sagna T, Barry AM, Mbawah AK, Doumbia CO, Diouf S, Cisse K, Harding M, Donven P, May J, Puradiredja DI, Fusco D. Factors influencing hesitancy towards adult and child COVID-19 vaccines in rural and urban West Africa: a cross-sectional study. BMJ Open 2022; 12:e059138. [PMID: 35418436 PMCID: PMC9013792 DOI: 10.1136/bmjopen-2021-059138] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study aims: (1) to identify and describe similarities and differences in both adult and child COVID-19 vaccine hesitancy, and (2) to examine sociodemographic, perception-related and behavioural factors influencing vaccine hesitancy across five West African countries. DESIGN Cross-sectional survey carried out between 5 May and 5 June 2021. PARTICIPANTS AND SETTING 4198 individuals from urban and rural settings in Burkina Faso, Guinea, Mali, Senegal and Sierra Leone participated in the survey. STUDY REGISTRATION The general protocol is registered on clinicaltrial.gov. RESULTS Findings show that in West Africa at the time only 53% of all study participants reported to be aware of COVID-19 vaccines, and television (60%, n=1345), radio (56%; n=1258), social media (34%; n=764) and family/friends/neighbours (28%; n=634) being the most important sources of information about COVID-19 vaccines. Adult COVID-19 vaccine acceptance ranges from 60% in Guinea and 50% in Sierra Leone to 11% in Senegal. This is largely congruent with acceptance levels of COVID-19 vaccinations for children. Multivariable regression analysis shows that perceived effectiveness and safety of COVID-19 vaccines increased the willingness to get vaccinated. However, sociodemographic factors, such as sex, rural/urban residence, educational attainment and household composition (living with children and/or elderly), and the other perception parameters were not associated with the willingness to get vaccinated in the multivariable regression model. CONCLUSIONS Primary sources of information about COVID-19 vaccines include television, radio and social media. Communication strategies addressed at the adult population using mass and social media, which emphasise COVID-19 vaccine effectiveness and safety, could encourage greater acceptance also of COVID-19 child vaccinations in sub-Saharan countries. TRIAL REGISTRATION NUMBER NCT04912284.
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Affiliation(s)
- Sylvain Landry B Faye
- Department of Sociology, Université Cheikh Anta Diop Faculté des Lettres et Sciences Humaines, Dakar, Senegal
| | - Ralf Krumkamp
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany, Hamburg, Germany
| | - Seydou Doumbia
- Département d'Enseignement et de Recherche en Santé Publique et Spécialités, Faculté de Médecine et d'OdontoStomatologie- Université des Sciences, des Techniques et des Technologies, USTTB, Bamako, Mali
- University Clinical Research Center (UCRC), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Moctar Tounkara
- Département d'Enseignement et de Recherche en Santé Publique et Spécialités, Faculté de Médecine et d'OdontoStomatologie- Université des Sciences, des Techniques et des Technologies, USTTB, Bamako, Mali
- University Clinical Research Center (UCRC), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Ricardo Strauss
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
| | - Henri Gautier Ouedraogo
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso, Ouagadougou, Centre, Burkina Faso
| | - Tani Sagna
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso, Ouagadougou, Centre, Burkina Faso
| | - Alpha Mahmoud Barry
- Gamal Abdel Nasser University of Conakry. Santé Plus Organization, Conakry, Guinea
| | - Abdul Karim Mbawah
- University of Sierra Leone, College of Medical - Medicine and Allied Health Sciences (COMAHS), Freetown, Western Area, Sierra Leone
| | - Cheick Oumar Doumbia
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany, Hamburg, Germany
- Département d'Enseignement et de Recherche en Santé Publique et Spécialités, Faculté de Médecine et d'OdontoStomatologie- Université des Sciences, des Techniques et des Technologies, USTTB, Bamako, Mali
- University Clinical Research Center (UCRC), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Souleymane Diouf
- Department of Sociology, Université Cheikh Anta Diop Faculté des Lettres et Sciences Humaines, Dakar, Senegal
| | - Kadari Cisse
- Biomedical and Public Health Department, Institut de Recherche en Sciences de la Santé (IRSS), Centre National de la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso, Ouagadougou, Centre, Burkina Faso
| | - Mohamed Harding
- University of Sierra Leone, College of Medical - Medicine and Allied Health Sciences (COMAHS), Freetown, Western Area, Sierra Leone
| | - Paule Donven
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
| | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany, Hamburg, Germany
| | - Dewi Ismajani Puradiredja
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
| | - Daniela Fusco
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany, Hamburg, Germany
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Swahn MH, Robow Z, Umenze F, Balenger A, Dumbili EW, Obot I. A readiness assessment for the prevention of alcohol-related harm in West Africa: A new methodological approach to inform practice and policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103650. [PMID: 35339092 DOI: 10.1016/j.drugpo.2022.103650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/05/2022] [Accepted: 03/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Alcohol-related harm is a growing concern globally and particularly in West Africa. However, tools for assessing the readiness for prevention of alcohol-related harm in low-resource settings have been lacking. We modified the WHO tool, the Readiness Assessment for the Prevention of Child Maltreatment Short Form (RAP-CM), to assess readiness for the prevention of alcohol-related harm across West Africa. METHODS We conducted a cross-sectional survey in the fall of 2020, distributed by the West Africa Alcohol Policy Alliance to their member alliances and stakeholders, predominantly community-based organizations (CBOs) and non-governmental organizations (NGOs), across 7 countries in West Africa (N = 140). The survey included modified measures from the RAP-CM short form. RESULTS In terms of general readiness, the overall adjusted aggregate score for West Africa was 45.0% (ranging from 42.9% in Liberia to 52.7% in Senegal). Of the ten domains assessed (on a 0-10 scale), across all countries, knowledge of alcohol-related harm prevention (8.3) and legislation, mandates, and policies (6.7) received the highest readiness scores. The lowest readiness scores were observed for human and technical resources (2.5), attitudes toward preventing alcohol-related harm (2.7), and the will to address the problem (2.9). CONCLUSIONS Our results demonstrate substantial variability across domains in the readiness to address alcohol-related harm with clear strengths and limitations for future priority setting and capacity building. The barriers to progress include attitudes toward alcohol-related harm prevention, lack of willingness to address the problem, and limited human and technical resources available. These barriers need to be mitigated to address the high burden of alcohol-related harm in the region and to inform both practice and policy.
