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Frisendahl C, Looft-Trägårdh E, Cleeve A, Atuhairwe S, Larsson EC, Kakaire O, Kayiga H, Aronsson A, Kihara A, Temmerman M, Klingberg Allvin M, Byamugisha J, Gemzell Danielsson K. Two decades of research capacity strengthening and reciprocal learning on sexual and reproductive health in East Africa - a point of (no) return. Glob Health Action 2024; 17:2353957. [PMID: 38826144 PMCID: PMC11149584 DOI: 10.1080/16549716.2024.2353957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/07/2024] [Indexed: 06/04/2024] Open
Abstract
As the world is facing challenges such as pandemics, climate change, conflicts, and changing political landscapes, the need to secure access to safe and high-quality abortion care is more urgent than ever. On 27th of June 2023, the Swedish government decided to cut funding resources available for developmental research, which has played a fundamental role in the advancement of sexual and reproductive health and rights (SRHR) globally, including abortion care. Withdrawal of this funding not only threatens the fulfilment of the United Nations sustainable development goals (SDGS) - target 3.7 on ensuring universal access to SRHR and target 5 on gender equality - but also jeopardises two decades of research capacity strengthening. In this article, we describe how the partnerships that we have built over the course of two decades have amounted to numerous publications, doctoral graduates, and important advancements within the field of SRHR in East Africa and beyond.
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Affiliation(s)
- Caroline Frisendahl
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Emelie Looft-Trägårdh
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Amanda Cleeve
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Susan Atuhairwe
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Elin C. Larsson
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Othman Kakaire
- Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Herbert Kayiga
- Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Annette Aronsson
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Anne Kihara
- Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Marleen Temmerman
- Department of Obstetrics and Gynecology, Aga Khan University, Nairobi, Kenya
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Marie Klingberg Allvin
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Josaphat Byamugisha
- Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Kristina Gemzell Danielsson
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Peterson SS. Embedded implementation research in programming at scale - the new normal to be! BMC Pediatr 2024; 23:650. [PMID: 38413894 PMCID: PMC10900539 DOI: 10.1186/s12887-023-04470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/06/2023] [Indexed: 02/29/2024] Open
Abstract
If you want to run faster, don't just buy a new pair of shoes; also consider your training methods and where you run.This supplement examines six countries that have run faster than others in reducing under-five mortality, taking an implementation research approach, with country case studies done with local researchers and local institutions. Key generalizable learnings are to choose and adapt implementation strategies to context, design strategies to target the most vulnerable, systematically learn from implementation experience, and to leverage non-health-sector contributions.Embedding implementation research in programming has the potential to greatly improve and accelerate the contextualization and implementation of evidence-based child survival interventions to improve equity in coverage and overall effectiveness in reducing under-five mortality. It is now time to build such capacity in local institutions at scale, and incentives for concerned stakeholders to make this the new normal. Regional institutions should now take the lead in making this happen, not just in individual institutions and countries, but across entire regions, supported by global partners.Trial registration N/A.
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Affiliation(s)
- Stefan Swartling Peterson
- Karolinska Institutet and Uppsala University, Stockholm, Sweden.
- Makerere University, Kampala, Uganda.
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3
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Perrotta C, Downey V, Elabbasy D, Ingram C, Lo C, Naseer A, Thorson A, Brizuela V. Remote training for strengthening capacity in sexual and reproductive health and rights research: a systematic review. BMC Public Health 2023; 23:1964. [PMID: 37817136 PMCID: PMC10566165 DOI: 10.1186/s12889-023-16851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Training has been used to develop research skills among sexual and reproductive health and rights (SRHR) researchers. Remote education may accelerate transfer of skills and reduce barriers to strengthening research capacity. This systematic review aimed to assess the effectiveness of remote training on SRHR research and describe enablers and barriers of effective remote training. METHODS PubMed, Embase, and Scielo were searched up to December 2022 for studies that evaluated in any language online research training programmes either on a SRHR topic or tailored for professionals working in SRHR published since 1990. Characteristics of included studies, the programmes they evaluated, the programme's effectiveness, and reported barriers and enablers to remote learning were extracted. Three researchers synthesized and described findings on effectiveness, impact and outcomes mapping them against the Kirkpatrick model. Additionally, thematic analysis from qualitative data was conducted to identify themes relating to the barriers and enablers of remote learning. RESULTS Of 1,510 articles retrieved, six studies that included 2,058 remote learners met the inclusion criteria. Five out of six studies described empirical improvements in participant research knowledge/skills and three studies reported improvements in attitudes/self-efficacy towards research. Follow-up surveys from four studies revealed frequent application of new research skills and improved opportunities for career advancement and publication following online trainings. Cited barriers to effective online SRHR research training included time management challenges and participants' competing professional obligations; limited opportunities for interaction; and lack of support from home institutions. Cited enablers included well-structured and clear courses, learning objectives and expectations with participants; ensuring a manageable workload; facilitating interactions with mentors and hands-on experience; and selecting programme topics relevant to participants' jobs. CONCLUSION Remote SRHR training can lead to improvements in research knowledge, skills, and attitudes, particularly when course learning objectives, structure, and expectations are outlined clearly, and ongoing mentorship is provided.
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Affiliation(s)
- Carla Perrotta
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland.
| | - Vicky Downey
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Darin Elabbasy
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Carolyn Ingram
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Chungwan Lo
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Amara Naseer
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Anna Thorson
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, CH, Switzerland
| | - Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, CH, Switzerland
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4
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Cichocki MN, Chung WT, Chung KC. Equity in Global Health Research. Plast Reconstr Surg 2023; 151:687-692. [PMID: 36989337 DOI: 10.1097/prs.0000000000009978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Affiliation(s)
- Meghan N Cichocki
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - William T Chung
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Kevin C Chung
- From the Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
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Ibe C, Otu AA, Mnyambwa NP. Advancing disease genomics beyond COVID-19 and reducing health disparities: what does the future hold for Africa? Brief Funct Genomics 2022; 22:241-249. [DOI: 10.1093/bfgp/elac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
The COVID-19 pandemic has ushered in high-throughput sequencing technology as an essential public health tool. Scaling up and operationalizing genomics in Africa is crucial as enhanced capacity for genome sequencing could address key health problems relevant to African populations. High-quality genomics research can be leveraged to improve diagnosis, understand the aetiology of unexplained illnesses, improve surveillance of infectious diseases and inform efficient control and therapeutic methods of known, rare and emerging infectious diseases. Achieving these within Africa requires strong commitment from stakeholders. A roadmap is needed to guide training of scientists, infrastructural development, research funding, international collaboration as well as promote public–private partnerships. Although the COVID-19 pandemic has significantly boosted genomics capacity in Africa, the continent still lags other regions. Here, we highlighted key initiatives in genomics research and efforts to address health challenges facing the diverse and fast-growing populations on the continent. We explore the scalability of genomic tools and techniques to tackle a broader range of infectious diseases in Africa, a continent that desperately requires a boost from genomic science.
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Affiliation(s)
- Chibuike Ibe
- Abia State University Department of Microbiology, Faculty of Biological Sciences, , Uturu, Nigeria
| | | | - Nicholaus P Mnyambwa
- National Institute for Medical Research , Muhimbili Research Centre, Dar es Salaam , Tanzania
- Alliance for Africa Health and Research (A4A), Dar es Salaam , Tanzania
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Rajabzadeh V, McGrath M, Van Loggerenberg F, Bird VJ, Priebe S. What are the expectations and experiences of a GMH research programme delivered in Bosnia-Herzegovina, Colombia and Uganda? A prospective longitudinal qualitative study. BMJ Open 2022; 12:e059590. [PMID: 36691243 PMCID: PMC9171268 DOI: 10.1136/bmjopen-2021-059590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/09/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Global health research collaborations between partners in high-income countries and low-income and middle-income countries (LMICs) aim to generate new evidence, strengthen research capacity, tackle health inequalities and improve outcomes. Previous evaluations of such programmes have identified areas for improvement but consisted only of retrospective experiences. We conducted the first prospective study to assess the initial expectations as well as the final experiences of participants of a global health research programme. DESIGN, SETTINGS AND PARTICIPANTS This study adopted a prospective longitudinal qualitative study, 38 participants of a global mental health research programme with partners in Bosnia-Herzegovina, Colombia, Uganda and the (UK). The interviewees included senior investigators, coordinators and researchers. Framework analysis was used to analyse the data. OUTCOME MEASURES Participants were interviewed about their initial expectations at the inception of the research programme and their final experiences at the end. RESULTS Many of the original expectations were later reported as met or even exceeded. They included experiences of communication, relationships, developed research expertise, further research opportunities and extending networks. However, other expectations were not met or only partially met, mainly on developing local leadership, strengthening institutional research capacity and opportunities for innovation and for mutual learning. Around equity of partnership and ownership of research the views of participants in the UK tended to be more critical than those of partners in LMICs. CONCLUSIONS The findings suggest that global health research programmes can achieve several of their aims, and that partners in LMICs feel equity has been established in the partnership despite the imbalance of the funding arrangement. Aims of global health research projects should have a realistic focus and be proportionate to the parameters of the funding arrangement. More resources and longer time scales may be required to address sustainable structural capacity and long-standing local leadership sufficiently.
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Affiliation(s)
- Vian Rajabzadeh
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Michael McGrath
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Francois Van Loggerenberg
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Victoria Jane Bird
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
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Tirupakuzhi Vijayaraghavan BK, Gupta E, Ramakrishnan N, Beane A, Haniffa R, Lone N, de Keizer N, Adhikari NKJ. Barriers and facilitators to the conduct of critical care research in low and lower-middle income countries: A scoping review. PLoS One 2022; 17:e0266836. [PMID: 35511911 PMCID: PMC9071139 DOI: 10.1371/journal.pone.0266836] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Improvements in health-related outcomes for critically ill adults in low and lower-middle income countries need systematic investments in research capacity and infrastructure. High-quality research has been shown to strengthen health systems; yet, research contributions from these regions remain negligible or absent. We undertook a scoping review to describe barriers and facilitators for the conduct of critical care research.
Methods
We searched MEDLINE and EMBASE up to December 2021 using a strategy that combined keyword and controlled vocabulary terms. We included original studies that reported on barriers or facilitators to the conduct of critical care research in these settings. Two reviewers independently reviewed titles and abstracts, and where necessary, the full-text to select eligible studies. For each study, reviewers independently extracted data using a standardized data extraction form. Barriers and facilitators were classified along the lines of a previous review and based on additional themes that emerged. Study quality was assessed using appropriate tools.
Results
We identified 2693 citations, evaluated 49 studies and identified 6 for inclusion. Of the included studies, four were qualitative, one was a cross-sectional survey and one was reported as an ‘analysis’. The total number of participants ranged from 20–100 and included physicians, nurses, allied healthcare workers and researchers. Barriers identified included limited funding, poor institutional & national investment, inadequate access to mentors, absence of training in research methods, limited research support staff, and absence of statistical support. Our review identified potential solutions such as developing a mentorship network, streamlining of regulatory processes, implementing a centralized institutional research agenda, developing a core-outcome dataset and enhancing access to low-cost technology.
Conclusion
Our scoping review highlights important barriers to the conduct of critical care research in low and lower-middle income countries, identifies potential solutions, and informs researchers, policymakers and governments on the steps necessary for strengthening research systems.
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Affiliation(s)
| | - Ena Gupta
- Department of Pulmonary and Critical Care Medicine, Einstein Health Network, Philadelphia, Pennsylvania, United States of America
| | | | - Abi Beane
- Mahidol-Oxford Tropical Research Unit, Bangkok, Thailand
| | - Rashan Haniffa
- Mahidol-Oxford Tropical Research Unit, Bangkok, Thailand
- Department of Anaesthesia and Critical Care Medicine, University College London, London, United Kingdom
| | - Nazir Lone
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nicolette de Keizer
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Neill K. J. Adhikari
- Interdepartmental Division of Critical Care Medicine, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
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Rodríguez-Gómez I, Gray SR, Ho FK, Petermann-Rocha F, Welsh P, Cleland J, Iliodromiti S, Ara I, Pell J, Sattar N, Ferguson LD, Celis-Morales C. Osteoporosis and Its Association With Cardiovascular Disease, Respiratory Disease, and Cancer: Findings From the UK Biobank Prospective Cohort Study. Mayo Clin Proc 2022; 97:110-121. [PMID: 34996542 DOI: 10.1016/j.mayocp.2021.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate sex-specific associations of osteoporosis with incidence of and mortality from cardiovascular disease (CVD), respiratory disease, and cancer as well as with all-cause mortality. METHODS In total, 305,072 participants (53% [161,383] women) of UK Biobank were included in this study (2007-2010). Self-reported diagnosis of osteoporosis at baseline was the exposure of interest. The outcomes were CVD, respiratory disease, chronic obstructive pulmonary disease (COPD), all cancer, and prostate and breast cancer incidence and mortality and all-cause mortality. Associations between osteoporosis and outcomes were investigated using Cox proportional hazards models. RESULTS In men, osteoporosis was associated with a higher incident risk of all respiratory diseases (hazard ratio [HR], 1.26; 95% CI, 1.06 to 1.50) including COPD (HR, 1.82; 95% CI, 1.38 to 2.40). Men with osteoporosis also had a higher mortality risk from all causes (HR, 1.71; 95% CI, 1.38 to 2.11), CVD (HR, 1.68; 95% CI, 1.19 to 2.37), respiratory disease (HR, 2.35; 95% CI, 1.70 to 3.24), and COPD (HR, 3.64; 95% CI, 2.24 to 5.91). These associations persisted after adjustment for age, body mass index, and comorbidities. Women with osteoporosis had a higher risk of incident CVD (HR, 1.24; 95% CI, 1.97 to 1.44), respiratory disease (HR, 1.23; 95% CI, 1.13 to 1.33), and COPD (HR, 1.29; 95% CI, 1.10 to 1.52). Women with osteoporosis also had a higher mortality risk from respiratory disease (HR, 1.31; 95% CI, 1.00 to 1.72) and breast cancer (HR, 1.60; 95% CI, 1.14 to 2.26). CONCLUSION Compared with women, men with osteoporosis had a higher risk of all-cause mortality, mortality from respiratory diseases including COPD, and cancer incidence. Osteoporosis was strongly associated with respiratory disease and COPD in both sexes, even after full adjustment for covariates, although men with osteoporosis experienced a higher risk of adverse outcomes.