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Affiliation(s)
- Monica H Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, USA.
| | - Zakaria Robow
- School of Public Health, Georgia State University, USA
| | - Franklin Umenze
- Preston Hospital Lekki, West African Alcohol Policy Alliance, Lagos, Nigeria
| | | | - Emeka W Dumbili
- Institute for Therapy and Health Research, Kiel, Germany, Department of Sociology and Anthropology, Nnamdi Azikiwe University, Anambra State, Nigeria
| | - Isidore Obot
- Centre for Research and Information on Substance Abuse (CRISA), Uyo, Nigeria
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9
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Uneke C, Sombie I, Johnson E, Uneke B, Okolo S. Promoting the use of evidence in health policy-making in the economic commission of the West African States Region: Exploring the perception of policy-makers on the necessity of an evidence-based policy-making guidance. Ann Afr Med 2022; 21:223-230. [DOI: 10.4103/aam.aam_90_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Jesus TS, Castellini G, Gianola S. Global health workforce research: Comparative analyses of the scientific publication trends in PubMed. Int J Health Plann Manage 2021; 37:1351-1365. [PMID: 34897803 DOI: 10.1002/hpm.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/21/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
AIM To analyse the amount of Human Resources for Health (HRH) research publication trends [1990-2019], compared to the broader health policy, systems, and services research (HPSSR). METHODS PubMed and its indexation system with Medical Subject Headings (MeSH) are used for this time-trend study. Searches combine MeSH terms for research publications and HPSSR or HRH subjects, except education. Sub-group searches are conducted on: funding support, and high- versus low- and middle-income countries (HICs vs. LMICs). Linear regressions are used for the analysis. RESULTS HRH research publications rose exponentially (r2 = 0.94; p < 0.001) from 129 yearly publications in 1990, to 867 in 2018. Yet, HRH research publications had a logarithmic decrease (p < 0.001) in percentage of broader HPSSR publications, from 2.5% to 1.5% [1990-2018]. Funding support increased significantly and linearly (p < 0.001 r2 = 0.88), up to 44% in 2018. The percentage of HRH research publications addressing LMICs grew linearly (p < 0.001; r2 = 0.75), up to 23% in 2018. CONCLUSION HRH research publications in the PubMed database increased especially in the more recent years but did not outpace (in earlier times was outpaced) by the growth of HPSSR publications overall. Yearly, HICs still accounted for more than three-quarters of HRH research. These findings can inform global and health research policies.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Lisbon, Portugal.,Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Greta Castellini
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
| | - Silvia Gianola
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
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11
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Jones CM, Gautier L, Ridde V. A scoping review of theories and conceptual frameworks used to analyse health financing policy processes in sub-Saharan Africa. Health Policy Plan 2021; 36:1197-1214. [PMID: 34027987 DOI: 10.1093/heapol/czaa173] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2020] [Indexed: 11/15/2022] Open
Abstract
Health financing policies are critical policy instruments to achieve Universal Health Coverage, and they constitute a key area in policy analysis literature for the health policy and systems research (HPSR) field. Previous reviews have shown that analyses of policy change in low- and middle-income countries are under-theorised. This study aims to explore which theories and conceptual frameworks have been used in research on policy processes of health financing policy in sub-Saharan Africa and to identify challenges and lessons learned from their use. We conducted a scoping review of literature published in English and French between 2000 and 2017. We analysed 23 papers selected as studies of health financing policies in sub-Saharan African countries using policy process or health policy-related theory or conceptual framework ex ante. Theories and frameworks used alone were from political science (35%), economics (9%) and HPSR field (17%). Thirty-five per cent of authors adopted a 'do-it-yourself' (bricolage) approach combining theories and frameworks from within political science or between political science and HPSR. Kingdon's multiple streams theory (22%), Grindle and Thomas' arenas of conflict (26%) and Walt and Gilson's policy triangle (30%) were the most used. Authors select theories for their empirical relevance, methodological rational (e.g. comparison), availability of examples in literature, accessibility and consensus. Authors cite few operational and analytical challenges in using theory. The hybridisation, diversification and expansion of mid-range policy theories and conceptual frameworks used deductively in health financing policy reform research are issues for HPSR to consider. We make three recommendations for researchers in the HPSR field. Future research on health financing policy change processes in sub-Saharan Africa should include reflection on learning and challenges for using policy theories and frameworks in the context of HPSR.
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Affiliation(s)
- Catherine M Jones
- London School of Economics and Political Science, LSE Health, Houghton Street, London WC2A 2AE, UK
| | - Lara Gautier
- Département de Gestion, d'Évaluation et de Politique de Santé, École de Santé Publique de l'Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 7101 avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Valéry Ridde
- Institut de Recherche pour le Développement, Centre Population et Développement - CEPED (IRD-Université de Paris), Université de Paris ERL INSERM SAGESUD, 45 rue des Saints-Peres, Paris 75006, France
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12
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Adetokunboh OO, Mthombothi ZE, Dominic EM, Djomba-Njankou S, Pulliam JRC. African based researchers' output on models for the transmission dynamics of infectious diseases and public health interventions: A scoping review. PLoS One 2021; 16:e0250086. [PMID: 33956823 PMCID: PMC8101744 DOI: 10.1371/journal.pone.0250086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Applied epidemiological models are used in predicting future trends of diseases, for the basic understanding of disease and health dynamics, and to improve the measurement of health indicators. Mapping the research outputs of epidemiological modelling studies concerned with transmission dynamics of infectious diseases and public health interventions in Africa will help to identify the areas with substantial levels of research activities, areas with gaps, and research output trends. METHODS A scoping review of applied epidemiological models of infectious disease studies that involved first or last authors affiliated to African institutions was conducted. Eligible studies were those concerned with the transmission dynamics of infectious diseases and public health interventions. The review was consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for scoping reviews. Four electronic databases were searched for peer-reviewed publications up to the end of April 2020. RESULTS Of the 5927 publications identified, 181 met the inclusion criteria. The review identified 143 publications with first authors having an African institutional affiliation (AIA), while 81 had both first and last authors with an AIA. The publication authors were found to be predominantly affiliated with institutions based in South Africa and Kenya. Furthermore, human immunodeficiency virus, malaria, tuberculosis, and Ebola virus disease were found to be the most researched infectious diseases. There has been a gradual increase in research productivity across Africa especially in the last ten years, with several collaborative efforts spread both within and beyond Africa. CONCLUSIONS Research productivity in applied epidemiological modelling studies of infectious diseases may have increased, but there remains an under-representation of African researchers as leading authors. The study findings indicate a need for the development of research capacity through supporting existing institutions in Africa and promoting research funding that will address local health priorities.
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Affiliation(s)
- Olatunji O. Adetokunboh
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Zinhle E. Mthombothi
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Emanuel M. Dominic
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Sylvie Djomba-Njankou
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Juliet R. C. Pulliam
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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13
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Park JJH, Grais RF, Taljaard M, Nakimuli-Mpungu E, Jehan F, Nachega JB, Ford N, Xavier D, Kengne AP, Ashorn P, Socias ME, Bhutta ZA, Mills EJ. Urgently seeking efficiency and sustainability of clinical trials in global health. Lancet Glob Health 2021; 9:e681-e690. [PMID: 33865473 PMCID: PMC8424133 DOI: 10.1016/s2214-109x(20)30539-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/22/2022]
Abstract
This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current trial planning and designs that are often used in clinical trial research undertaken in low-income and middle-income countries, as an overview of the global health trials landscape. Finally, we discuss the importance of collaborative work in global health research towards generating sustainable and culturally appropriate research environments.
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Affiliation(s)
- Jay J H Park
- Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Fyezah Jehan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa; Department of Epidemiology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology and Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Nathan Ford
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Denis Xavier
- Department of Pharmacology and Division of Clinical Research, St John's Medical College, Bangalore, India
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Per Ashorn
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Maria Eugenia Socias
- Fundación Huésped, Buenos Aires, Argentina; British Columbia Centre for Substance Use, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Institute of Global Health and Development, and Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Edward J Mills
- School of Public Health, University of Rwanda, Kigali, Rwanda; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Cytel, Vancouver, BC, Canada.
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14
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Agyepong IA, Godt S, Sombie I, Binka C, Okine V, Ingabire MG. Strengthening capacities and resource allocation for co-production of health research in low and middle income countries. BMJ 2021; 372:n166. [PMID: 33593725 PMCID: PMC7879269 DOI: 10.1136/bmj.n166] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Irene Akua Agyepong
- Ghana Health Service, Research and Development Division, Dodowa Health Research Center, Dodowa, Ghana
- Ghana College of Physicians and Surgeons, Accra, Ghana
| | | | | | | | - Vicky Okine
- Alliance for Reproductive Health Rights, Accra, Ghana
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15
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Uneke CJ, Sombie I, Johnson E, Uneke BI. Lessons Learned from Strategies for Promotion of Evidence-to-Policy Process in Health Interventions in the ECOWAS Region: A Rapid Review. Niger Med J 2021; 61:227-236. [PMID: 33487844 PMCID: PMC7808283 DOI: 10.4103/nmj.nmj_188_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/04/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022] Open
Abstract
Context: The West African Health Organization (WAHO) is vigorously supporting evidence-informed policymaking (EIPM) in the countries of West Africa. EIPM is increasingly recognized as one of the key strategies that can contribute to health systems strengthening and the improvement of health outcomes. The purpose of this rapid review is to examine two key examples of evidence-based strategies used to successfully implement health interventions in each of the West African countries and to highlight the lessons learned. Methods: A rapid review technique, defined as a type of knowledge synthesis in which systematic review processes are accelerated and methods are streamlined to complete the review more quickly, was used. A PubMed search was conducted using the combination of the following keywords: Health, policy making, evidence, plus name of each of the 15 countries to identify studies that described the process of use of evidence in policymaking in health interventions. Two examples of the publications that fulfilled the study inclusion criteria were selected. Results: Among the key processes used by the countries to promote EIPM in health interventions include policy cycle mechanism and political prioritization, rapid response services, technical advisory group and steering committees (SCs), policy dialog, capacity-strengthening mechanisms, local context evidence and operational guidelines, multisectoral action and consultative process. Conclusion: Various degrees of success have been achieved in by West African countries in the promotion of EIPM. As the science of EIPM continues to evolve and better understanding of the process is gained among policymakers, more studies on effective strategies to improve the evidence-to-policy process are advocated.