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Affiliation(s)
- Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - John Cleland
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Stamatina Iliodromiti
- Centre for Women's Health, Institute of Population Health Sciences, Queen Mary University London, London, United Kingdom
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Jill Pell
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Naveed Sattar
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Lyn D Ferguson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom; Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago, Chile; Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
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Noormahomed EV, Mandane A, Cuambe A, Rodrigues MA, Noormahomed S, Carrilho C, Mocumbi AO, Ali M, Vintuar P, Ismail M, Guilundo C, Bickler S, Benson CA, Ferrão JL, Schooley RT. Design and Implementation of Postgraduate Programs in Health in a Resource-Limited Setting in Mozambique (The Lúrio University). ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:399-412. [PMID: 33911914 PMCID: PMC8075734 DOI: 10.2147/amep.s291364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/22/2021] [Indexed: 05/06/2023]
Abstract
PURPOSE To describe the strategies used to design and implement three postgraduate programs at Lúrio University (UniLúrio), a resource-limited setting, in northern Mozambique. METHODS We conducted a longitudinal, descriptive case study from 2011 to 2018 in two phases: 1) needs assessment (2011-2012), 2) implementation strategies (2013-2018), taking into account innovations whenever necessary. RESULTS Several obstacles and barriers to the establishment of postgraduate programs were identified. These included a lack of a core curricula aimed at postgraduate programs, shortage of human resources for teaching and mentorship, limited teaching and research infrastructures, limited financial resources, and lack of administrative capacity. With the support of the Medical Education Partnership Initiative (MEPI), three Master degree programs were designed and implemented. During the period of 2013-2018, UniLúrio enrolled 202 students, distributed as follows: Master degree in Tropical Medicine and Global Health (55), Master degree in Health Professional Education (99), and Master degree in Nutrition and Food Security (48). Of those, 152 (75.2%) obtained a Postgraduate Diploma as they did not present a master dissertation, 89 (44.0%) obtained their Master degree, 30 (14.8%) dropped out, and 20 (9.9%) are awaiting decision. UniLurio's staff trained a Master's degree or a Postgraduate Diploma in 34 (16.8%) and 15 (7.4%), respectively. Our strategies allowed us to improve research capacity building, and set the basis for long-term sustainability by allowing for the establishment of other postgraduate programs, and offered UniLurio a strong role in its internationalization. CONCLUSION By sharing multiple resources, long-lasting partnerships were established with multiple institutions, and competency-based training and postgraduate studies management were developed. Research and eLearning were leveraged, retention and faculty development was enhanced, and some inequalities within the country were reduced. These strategies and innovations can be applied to other resource-limited settings, allowing the scaleup of health professional's training and research capacity building.
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Affiliation(s)
- Emília Virgínia Noormahomed
- Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Department of Medicine, Infectious Disease Division, School of Medicine, University of California, San Diego, CA, USA
- Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique
| | - Amélia Mandane
- Department of Public Health, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique
| | - Agnesse Cuambe
- Department of Public Health, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique
| | | | - Sérgio Noormahomed
- Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique
| | - Carla Carrilho
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Ana Olga Mocumbi
- Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique
- Department of Chronic Diseases, National Institute of Health, Maputo, Mozambique
| | - Momade Ali
- Department of Public Health, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique
| | - Pompilio Vintuar
- Department of Public Health, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique
| | - Mamudo Ismail
- Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Carvalho Guilundo
- Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique
| | - Stephen Bickler
- Department of Surgery, School of Medicine, University of California, San Diego, CA, USA
| | - Constance A Benson
- Department of Medicine, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, California, USA
| | - Jorge Luis Ferrão
- Department of Public Health, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique
- Office of the Rector, Maputo Pedagogic University, Maputo, Mozambique
| | - Robert T Schooley
- Department of Medicine, Infectious Disease Division, School of Medicine, University of California, San Diego, CA, USA
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Igwaran A, Edoamodu CE. Bibliometric Analysis on Tuberculosis and Tuberculosis-Related Research Trends in Africa: A Decade-Long Study. Antibiotics (Basel) 2021; 10:antibiotics10040423. [PMID: 33921235 PMCID: PMC8069363 DOI: 10.3390/antibiotics10040423] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/02/2022] Open
Abstract
Tuberculosis is one of the oldest known diseases and the leading communicable cause of deaths worldwide. Although several studies have been carried out on tuberculosis, no research has examined the publication trends in this area. Hence, this study aimed to fill the gap by conducting a bibliometric study in publications trends on tuberculosis and tuberculosis-related studies in Africa from 2010–2019 and explore the hotspots. Information in published documents on tuberculosis and its related studies from 2010 to 2019 were retrieved from the Web of Science (WoS) database. The bibliometric tool biblioshiny and Microsoft Excel 2016 were used to analyse the top leading journals, top cited documents, authors’ country production, country collaboration networks, most relevant authors, authors’ impacts, most relevant authors by corresponding author, most cited countries, university collaborations, most relevant affiliations, conceptual structural maps, title word co-occurrence networks, collaboration and significance of individual sources, university, country and keyword relations. A total of 3945 published documents were retrieved. The analyses showed that European Respiratory Journal was the leading journal in publications on tuberculosis studies with a total of 452 published articles, the WHO 2012 report was the most cited document with 2485 total citations while South Africa was the most productive country in tuberculosis publications as well as the leading country with the highest co-authorship collaboration. Analysis of top relevant authors revealed that Anonymous (133) and Dheda (44) were the two topmost relevant authors of tuberculosis publications, South Africa was the most relevant country by corresponding authors and the topmost cited country for tuberculosis publications. Furthermore, analysis of the university collaborations network showed that the University of Cape Town was the topmost university in Africa with the highest collaboration network, tuberculosis as a word had the highest co-occurrence network while the Three Field Plot diagram revealed the relations between universities, keywords and countries. This study provides a quantitative and qualitative analyses of the leading journals, most cited published articles, title word occurrences, and most relevant authors in published documents on tuberculosis and tuberculosis related studies from 2010–2019.
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Viruses in Extreme Environments, Current Overview, and Biotechnological Potential. Viruses 2021; 13:v13010081. [PMID: 33430116 PMCID: PMC7826561 DOI: 10.3390/v13010081] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/14/2020] [Accepted: 12/29/2020] [Indexed: 12/27/2022] Open
Abstract
Virus research has advanced significantly since the discovery of the tobacco mosaic virus (TMV), the characterization of its infection mechanisms and the factors that determine their pathogenicity. However, most viral research has focused on pathogenic viruses to humans, animals and plants, which represent only a small fraction in the virosphere. As a result, the role of most viral genes, and the mechanisms of coevolution between mutualistic viruses, their host and their environment, beyond pathogenicity, remain poorly understood. This review focuses on general aspects of viruses that interact with extremophile organisms, characteristics and examples of mechanisms of adaptation. Finally, this review provides an overview on how knowledge of extremophile viruses sheds light on the application of new tools of relevant use in modern molecular biology, discussing their value in a biotechnological context.
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12
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Seo SW, Ombengi D, Sultan DH, Kahaleh AA, Nonyel N, Karwa R, Abrons J, Lukas S, Singhal M, Miller M, Truong HA. An ethics-based approach to global health research part 1: Building partnerships in global health. Res Social Adm Pharm 2020; 16:1574-1579. [PMID: 32952088 DOI: 10.1016/j.sapharm.2020.08.022] [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: 02/18/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 01/23/2023]
Abstract
Global health partnerships (GHPs) can be the cornerstone for advancing research and public health. The steps to build a global research partnership focus on sharing a common research agenda, identifying key partners in the community, and establishing goals and expectations for partnerships. Moreover, upholding important values, such as communication, trust, and transparency is essential for building successful partnerships. Ethical dilemmas can propose challenges to researchers in global health. These challenges can be overcome by creating a shared vision for a research agenda, maintaining communication, and providing bidirectional training.
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Affiliation(s)
- See-Won Seo
- Albany College of Pharmacy and Health Sciences, 106 New Scotland Ave, Albany, NY, 12208, USA.
| | - David Ombengi
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Dawood H Sultan
- Mercer University College of Health Professions, 3001 Mercer University Drive, Atlanta, GA, 30341, USA.
| | - Abby A Kahaleh
- Roosevelt University College of Pharmacy, 1400 N Roosevelt Blvd, Schaumburg, IL, 13 60173, USA.
| | - Nkem Nonyel
- University of Maryland, Eastern Shore School of Pharmacy and Health Professions, Hazel Hall, Room 1041, Princess Anne, MD, 21853, USA.
| | - Rakhi Karwa
- Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN, 47907, USA.
| | - Jeanine Abrons
- University of Iowa College of Pharmacy, 180 S Grand Avenue, CP 354, Iowa City, IA, 52241, USA.
| | - Stephanie Lukas
- St. Louis College of Pharmacy, St. Louis, Missouri, 4588 Parkview Place, St. Louis, MO, 63110-1088, USA.
| | - Mudit Singhal
- D'Youville School of Pharmacy, 320 Porter Avenue, Buffalo, NY, 14201, USA.
| | - Monica Miller
- Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN, 47906, USA.
| | - Hoai-An Truong
- University of Maryland Eastern Shore, School of Pharmacy and Health Professions, 1 College Backbone Road, Princess Anne, MD, 21853, USA.
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13
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Siddiqi S, Aftab W, Siddiqui FJ, Huicho L, Mogilevskii R, Friberg P, Lindgren-Garcia J, Causevic S, Khamis A, Shah MM, Bhutta ZA. Global strategies and local implementation of health and health-related SDGs: lessons from consultation in countries across five regions. BMJ Glob Health 2020; 5:e002859. [PMID: 32900695 PMCID: PMC7478033 DOI: 10.1136/bmjgh-2020-002859] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/13/2022] Open
Abstract
Evidence on early achievements, challenges and opportunities would help low-income and middle-income countries (LMICs) accelerate implementation of health and health-related sustainable development goals (HHSDGs). A series of country-specific and multicountry consultative meetings were conducted during 2018-2019 that involved 15 countries across five regions to determine the status of implementation of HHSDGs. Almost 120 representatives from health and non-health sectors participated. The assessment relied on a multidomain analytical framework drawing on existing public health policy frameworks. During the first 5 years of the sustainable development goals (SDGs) era, participating LMICs from South and Central Asia, East Africa and Latin America demonstrated growing political commitment to HHSDGs, with augmentation of multisectoral institutional arrangements, strengthening of monitoring systems and engagement of development partners. On the other hand, there has been limited involvement of civic society representatives and academia, relatively few capacity development initiatives were in place, a well-crafted communication strategy was missing, and there is limited evidence of additional domestic financing for implementing HHSDGs. While the momentum towards universal health coverage is notable, explicit linkages with non-health SDGs and integrated multisectoral implementation strategies are lacking. The study offers messages to LMICs that would allow for a full decade of accelerated implementation of HHSDGs, and points to the need for more implementation research in each domain and for testing interventions that are likely to work before scale-up.
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Affiliation(s)
- Sameen Siddiqi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Wafa Aftab
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Fahad Javaid Siddiqui
- Centre for Global Child Health, Hospital for Sick Children SickKids Learning Institute, Toronto, Ontario, Canada
- The Academia, Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Luis Huicho
- Centro de Inveswtigaciónn en Salud Materna e Infantil, Lima, Peru
| | - Roman Mogilevskii
- Institute of Public Policy and Administration, University of Central Asia, Bishkek, Kyrgyzstan
| | - Peter Friberg
- Department of Physiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Sara Causevic
- Swedish Institute for Global Health Transformation (SIGHT), Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anil Khamis
- Institute for Human Development & Institue for Educational Development, Aga Khan University, Karachi, Pakistan
- Institute of Education, University College London, London, UK
| | - Mashal Murad Shah
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar Ahmed Bhutta
- Centre for Global Child Health, Hospital for Sick Children SickKids Learning Institute, Toronto, Ontario, Canada
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
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14
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Nakanjako D, Zalwango F, Wairagala P, Luboga F, Andia Biraro I, Bukirwa VD, Mboowa MG, Cose S, Seeley J, Elliott A. Career development for infection and immunity research in Uganda: a decade of experience from the Makerere University - Uganda Virus Research Institute research and training programme. AAS Open Res 2020; 3:26. [PMID: 32734140 PMCID: PMC7372530 DOI: 10.12688/aasopenres.13066.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
Background: The Makerere University/Uganda Virus Research Institute (UVRI) Centre of Excellence for Infection & Immunity Research and Training (MUII) is a collaborative programme supporting excellence in Infection and Immunity (I&I) research in Uganda. Set up in 2008, MUII aims to produce internationally competitive Ugandan and East African I&I research leaders, and develop human and infrastructural resources to support research and training excellence. We undertook an internal evaluation of MUII’s achievements, challenges and lessons learned between 08-2008 and 12-2019, to inform programmes seeking to build Africa’s health research expertise. Methods: Quantitative data were abstracted from programme annual reports. Qualitative data were obtained in 03-04/2019: a cross-sectional evaluation was undertaken among a purposefully selected representative sample of 27 trainees and two programme staff. Qualitative data was analysed according to pre-determined themes of achievements, challenges, lessons learned and recommendations for improvement. Results: By 12-2019, MUII had supported 68 fellowships at master’s-level and above (50% female: 23 Masters, 27 PhD, 15 post-doctoral, three group-leaders) and over 1,000 internships. Fellows reported career advancement, mentorship by experts, and improved research skills and outputs. Fellows have published over 300 papers, secured grants worth over £20m, established over 40 international collaborations, and taken on research and academic leadership positions in the country. Key lessons were: i) Efficient administration provides a conducive environment for high quality research; ii) Institutions need supportive policies for procurement, including provisions for purchases of specific biological research reagents from international manufacturers; iii) Strong international and multi-disciplinary collaboration provides a critical mass of expertise to mentor researchers in development; and iv) Mentorship catalyses young scientists to progress from graduate trainees to productive academic researchers, relevant to society’s most pressing health challenges. Conclusions: Sustainable academic productivity can be achieved through efficient operational support, global collaboration and mentorship to provide solutions to Africa’s health challenges.