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Affiliation(s)
- Chigozie Jesse Uneke
- Department of Health Policy/Systems, African Institute for Health Policy and Health Systems, Ebonyi State University, CAS Campus, Abakaliki, Nigeria
| | - Issiaka Sombie
- Department of Public Health and Research, West African Health Organisation, 175, Avenue Ouezzin Coulibaly, Bobo Dioulasso 01 01 BP 153, Burkina Faso
| | - Ermel Johnson
- Department of Public Health and Research, West African Health Organisation, 175, Avenue Ouezzin Coulibaly, Bobo Dioulasso 01 01 BP 153, Burkina Faso
| | - Bilikis Iyabo Uneke
- Department of Health Policy/Systems, African Institute for Health Policy and Health Systems, Ebonyi State University, CAS Campus, Abakaliki, Nigeria
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16
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Erhabor O, Erhabor T, Adias T, Okara G, Retsky M. Zero tolerance for complacency by government of West African countries in the face of COVID-19. Hum Antibodies 2021; 29:27-40. [PMID: 32417768 PMCID: PMC8150474 DOI: 10.3233/hab-200413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A novel Coronavirus (SARS-CoV-2) causing a cluster of respiratory infections (Coronavirus Disease 2019, COVID-19) first discovered in Wuhan, China, is responsible for a new illness that has been found to affect the lungs and airways of patients with associated symptoms of fever, cough and shortness of breath. In the light of few cases recorded so far in West Africa there is tendency for complacency. The region needs to make strategic plans based on available evidence to enable them effectively deal with this rapidly evolving pandemic. At this very moment countries like China, Italy, France, Spain, Iran, UK and many others are witnessing sustained and intensive community transmission of this virus and increasing numbers of severe disease and death particularly among elderly patients with other comorbidities. The reality of the seriousness of this pandemic is alarming. Government of member states of ECOWAS need to prepare themselves by building capacity as well as implement evidenced-based steps to mitigate this rapidly evolving pandemic by testing persons presenting with symptoms (fever, cough and shortness of breath), isolating and treating those found positive, tracing and quarantining contacts, implementing social distancing as well as optimizing human and material endowment to allow healthcare workers offer safe quality clinical care for affected patients to prevent secondary infection among healthcare workers.
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Affiliation(s)
- O. Erhabor
- Department of Haematology, SMLS, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - T. Erhabor
- Medical Laboratory Science Council of Nigeria, Nigeria
| | - T.C. Adias
- Federal University Otuoke Bayelsa State, Nigeria
| | - G.C. Okara
- West African Postgraduate College of Medical Laboratory Science, Nigeria
| | - M. Retsky
- Harvard School of Public Health, Boston, MA, USA
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17
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Kwamie A, Jalaghonia N. Supporting early-career mentorship for women in Health Policy and Systems Research: a vital input to building the field. Health Policy Plan 2020; 35:i4-i6. [PMID: 33165579 PMCID: PMC7649665 DOI: 10.1093/heapol/czaa105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aku Kwamie
- Alliance for Health Policy and Systems Research, World Health Organisation, 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | - Nanuka Jalaghonia
- Health Systems Global, Curatio International Foundation, 0179 Kavsadze street. 3, Office 5, Tbilisi, Georgia
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18
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Uneke CJ, Sombie I, Johnson E, Uneke BI, Okolo S. Promoting the use of evidence in health policymaking in the ECOWAS region: the development and contextualization of an evidence-based policymaking guidance. Global Health 2020; 16:73. [PMID: 32762759 PMCID: PMC7409627 DOI: 10.1186/s12992-020-00605-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/27/2020] [Indexed: 01/02/2023] Open
Abstract
Background The Economic Commission of the West African States (ECOWAS), through her specialised health Institution, the West African Health Organization (WAHO) is supporting Members States to improve health outcomes in West Africa. There is a global recognition that evidence-based health policies are vital towards achieving continued improvement in health outcomes. The need to have a tool that will provide systematic guide on the use of evidence in policymaking necessitated the production of the evidence-based policy-making (EBPM) Guidance. Methods Google search was performed to identify existing guidance on EBPM. Lessons were drawn from the review of identified guidance documents. Consultation, interaction and interviews were held with policymakers from the 15 West African countries during WAHO organized regional meetings in Senegal, Nigeria, and Burkina Faso. The purpose was to elicit their views on the strategies to promote the use of evidence in policymaking to be included in the EBPM Guidance. A regional Guidance Validation Meeting for West African policymakers was thereafter convened by WAHO to review findings from review of existing guidance documents and validate the EBPM Guidance. Results Out of the 250 publications screened, six publications fulfilled the study inclusion criteria and were reviewed. Among the important issues highlighted include: what evidence informed decision-making is; different types of research methods, designs and approaches, and how to judge the quality of research. The identified main target end users of the EBPM Guidance are policy/decision makers in the West African sub-region, at local, sub-national, national and regional levels. Among the key recommendations included in the EBPM Guidance include: properly defining/refining policy problem; reviewing contextual issues; initiating policy priority setting; considering political acceptability of policy; commissioning research; use of rapid response services, use of policy advisory/technical/steering committees; and use of policy briefs and policy dialogue. Conclusion The EBPM Guidance is one of the emerging tools that can enhance the understanding of evidence to policy process. The strategies to facilitate the use of evidence in policymaking outlined in the Guidance, can be adapted to local context, and incorporated validated approaches that can be used to promote evidence-to-policy-to-practice process in West Africa.
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Affiliation(s)
- Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University, CAS Campus, Abakaliki, PMB 053, Nigeria.