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Affiliation(s)
- Damalie Nakanjako
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda.,Department of Medicine, School of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Flavia Zalwango
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit,, Uganda Virus Research Institute, Entebbe, Uganda
| | - Pamela Wairagala
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit,, Uganda Virus Research Institute, Entebbe, Uganda
| | - Fiona Luboga
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda
| | - Irene Andia Biraro
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda.,Department of Medicine, School of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Victoria Diana Bukirwa
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda
| | - Mary Gorrethy Mboowa
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda
| | - Steve Cose
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit,, Uganda Virus Research Institute, Entebbe, Uganda
| | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit,, Uganda Virus Research Institute, Entebbe, Uganda.,Global Health and Development Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Alison Elliott
- Makerere University-Uganda Virus Research Institute Infection and Immunity (MUII), Uganda Virus Research Institute, Entebbe, Uganda.,Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit,, Uganda Virus Research Institute, Entebbe, Uganda
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15
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Nakanjako D, Zalwango F, Wairagala P, Luboga F, Andia Biraro I, Bukirwa VD, Mboowa MG, Cose S, Seeley J, Elliott A. Career development for infection and immunity research in Uganda: a decade of experience from the Makerere University – Uganda Virus Research Institute research and training programme. AAS Open Res 2020; 3:26. [DOI: 10.12688/aasopenres.13066.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The Makerere University/Uganda Virus Research Institute (UVRI) Centre of Excellence for Infection & Immunity Research and Training (MUII) is a collaborative programme supporting excellence in Infection and Immunity (I&I) research in Uganda. Set up in 2008, MUII aims to produce internationally competitive Ugandan and East African I&I research leaders, and develop human and infrastructural resources to support research and training excellence. We undertook an internal evaluation of MUII’s achievements, challenges and lessons learned between August 2008 and December 2019, to inform programmes seeking to build Africa’s health research expertise. Methods: Quantitative data were abstracted from programme annual reports. Qualitative data were obtained in March and April 2019: a cross-sectional evaluation was undertaken among a purposefully selected representative sample of 27 trainees and two programme staff. Qualitative data was analysed according to pre-determined themes of achievements, challenges, lessons learned and recommendations for improvement. Results: By December 2019, MUII had supported 68 fellowships at master’s-level and above (50% female: 23 Masters, 27 PhD, 15 post-doctoral, three group-leader fellows) and over 1,000 internships. Fellows reported career advancement, mentorship by experts, and improved research skills and outputs. Fellows have published over 300 papers, secured grants worth over £20m, established over 40 international collaborations, and taken on research and academic leadership positions in the country. Key lessons for success include the following: efficient administration provides an enabling environment; institutions need supportive policies for procurement, including provisions for purchases of specific biological research reagents from international manufacturers; strong international, multi-disciplinary collaboration provides a critical mass of expertise to mentor researchers in development; and mentorship catalyses young scientists to progress from graduate trainees to productive academic researchers, relevant to society’s most pressing health challenges. Conclusions: Sustainable academic productivity can be achieved through efficient operational support, global collaboration and mentorship to provide solutions to Africa’s health challenges.
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16
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Leresche E, Truppa C, Martin C, Marnicio A, Rossi R, Zmeter C, Harb H, Hamadeh RS, Leaning J. Conducting operational research in humanitarian settings: is there a shared path for humanitarians, national public health authorities and academics? Confl Health 2020; 14:25. [PMID: 32435274 PMCID: PMC7222467 DOI: 10.1186/s13031-020-00280-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
In humanitarian contexts, it is a difficult and multi-faceted task to enlist academics, humanitarian actors and health authorities in a collaborative research effort. The lack of research in such settings has been widely described in the past decade, but few have analysed the challenges in building strong and balanced research partnerships. The major issues include considering operational priorities, ethical imperatives and power differentials. This paper analyses in two steps a collaborative empirical endeavour to assess health service utilization by Syrian refugee and Lebanese women undertaken by the International Committee of the Red Cross (ICRC), the Lebanese Ministry of Public Health (MoPH) and the Harvard François-Xavier Bagnoud (FXB) Center. First, based on challenges documented in the literature, we shed light on how we negotiated appropriate research questions, methodologies, bias analyses, resource availability, population specificities, security, logistics, funding, ethical issues and organizational cultures throughout the partnership. Second, we describe how the negotiations required each partner to go outside their comfort zones. For the academics, the drivers to engage included the intellectual value of the collaboration, the readiness of the operational partners to conduct an empirical investigation and the possibility that such work might lead to a better understanding in public health terms of how the response met population needs. For actors responding to the humanitarian crisis (the ICRC and the MOPH), participating in a technical collaboration permitted methodological issues to be worked through in the context of deliberations within the wider epistemic community. We find that when they collaborate, academics, humanitarian actors and health authorities deploy their respective complementarities to build a more comprehensive approach. Barriers such as the lack of uptake of research results or weak links to the existing literature were overcome by giving space to define research questions and develop a longer-term collaboration involving individual and institutional learning. There is the need ahead of time to create balanced decision-making mechanisms, allow for relative financial autonomy, and define organizational responsibilities. Ultimately, mutual respect, trust and the recognition of each other's expertise formed the basis of an initiative that served to better understand populations affected by conflict and meet their needs.