| | - Issiaka Sombie
- West African Health Organisation, 175, Avenue Ouezzin Coulibaly, Bobo Dioulasso, 01 01 BP 153, Burkina Faso
| | - Ermel Johnson
- West African Health Organisation, 175, Avenue Ouezzin Coulibaly, Bobo Dioulasso, 01 01 BP 153, Burkina Faso
| | - Bilikis Iyabo Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University, CAS Campus, Abakaliki, PMB 053, Nigeria
| | - Stanley Okolo
- West African Health Organisation, 175, Avenue Ouezzin Coulibaly, Bobo Dioulasso, 01 01 BP 153, Burkina Faso
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19
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El Bcheraoui C, Mimche H, Miangotar Y, Krish VS, Ziegeweid F, Krohn KJ, Ekat MH, Nansseu JR, Dimbuene ZT, Olsen HE, Tine RCK, Odell CM, Troeger CE, Kassebaum NJ, Farag T, Hay SI, Mokdad AH. Burden of disease in francophone Africa, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GLOBAL HEALTH 2020; 8:e341-e351. [PMID: 32087171 PMCID: PMC7034333 DOI: 10.1016/s2214-109x(20)30024-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 11/07/2019] [Accepted: 01/14/2020] [Indexed: 02/06/2023]
Abstract
Background Peer-reviewed literature on health is almost exclusively published in English, limiting the uptake of research for decision making in francophone African countries. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to assess the burden of disease in francophone Africa and inform health professionals and their partners in the region. Methods We assessed the burden of disease in the 21 francophone African countries and compared the results with those for their non-francophone counterparts in three economic communities: the Economic Community of West African States, the Economic Community of Central African States, and the Southern African Development Community. GBD 2017 employed a variety of statistical models to determine the number of deaths from each cause, through the Cause of Death Ensemble model algorithm, using CoDCorrect to ensure that the number of deaths per cause did not exceed the total number of estimated deaths. After producing estimates for the number of deaths from each of the 282 fatal outcomes included in the GBD 2017 list of causes, the years of life lost (YLLs) due to premature death were calculated. Years lived with disability (YLDs) were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae. Disability-adjusted life-years (DALYs) were calculated as the sum of YLLs and YLDs. All calculations are presented with 95% uncertainty intervals (UIs). A sample of 1000 draws was taken from the posterior distribution of each estimation step; aggregation of uncertainty across age, sex, and location was done on each draw, assuming independence of uncertainty. The lower and upper UIs represent the ordinal 25th and 975th draws of each quantity and attempt to describe modelling as well as sampling error. Findings In 2017, 779 deaths (95% UI 750–809) per 100 000 population occurred in francophone Africa, a decrease of 45·3% since 1990. Malaria, lower respiratory infections, neonatal disorders, diarrhoeal diseases, and tuberculosis were the top five Level 3 causes of death. These five causes were found among the six leading causes of death in most francophone countries. In 2017, francophone Africa experienced 53 570 DALYs (50 164–57 361) per 100 000 population, distributed between 43 708 YLLs (41 673–45 742) and 9862 YLDs (7331–12 749) per 100 000 population. In 2017, YLLs constituted the majority of DALYs in the 21 countries of francophone Africa. Age-specific and cause-specific mortality and population ageing were responsible for most of the reductions in disease burden, whereas population growth was responsible for most of the increases. Interpretation Francophone Africa still carries a high burden of communicable and neonatal diseases, probably due to the weakness of health-care systems and services, as evidenced by the almost complete attribution of DALYs to YLLs. To cope with this burden of disease, francophone Africa should define its priorities and invest more resources in health-system strengthening and in the quality and quantity of health-care services, especially in rural and remote areas. The region could also be prioritised in terms of technical and financial assistance focused on achieving these goals, as much as on demographic investments including education and family planning. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- Charbel El Bcheraoui
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA; Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany.
| | - Honoré Mimche
- Institut de Formation et de Recherche Démographiques, Université de Yaoundé II, Yaoundé, Cameroon
| | - Yodé Miangotar
- Faculté des Sciences Humaines et Sociales, Université de N'Djaména, N'Djaména, Chad
| | - Varsha Sarah Krish
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Faye Ziegeweid
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kris J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Martin Herbas Ekat
- National AIDS Control Program, Ministry of Health and Population, Brazzaville, Congo
| | - Jobert Richie Nansseu
- Department for the Control of Disease, Epidemics and Pandemics, Ministry of Public Health, Yaoundé, Cameroon; Department of Public Heath, Faculty of Medicine and Biomedical Sciences, Université de Yaoundé I, Yaoundé, Cameroon
| | - Zacharie Tsala Dimbuene
- Department of Population Sciences and Development, Faculty of Economics and Management, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; Microdata Access Division, Statistics Canada, Ottawa, ON, Canada
| | | | - Roger C K Tine
- Service de Parasitologie, Faculté de Médecine, de Pharmacie et d'Odontologie, Université Cheikh Anta Diop, Dakar, Senegal
| | - Christopher M Odell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher E Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nicholas J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA
| | - Tamer Farag
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Craveiro I, Carvalho A, Ferrinho P. "Get us partnerships!" - a qualitative study of Angolan and Mozambican health academics' experiences with North/South partnerships. Global Health 2020; 16:33. [PMID: 32295611 PMCID: PMC7161017 DOI: 10.1186/s12992-020-00562-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 03/27/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sustainable Development Goal (SDG) 17 focuses on North/South partnerships for sustainable development. Literature on research partnerships and capacity -building often neglects how these processes are carried out in practice, their social impacts and participants' subjective experiences. Recognizing the increasingly global dimensions of Higher Education Institutions, the University Development and Innovation - Africa project (UDI-A) was designed to train lecturers and administrative staff of Angolan and Mozambican Universities through collaborations with European institutions, aiming at strengthening African academic and social landscapes through knowledge translation and dissemination. This paper examines potential outcomes of UDI-A on participants' academic pathways, investigating the conflict between different imaginaries of capacity-building and partnerships, focusing on how Angolan and Mozambican health sciences researchers experience international collaborations. METHODS Semi-structured interviews were conducted with seven health academics, as well as a focus group discussion involving all participants. These were recorded, fully transcribed, anonymized and coded to identify common themes. A consent form was signed by all participants. RESULTS AND DISCUSSION UDI-A was considered innovative, fostering the improvement of pedagogical skills and increasing social entrepreneurship activities. Participants arrived with a specific institutional mandate and believed that the training received should be incorporated into institutional practices to "modernize" these specific Portuguese speaking African Universities and the health sector. The institutional mechanisms put in place to attain this goal, Centres for Academic Development and Innovation ("CADIs"), were considered potential research and development hubs and drivers of academic and societal transformation. Nevertheless, participants shared a sense of asymmetry (infrastructural, financial, in terms of access to information) between them and European trainers. Although this asymmetry was the underlying basis of this capacity-building project, they argued that UDI-A did not fully acknowledge their local contexts, compromising the prospective development of partnerships in the health field. CONCLUSIONS More attention should be devoted to understanding how participants experience capacity building processes, integrating the diversity of their aspirations and perceptions into subsequent phases of the project, requiring the development of methodological innovations to increase the impact of these programs.
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Affiliation(s)
- Isabel Craveiro
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - António Carvalho
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
- Centre for Social Studies, University of Coimbra, Praça Dom Dinis, 3000-104 Coimbra, Portugal
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
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Jesus TS, Hoenig H, Landry MD. Development of the Rehabilitation Health Policy, Systems, and Services Research field: Quantitative Analyses of Publications over Time (1990-2017) and across Country Type. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E965. [PMID: 32033180 PMCID: PMC7036950 DOI: 10.3390/ijerph17030965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Health policy, systems and services research (HPSSR) is increasingly needed to enable better access to, and value of, rehabilitation services worldwide. We aim to quantify the growth of Rehabilitation HPSSR publications since 1990, compared to that of overall rehabilitation research and overall HPSSR. METHODS Quantitative, comparative analysis of publication trends using the PubMed database and its indexation system. Comprehensive search filters, based on Medical Subject Headings (MeSH), were built and calibrated to locate research articles with content on HPSSR and rehabilitation of physical impairments. Additional filters were used for locating research publications declaring funding support, publications in rehabilitation journals, and finally publications focused on high-income (HICs) or low- and middle-income countries (LMICs). The same approach was used for retrieving data on comparator fields-overall HPSSR and overall rehabilitation research. Linear regressions, with ANOVA, were used for analyzing yearly publication growths over the 28-year time frame. RESULTS Rehabilitation HPSSR publications in PubMed have grown significantly from 1990 to 2017 in the percentage of all rehabilitation research (from 11% to 18%) and all HPSSR (from 2.8% to 3.9%; both p < 0.001). The rate of Rehabilitation HPSSR published in rehabilitation journals did not change significantly over time (p = 0.47). The rates of publications with declared funding support increased significantly, but such growth did not differ significantly from that of the comparator fields. Finally, LMICs accounted for 9.3% of the country-focused rehabilitation HPSSR since 1990, but this percentage value increased significantly (p < 0.001) from 6% in 1990 to 13% in 2017. CONCLUSION Rehabilitation HPSSR publications, i.e., those indexed in PubMed with related MeSH terms, have grown in both absolute and relative values. Rehabilitation HPSSR publications focused on LMICs also grew significantly since 1990, but still remained a tiny portion of the Rehabilitation HPSSR publications with country-specific MeSH terms.
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Affiliation(s)
- Tiago S. Jesus
- Global Health and Tropical Medicine & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, 1349-008 Lisbon, Portugal
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC 27705, USA;
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
| | - Michel D. Landry
- School of Medicine, Duke University, Durham, NC 27710, USA;
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
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Meessen B, Akhnif ELH, Kiendrébéogo JA, Belghiti Alaoui A, Bello K, Bhattacharyya S, Faich Dini HS, Dkhimi F, Dossou JP, Gamble Kelley A, Keugoung B, Millimouno TM, Pfaffmann Zambruni J, Rouve M, Sieleunou I, van Heteren G. Learning for Universal Health Coverage. BMJ Glob Health 2019; 4:e002059. [PMID: 31908875 PMCID: PMC6936401 DOI: 10.1136/bmjgh-2019-002059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/15/2019] [Accepted: 11/17/2019] [Indexed: 12/04/2022] Open
Abstract
The journey to universal health coverage (UHC) is full of challenges, which to a great extent are specific to each country. 'Learning for UHC' is a central component of countries' health system strengthening agendas. Our group has been engaged for a decade in facilitating collective learning for UHC through a range of modalities at global, regional and national levels. We present some of our experience and draw lessons for countries and international actors interested in strengthening national systemic learning capacities for UHC. The main lesson is that with appropriate collective intelligence processes, digital tools and facilitation capacities, countries and international agencies can mobilise the many actors with knowledge relevant to the design, implementation and evaluation of UHC policies. However, really building learning health systems will take more time and commitment. Each country will have to invest substantively in developing its specific learning systemic capacities, with an active programme of work addressing supportive leadership, organisational culture and knowledge management processes.
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Affiliation(s)
| | | | - Joël Arthur Kiendrébéogo
- Department of Public Health, University Joseph Ki-Zerbo,Health Sciences Training and Research Unit, Ouagadougou, Burkina Faso
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Kefilath Bello
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Public Health, Centre de recherche en Reproduction Humaine et en Démographie, Cotonou, Benin
| | - Sanghita Bhattacharyya
- Collective Horizon, New Delhi, India
- Community Health Community of Practice, New Delhi, India
| | | | | | - Jean-Paul Dossou
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Public Health, Centre de recherche en Reproduction Humaine et en Démographie, Cotonou, Benin
| | | | | | - Tamba Mina Millimouno
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | | | - Maxime Rouve
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isidore Sieleunou
- Médecine Sociale et Préventive, Université de Montréal, Ecole de Sante Publique, Montreal, Quebec, Canada
- Collective Horizon, Montreal, Québec, Canada
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Mudie K, Jin MM, Tan, Kendall L, Addo J, Dos-Santos-Silva I, Quint J, Smeeth L, Cook S, Nitsch D, Natamba B, Gomez-Olive FX, Ako A, Perel P. Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies. J Glob Health 2019; 9:020409. [PMID: 31448113 PMCID: PMC6684871 DOI: 10.7189/jogh.09.020409] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. We aimed to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA. Methods We conducted a scoping review to map the extent of current NCDs research in SSA by identifying studies published after the year 2000 using prospectively collected cohort data on any of the six NCDs (cardiovascular diseases, diabetes, obesity, chronic kidney disease, chronic respiratory diseases, and cancers), ≥1 major risk factor (other than age and sex), set only within SSA, enrolled ≥500 participants, and ≥12 months of follow-up with ≥2 data collection points (or with plans to). We performed a systematic search of databases, a manual search of references lists from included articles and the INDEPTH network website, and study investigators from SSA were contacted for further articles. Results We identified 30 cohort studies from the 101 included articles. Eighteen countries distributed in West, Central, East and Southern Africa, were represented. The majority (27%) set in South Africa. There were three studies including children, twenty with adults, and seven with both. 53% of cohorts were sampled in general populations, 47% in clinical populations, and 1 occupational cohort study. Hypertension (n = 23) was most commonly reported, followed by obesity (n = 16), diabetes (n = 15), CKD (n = 6), COPD (n = 2), cervical cancer (n = 3), and breast cancer (n = 1). The majority (n = 22) reported data on at least one demographic/environmental, lifestyle, or physiological risk factor but these data varied greatly. Conclusions Most studies collected data on a combination of hypertension, diabetes, and obesity and few studies collected data on respiratory diseases and cancer. Although most collected data on different risk factors the methodologies varied greatly. Several methodological limitations were found including low recruitment rate, low retention rate, and lack of validated and standardized data collection. Our results could guide potential collaborations and maximize impact to improve our global understanding of NCDs (and their risk factors) in SSA and also to inform future research, as well as policies.