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Affiliation(s)
- Enrica Leresche
- International Committee of the Red Cross Delegation, Beirut, Lebanon
| | - Claudia Truppa
- International Committee of the Red Cross Delegation, Beirut, Lebanon
| | - Christophe Martin
- International Committee of the Red Cross Delegation, Beirut, Lebanon
| | | | - Rodolfo Rossi
- International Committee of the Red Cross, Geneva, Switzerland
| | - Carla Zmeter
- International Committee of the Red Cross Delegation, Beirut, Lebanon
| | - Hilda Harb
- Lebanese Ministry of Public Health, Beirut, Lebanon
| | | | - Jennifer Leaning
- Harvard François Xavier Bagnoud Center for Health and Human Rights, Boston, USA
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17
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Zember J. Pediatric Radiology Fellowship Creation as an International Education Outreach Effort in Ethiopia. J Grad Med Educ 2020; 12:98-103. [PMID: 32089800 PMCID: PMC7012509 DOI: 10.4300/jgme-d-19-00291.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/14/2019] [Accepted: 10/14/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In 2008, there were no pediatric radiologists in Ethiopia, a country of 100 million people. The radiology residency programs lacked training in pediatric imaging acquisition and interpretation. OBJECTIVE We established an accredited local pediatric radiology fellowship program in Ethiopia. METHODS With assistance from US faculty from the Children's Hospital of Philadelphia, Ethiopian radiologists created a 2-year fellowship training program in a university-based Ethiopian radiology residency program that incorporated formal lectures and seminars, case tutorials, journal clubs, teleradiological conferences, paper presentations, and online courses from collaborating institutions. Formal accreditation of the program was achieved from the university, and core values were established to ensure sustainability and self-sufficiency. The Ethiopian institution provided funding for the fellows, and US faculty volunteered their time. RESULTS In 2015, 2 radiologists were recruited to the new fellowship; after graduation in 2017, they formed the first pediatric radiology section at the Ethiopian institution. Three new fellows were recruited in 2019, and the program is now self-sustaining. Pediatric imaging training has also been added to the radiology residency. CONCLUSIONS Establishing a pediatric radiology fellowship in a country with high need but little existing faculty expertise is feasible through outreach efforts.
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Abstract
The emigration of physicians and scientists from resource-constrained countries decreases the country's ability to undertake research. Re-establishing research environments and increasing capacity reduced by these losses are important, particularly in the health sciences. One mechanism for re-establishing strong health sciences research is the introduction of an Alumni Diaspora Fellowship Programme. We define the beneficial effects of a successful single partnership in an Alumni Diaspora Programme. This Host/Alumnus collaboration demonstrates that bi-directional advantages have accrued for both the Host Institution situated in a resource-constrained country and the Alumni's Institution, located in a high-income country. In addition to expanding research in the resource-constrained country, collaborations expanded to other faculty beyond the Alumnus in the sending Institution, in multiple fields including those not readily available in the high-income country (HIV, TB, malaria). The environment at the host Institution in the resource-constrained country has been enriched by increased research publications, training of young scholars (over 200 trained in manuscript and grant application writing), and substantial advances in biomedical informatics. There has been considerable knowledge exchange and development between both Institutions, showing that 'brain circulation' and Diaspora Programmes are valuable strategies for expanding research.
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Affiliation(s)
- Beverley Kramer
- a School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Roy Zent
- b Division of Nephrology and Hypertension, Department of Medicine , Nashville , TN , USA.,c Department of Cell and Developmental Biology, Vanderbilt University Medical Center , Nashville , TN , USA.,d Veterans Affairs Hospital , Nashville , TN , USA
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19
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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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van Olmen J, Delobelle P, Guwatudde D, Absetz P, Sanders D, Mölsted Alvesson H, Puoane T, Ostenson CG, Tomson G, Mayega RW, Sundberg CJ, Peterson S, Daivadanam M. Using a cross-contextual reciprocal learning approach in a multisite implementation research project to improve self-management for type 2 diabetes. BMJ Glob Health 2018; 3:e001068. [PMID: 30555727 PMCID: PMC6267315 DOI: 10.1136/bmjgh-2018-001068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 11/16/2022] Open
Abstract
This paper reports on the use of reciprocal learning for identifying, adopting and adapting a type 2 diabetes self-management support intervention in a multisite implementation trial conducted in a rural setting in a low-income country (Uganda), a periurban township in a middle-income country (South Africa) and socioeconomically disadvantaged suburbs in a high-income country (Sweden). The learning process was guided by a framework for knowledge translation and structured into three learning cycles, allowing for a balance between evidence, stakeholder interaction and contextual adaptation. Key factors included commitment, common goals, leadership and partnerships. Synergistic outcomes were the cocreation of knowledge, interventions and implementation methods, including reverse innovations such as adaption of community-linked models of care. Contextualisation was achieved by cross-site exchanges and local stakeholder interaction to balance intervention fidelity with local adaptation. Interdisciplinary and cross-site collaboration resulted in the establishment of learning networks. Limitations of reciprocal learning relate to the complexity of the process with unpredictable outcomes and the limited generalisability of results.
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Affiliation(s)
- Josefien van Olmen
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Peter Delobelle
- Chronic Disease Initiative for Africa, Faculty of Health Sciences - University of Cape Town, Cape Town, South Africa
- School of Public Health, University of Western Cape, Bellville, South Africa
| | - David Guwatudde
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Pilvikki Absetz
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Collaborative Care Systems Finland, Helsinki, Finland
| | - David Sanders
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | | | - Thandi Puoane
- School of Public Health, University of Western Cape, Bellville, South Africa
| | - Claes-Goran Ostenson
- Department of Molecular Medicine and Surgery, Diabetes and Endocrine Unit, Karolinska Institutet, Stockholm, Sweden
| | - Göran Tomson
- Department of Public Health Sciences, Karolinska Institutet and Swedish Institute for Global Health Transformation (SIGHT), Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Roy William Mayega
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Carl Johan Sundberg
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Peterson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Uppsala University, Uppsala, Sweden
| | - Meena Daivadanam
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Dept of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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21
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Virgínia Noormahomed E, Carrilho C, Ismail M, Noormahomed S, Nguenha A, Benson CA, Mocumbi AO, Schooley RT. The Medical Education Partnership Initiative (MEPI), a collaborative paradigm for institutional and human resources capacity building between high- and low- and middle-income countries: the Mozambique experience. Glob Health Action 2018; 10:1272879. [PMID: 28452653 PMCID: PMC5328351 DOI: 10.1080/16549716.2017.1272879] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Collaborations among researchers based in lower and middle income countries (LMICs) and high income countries (HICs) have made major discoveries related to diseases disproportionately affecting LMICs and have been vital to the development of research communities in LMICs. Such collaborations have generally been scientifically and structurally driven by HICs. Objectives: In this report we outline a paradigm shift in collaboration, exemplified by the Medical Education Partnership Initiative (MEPI), in which the formulation of priorities and administrative infrastructure reside in the LMIC. Methods: This descriptive report outlines the critical features of the MEPI partnership. Results: In the MEPI, LMIC program partners translate broad program goals and define metrics into priorities that are tailored to local conditions. Program funds flow to a LMIC-based leadership group that contracts with peers from HICs to provide technical and scientific advice and consultation in a 'reverse funds flow' model. Emphasis is also placed on strengthening administrative capacity within LMIC institutions. A rigorous monitoring and evaluation process modifies program priorities on the basis of evolving opportunities to maximize program impact. Conclusions: Vesting LMIC partners with the responsibility for program leadership, and building administrative and fiscal capacity in LMIC institutions substantially enhances program relevance, impact and sustainability.