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Affiliation(s)
- Kathleen Mudie
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Melisa Mei Jin
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Biostatistics, GlaxoSmithKline, Stevenage, UK.,Africa NCD Open Lab, Global Health Catalyst, GlaxoSmithKline, Stevenage, UK.,Population and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK.,MRC/UVRI and LSHTM Uganda Research Unit.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa
| | - Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Juliet Addo
- Africa NCD Open Lab, Global Health Catalyst, GlaxoSmithKline, Stevenage, UK
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jennifer Quint
- Population and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Cook
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Dorothea Nitsch
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Francesc Xavier Gomez-Olive
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa
| | - Agbor Ako
- Africa NCD Open Lab, Global Health Catalyst, GlaxoSmithKline, Stevenage, UK
| | - Pablo Perel
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Ekeigwe AA. Drug manufacturing and access to medicines: the West African story. A literature review of challenges and proposed remediation. AAPS OPEN 2019. [DOI: 10.1186/s41120-019-0032-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Maleka EN, Currie P, Schneider H. Research collaboration on community health worker programmes in low-income countries: an analysis of authorship teams and networks. Glob Health Action 2019; 12:1606570. [PMID: 31066343 PMCID: PMC6508047 DOI: 10.1080/16549716.2019.1606570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Global health research partnerships, which promote the exchange of ideas, knowledge and expertise across countries, are considered key to addressing complex challenges facing health systems. Yet, many studies report inequalities in these partnerships, particularly in those between high and low-and-middle-income countries (LMICs). OBJECTIVE This paper examines global research collaborations on community health worker (CHW) programmes, specifically analysing the structures of authorship teams and networks in publications reporting research on CHW programmes in low-income countries (LICs). METHODS A sub-set of 206 indexed journal articles reporting on CHW programmes in LICs was purposefully selected from a prior review of research authorship on CHW programmes in all LMICs over a five year period (2012-2016). Data on country and primary organisational affiliation and number of publications for all individual authors, programme area (e.g. maternal child health) and total citations per paper were extracted and coded in excel spreadsheets. Data were then exported and analysed in Stata/ICV.14 and Gephi. RESULTS The 206 papers were authored by 1045 authors from 299 institutions, based in 43 countries. Half (50.1%) the authors came from LIC-based institutions, 43.8% from high-income country (HIC) institutions, 2.9% from middle-income country (MIC) institutions and 3.2% had different first affiliations in different publications. Authors based in the USA (302) and UK (68) accounted for just over a third (35.4%) of all authors. Partnership patterns revealed a primary mode of North-South collaboration with authors from the US, and to a lesser extent the UK, playing central bridging roles between institutions. Strong network clusters of multiple-affiliated authors were evident in research on MCH and HIV/TB aspects of CHW programmes. CONCLUSION Knowledge production on CHW programmes in LICs flows predominantly through a pool of connected HIC authors and North-South collaborations. There is a need for strategies harnessing more diverse, including South-South, forms of partnership.
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Affiliation(s)
- Elma Nelisiwe Maleka
- a School of Public Health , University of the Western Cape , Cape Town , South Africa
| | - Paul Currie
- b School of Public Leadership , Stellenbosch University , Stellenbosch , South Africa
| | - Helen Schneider
- c School of Public Health & SAMRC/UWC Health Services to Systems Unit , University of the Western Cape , Cape Town , South Africa
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Javadi D, Tran N, Ghaffar A. Building a Workforce for Future Health Systems: Reflections from Health Policy and Systems Research. Health Serv Res 2018; 53 Suppl 2:4024-4033. [PMID: 29797708 PMCID: PMC6149357 DOI: 10.1111/1475-6773.12978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The era of the Sustainable Development Goals calls for multidisciplinary research and intersectoral approaches to addressing health challenges. This presents a unique opportunity for multidisciplinary fields concerned with complex systems. Those working in system-oriented fields such as health policy and systems research (HPSR) and health services research must be forward-thinking in optimizing their collective ability to address these global challenges. OBJECTIVES The objective of this commentary was to share reflections on challenges and strategies in managing the HPSR workforce in order to stimulate dialogue and cross-learning across similar fields. STRATEGIES/FINDINGS The following strategies are discussed here: definitional clarity of expected competencies and coordination across HPS researchers, national investment in HPSR, institutional capacity for coproduction of knowledge across different types of actors, and participatory leadership. CONCLUSIONS Creative approaches in training, financing, developing, and leading the diverse workforce required to strengthen health systems can pave the way for its full-time and part-time members to work together.