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Affiliation(s)
- Emília Virgínia Noormahomed
- a Department of Microbiology, Faculty of Medicine , Universidade Eduardo Mondlane , Maputo , Mozambique.,b Department of Medicine, Infectious Disease Division , University of California , San Diego , CA , USA.,c Reitoria , Universidade Lurio , Nampula , Mozambique.,d Department of Planning and Cooperation , Mozambique Institute for Health Education and Research (MIHER/MEPI) , Maputo , Mozambique
| | - Carla Carrilho
- d Department of Planning and Cooperation , Mozambique Institute for Health Education and Research (MIHER/MEPI) , Maputo , Mozambique.,e Department of Pathology, Faculty of Medicine , Universidade Eduardo Mondlane , Maputo , Mozambique
| | - Mamudo Ismail
- d Department of Planning and Cooperation , Mozambique Institute for Health Education and Research (MIHER/MEPI) , Maputo , Mozambique.,e Department of Pathology, Faculty of Medicine , Universidade Eduardo Mondlane , Maputo , Mozambique
| | - Sérgio Noormahomed
- f Department of Administration and Finance , Mozambique Institute for Health and Research (MIHER/MEPI) , Maputo , Mozambique
| | - Alcido Nguenha
- f Department of Administration and Finance , Mozambique Institute for Health and Research (MIHER/MEPI) , Maputo , Mozambique
| | - Constance A Benson
- b Department of Medicine, Infectious Disease Division , University of California , San Diego , CA , USA
| | - Ana Olga Mocumbi
- d Department of Planning and Cooperation , Mozambique Institute for Health Education and Research (MIHER/MEPI) , Maputo , Mozambique.,g Department of Non Communicable Diseases , Instituto Nacional de Saúde , Maputo , Mozambique.,h Department of Medicine, Faculty of Medicine , Universidade Eduardo Mondlane , Maputo , Mozambique
| | - Robert T Schooley
- b Department of Medicine, Infectious Disease Division , University of California , San Diego , CA , USA
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22
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Ongolo-Zogo P, Lavis JN, Tomson G, Sewankambo NK. Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study. Health Policy Plan 2018; 33:539-554. [PMID: 29506146 PMCID: PMC5894086 DOI: 10.1093/heapol/czx194] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 12/21/2022] Open
Abstract
There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for EIHSP.
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Affiliation(s)
- Pierre Ongolo-Zogo
- Centre for Development of Best Practices in Health, Central Hospital Yaoundé, University of Yaoundé 1, Avenue H Dunant, Messa, Cameroon.,Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
| | - John N Lavis
- Department of Health Research Methods, Evidence and Impact, McMaster Health Forum, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON L8S 4L6, Canada.,Department of Political Science, McMaster University, 1280 Main Street West, MML-417, Hamilton, ON L8S 4L6, Canada and
| | - Goran Tomson
- Departments of Learning, Informatics, Management, Ethics and Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Stockholm SE 171 77, Sweden
| | - Nelson K Sewankambo
- Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda
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23
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Boum Ii Y, Burns BF, Siedner M, Mburu Y, Bukusi E, Haberer JE. Advancing equitable global health research partnerships in Africa. BMJ Glob Health 2018; 3:e000868. [PMID: 30167335 PMCID: PMC6112391 DOI: 10.1136/bmjgh-2018-000868] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/22/2018] [Accepted: 06/29/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yap Boum Ii
- Epicentre, Yaoundé, Cameroun.,Mbarara University of Science and Technology, Mbarara, Uganda
| | - Bridget F Burns
- MGH Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mark Siedner
- MGH Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Yvonne Mburu
- Independent Public Health Consultant, Paris, France
| | | | - Jessica E Haberer
- Epicentre, Yaoundé, Cameroun.,Mbarara University of Science and Technology, Mbarara, Uganda.,MGH Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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24
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Mboowa G, Mwesigwa S, Katagirya E, Retshabile G, Mlotshwa BC, Williams L, Kekitiinwa A, Kateete D, Wampande E, Wayengera M, Kintu BN, Kisitu GP, Kyobe S, Brown CW, Hanchard NA, Mardon G, Joloba M, Anabwani G, Pettitt E, Tsimako-Johnstone M, Kasvosve I, Maplanka K, Mpoloka SW, Hlatshwayo M, Matshaba M. The Collaborative African Genomics Network (CAfGEN): Applying Genomic technologies to probe host factors important to the progression of HIV and HIV-tuberculosis infection in sub-Saharan Africa. AAS Open Res 2018; 1:3. [PMID: 30714022 PMCID: PMC6358002 DOI: 10.12688/aasopenres.12832.2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2018] [Indexed: 01/25/2023] Open
Abstract
Background: Here, we describe how the Collaborative African Genomics Network ( CAfGEN) of the Human Heredity and Health in Africa (H3Africa) consortium is using genomics to probe host genetic factors important to the progression of HIV and HIV-tuberculosis (TB) coinfection in sub-Saharan Africa. The H3Africa was conceived to facilitate the application of genomics technologies to improve health across Africa.. Methods: CAfGEN is an H3Africa collaborative centre comprising expertise from the University of Botswana; Makerere University; Baylor College of Medicine Children's Clinical Centers of Excellence (COEs) in Botswana, Uganda, and Swaziland; as well as Baylor College of Medicine, Texas. The COEs provide clinical expertise for community engagement, participant recruitment and sample collection while the three University settings facilitate processing and management of genomic samples and provide infrastructure and training opportunities to sustain genomics research. Results: The project has focused on utilizing whole-exome sequencing to identify genetic variants contributing to extreme HIV disease progression phenotypes in children, as well as RNA sequencing and integrated genomics to identify host genetic factors associated with TB disease progression among HIV-positive children. These cohorts, developed using the COEs' electronic medical records, are exceptionally well-phenotyped and present an unprecedented opportunity to assess genetic factors in individuals whose HIV was acquired by a different route than their adult counterparts in the context of a unique clinical course and disease pathophysiology. Conclusions: Our approach offers the prospect of developing a critical mass of well-trained, highly-skilled, continent-based African genomic scientists. To ensure long term genomics research sustainability in Africa, CAfGEN contributes to a wide range of genomics capacity and infrastructure development on the continent, has laid a foundation for genomics graduate programs at its institutions, and continues to actively promote genomics research through innovative forms of community engagement brokered by partnerships with governments and academia to support genomics policy formulation.