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Affiliation(s)
- Dena Javadi
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
| | - Nhan Tran
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
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Schneider H, Maleka N. Patterns of authorship on community health workers in low-and-middle-income countries: an analysis of publications (2012-2016). BMJ Glob Health 2018; 3:e000797. [PMID: 29765777 PMCID: PMC5950650 DOI: 10.1136/bmjgh-2018-000797] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 03/23/2018] [Accepted: 04/06/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction Studies of authorship provide a barometer of local research capacity and ownership of research, considered key to defining appropriate research priorities, developing contextualised responses to health problems and ensuring that research informs policy and practice. This paper reports on an analysis of patterns of research authorship of the now substantial literature on community health workers (CHWs) in low-and-middle-income countries (LMICs) for the 5-year period: 2012–2016. Methods A search of five databases identified a total of 649 indexed publications reporting on CHWs in LMICs and meeting the inclusion criteria. The country, region and income classification of studies, affiliations (country, organisation) of lead (first) and last authors, proportions of all authors locally affiliated, programme area (eg, maternal child health) and funding source were extracted. Results The 649 papers reported experiences from 51 countries, 55% from middle-income countries (MICs) and 32% from low-income countries (LICs), with the remaining 13% multicountry studies. Overall, 47% and 54% of all the papers had a high-income country (HIC) lead and last author, respectively. Authorship followed three patterns: (1) a concentrated HIC pattern, with US-based authors numerically dominating LIC-based and multicountry studies; (2) an MIC pattern of autonomy, with a handful of countries—India, South Africa and Brazil, in particular—leading >70% of their CHW publications and (3) a pattern of unevenness among LICs in their lead authorship of publications varying from 14% (Malawi) to 54% (Uganda). Region, programme area and funding source were all associated with the distribution of authorship across country income categories. Conclusion The findings in this analysis mirror closely that of other authorship studies in global health. Collectively these provide a common message—that investments in global health programmes in the Millennium Development Goal era may have benefited health but not necessarily capacity for knowledge generation in LMICs.
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Affiliation(s)
- Helen Schneider
- School of Public Health and SAMRC/UWC Health Services to Systems Research Unit, University of the Western Cape, Cape Town, South Africa
| | - Nelisiwe Maleka
- School of Public Health, University of the Western Cape, Cape Town, South Africa
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Hanney SR, González-Block MA. 'Knowledge for better health' revisited - the increasing significance of health research systems: a review by departing Editors-in-Chief. Health Res Policy Syst 2017; 15:81. [PMID: 28965493 PMCID: PMC5623979 DOI: 10.1186/s12961-017-0248-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 01/22/2023] Open
Abstract
How can nations organise research investments to obtain the best bundle of knowledge and the maximum level of improved health, spread as equitably as possible? This question was the central focus of a major initiative from WHO led by Prof Tikki Pang, which resulted in a range of developments, including the publication of a conceptual framework for national health research systems - Knowledge for better health - in 2003, and in the founding of the journal Health Research Policy and Systems (HARPS). As Editors-in-Chief of the journal since 2006, we mark our retirement by tracking both the progress of the journal and the development of national health research systems. HARPS has maintained its focus on a range of central themes that are key components of a national health research system in any country. These include building capacity to conduct and use health research, identifying appropriate priorities, securing funds and allocating them accountably, producing scientifically valid research outputs, promoting the use of research in polices and practice in order to improve health, and monitoring and evaluating the health research system. Some of the themes covered in HARPS are now receiving increased attention and, for example, with the assessment of research impact and development of knowledge translation platforms, the journal has covered their progress throughout that expansion of interest. In addition, there is increasing recognition of new imperatives, including the importance of promoting gender equality in health research if benefits are to be maximised. In this Editorial, we outline some of the diverse and developing perspectives considered within each theme, as well as considering how they are held together by the growing desire to build effective health research systems in all countries.From 2003 until mid-June 2017, HARPS published 590 articles on the above and related themes, with authors being located in 76 countries. We present quantitative data tracing the journal's growth and the increasing external recognition of its role. We thank the many colleagues who have kindly contributed to the journal's success, and finish on an exciting note by welcoming the new Editors-in-Chief who will take HARPS forward.
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Affiliation(s)
- Stephen R. Hanney
- Health Economics Research Group, Institute of Environment, Health and Societies, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH United Kingdom
| | - Miguel A. González-Block
- Universidad Anáhuac, Av. Universidad Anáhuac 46, Lomas Anáhuac, 52786 Huixquilucan Mexico City, Mexico
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Abstract
West Africa was the focus of global attention during the Ebola virus disease outbreak, when systemic health system weaknesses compounded a serious emergency and complicated response efforts. Following the crisis, calls were made to strengthen health systems, but investments to date have fallen short of delivering the support needed to build strong health systems able to prevent and manage future outbreaks.In part, this reality serves to highlight the shortcomings of the solutions being repeatedly prioritised by external funders and experts, solutions that often fail to consider the wealth of West African evidence and actors actively working to strengthen the leadership and health systems needed to drive and sustainably improve national health outcomes. Unfortunately, this knowledge and experience are rarely heard in the global arena.This journal supplement is a contribution, although small, to changing this practice by putting the perspectives, experiences and knowledge of West Africans on the table. It presents findings from a series of research and capacity development projects in West Africa funded by the International Development Research Centre's Maternal and Child Health programme (formerly Governance for Equity in Health Systems).The evidence presented here centres around two key themes. First, the theme that context matters. The evidence shows how context can change the shape of externally imposed interventions or policies resulting in unintended outcomes. At the same time, it highlights evidence showing how innovative local actors are developing their own approaches, usually low-cost and embedded in the context, to bring about change. Second, the collection of articles discusses the critical need to overcome the existing fragmentation of expertise, knowledge and actors, and to build strong working relationships amongst all actors so they can effectively work together to identify priority issues that can realistically be addressed given the available windows of opportunity.Vibrant West African-led collaborations amongst researchers, decision-makers and civil society, which are effectively supported by national, regional and global funding, need to foster, strengthen and use locally-generated evidence to ensure that efforts to strengthen health systems and improve regional health outcomes are successful. The solutions are clearly not to be found in the 'travelling models' of standardised interventions.
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Affiliation(s)
- Sue Godt
- Maternal and Child Health Program, International Development Research Centre, PO Box 62084, 00200, Nairobi, Kenya.
| | - Sharmila Mhatre
- Open Society Foundation, New York, NY, 10019, United States of America
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