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Affiliation(s)
- Gerald Mboowa
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Savannah Mwesigwa
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Eric Katagirya
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gaone Retshabile
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | - Busisiwe C Mlotshwa
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | - Lesedi Williams
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | | | - David Kateete
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Eddie Wampande
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Bio-molecular Resources, College of Veterinary Medicine, Makerere University, Kampala, Uganda
| | - Misaki Wayengera
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Betty Nsangi Kintu
- Baylor College of Medicine Children's Foundation-Uganda, Kampala, Uganda
| | - Grace P Kisitu
- Baylor College of Medicine Children's Foundation-Uganda, Kampala, Uganda
| | - Samuel Kyobe
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Chester W Brown
- Genetics Division, Department of Pediatrics , University of Tennessee Health Science Center, Memphis, Memphis, TN, USA.,Le Bonheur Children's Hospital, Memphis, Memphis, TN, USA.,St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Neil A Hanchard
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.,ARS/USDA/Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine , Houston, TX, USA
| | - Graeme Mardon
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Moses Joloba
- Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gabriel Anabwani
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.,Baylor College of Medicine Children's Foundation-Swaziland, Mbabane, Swaziland
| | - Ed Pettitt
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
| | - Masego Tsimako-Johnstone
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | - Ishmael Kasvosve
- Department of Medical Laboratory Sciences, University of Botswana, Gaborone, Botswana
| | - Koketso Maplanka
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | - Sununguko W Mpoloka
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | | | - Mogomotsi Matshaba
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.,Pediatric Retrovirology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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25
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González-Alcaide G, Salinas A, Ramos JM. Scientometrics analysis of research activity and collaboration patterns in Chagas cardiomyopathy. PLoS Negl Trop Dis 2018; 12:e0006602. [PMID: 29912873 PMCID: PMC6023249 DOI: 10.1371/journal.pntd.0006602] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/28/2018] [Accepted: 06/10/2018] [Indexed: 12/18/2022] Open
Abstract
Background Chagas cardiomyopathy is a serious and common complication of Chagas disease. Methods Through bibliometric and Social Network Analysis, we examined patterns of research on Chagas cardiomyopathy, identifying the main countries, authors, research clusters, and topics addressed; and measuring the contribution of different countries. Results We found 1932 documents on Chagas cardiomyopathy in the MEDLINE database. The most common document type was ‘journal article’, accounting for 79.6% of the total (n = 1538), followed by ‘review’ (n = 217, 11.2%). The number of published records increased from 156 in 1980–1984 to 311 in 2010–2014. Only 2.5% were clinical trials. Brazil and the USA dominated the research, participating in 53.1% and 25.7%, respectively, of the documents. Other Latin American countries where Chagas is endemic contributed less, with Bolivia, where Chagas disease is most prevalent, producing only 1.8% of the papers. We observed a high rate of domestic collaboration (83.1% of the documents published in 2010–2016) and a lower but significant rate of international collaboration (32.5% in the same time period). Although clinical research dominated overall, the USA, Mexico and several countries in Europe produced a considerable body of basic research on animal models. We identified four main research clusters, focused on heart failure and dysfunction (physical symptoms, imaging techniques, treatment), and on myocarditis and parasitemia in animal models. Conclusions Research on Chagas cardiomyopathy increased over the study period. There were more clinical than basic studies, though very few of the documents were clinical trials. Brazil and the USA are currently leading the research on this subject, while some highly endemic countries, such as Bolivia, have contributed very little. Different approaches could help to redress this imbalance: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research. Scientific production on Chagas cardiomyopathy has grown considerably since the turn of the 21st century, probably reflecting the increased incidence of Chagas disease in non-endemic areas like the USA and Europe. Brazil and the USA dominate the research, but we found a very small proportion of clinical trials on Chagas cardiomyopathy and a low scientific production in several endemic countries with a high prevalence of the disease such as Colombia, Chile, Mexico and Bolivia. We observed a polarity between endemic and non-endemic countries where clinical research and basic research predominate, respectively. Different approaches could help to redress the observed imbalance of research on Chagas cardiomyopathy: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research. It is crucial to foster translational research in order to link basic knowledge on the physiology of the disease with clinical applications in diagnosis and treatment.
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Affiliation(s)
- Gregorio González-Alcaide
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain
- * E-mail:
| | | | - José M. Ramos
- Department of Clinical Medicine, Miguel Hernández University of Elche, Alicante, Spain
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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26
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Manabe YC, Nambooze H, Okello ES, Kamya MR, Katabira ET, Ssinabulya I, Kaddumukasa M, Nabunnya Y, Bollinger RC, Sewankambo NK. Group Mentorship Model to Enhance the Efficiency and Productivity of PhD Research Training in Sub-Saharan Africa. Ann Glob Health 2018; 84:170-175. [PMID: 30873808 PMCID: PMC6748251 DOI: 10.29024/aogh.25] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION High quality PhD training in sub-Saharan Africa is important to strengthen research evidence to advance development and health. Training a critical mass of independent investigators capable of original scientific research requires strong mentorship, research environments, and international networks. We sought to iteratively improve a PhD training model in Uganda through systems capacity building. METHODS PhD students were selected through a rigorous competitive application and selection process, which included a written proposal and a face-to-face panel interview. The program provided administrative support, paid tuition fees, tools (space, equipment, research money), skills (short research courses on study design, biostatistics, manuscript and grant writing), and infrastructure (finance, grants management support, and lab infrastructure). Guidance to identify local and international mentorship was also provided in addition to two to three group meetings per year where data was presented and progress assessed by the program leaders in addition to available local mentors. RESULTS Seventeen PhD students were selected, and fifteen will complete training through the MEPI-MESAU program. To date, 60% have completed, including 2 students who started 2 years into the program. So far, 169 publications have been published in the peer-reviewed literature. Our PhD students have supervised and mentored 65 Master's students, which illustrates the cascade effect of PhD training on the academic medical school environment. CONCLUSIONS The systems capacity building approach to PhD training is an efficient and productive training model that allowed strong outputs at lower cost and with relatively few additional mentors to rapidly achieve a critical mass of independent scientists able to conduct original research and mentor others.
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Affiliation(s)
- Yukari C Manabe
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, UG.,Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, US
| | - Harriet Nambooze
- MEPI-MESAU Secretariat, Makerere University College of Health Sciences, UG
| | - Elialilia S Okello
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
| | - Moses R Kamya
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
| | - Elly T Katabira
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
| | - Isaac Ssinabulya
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
| | - Yvonne Nabunnya
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
| | - Robert C Bollinger
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, US
| | - Nelson K Sewankambo
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, UG
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27
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Mboowa G, Mwesigwa S, Katagirya E, Retshabile G, Mlotshwa BC, Williams L, Kekitiinwa A, Kateete D, Wampande E, Wayengera M, Kintu BN, Kisitu GP, Kyobe S, Brown CW, Hanchard NA, Mardon G, Joloba M, Anabwani G, Pettitt E, Tsimako-Johnstone M, Kasvosve I, Maplanka K, Mpoloka SW, Hlatshwayo M, Matshaba M. The Collaborative African Genomics Network (CAfGEN): Applying Genomic technologies to probe host factors important to the progression of HIV and HIV-tuberculosis infection in sub-Saharan Africa. AAS Open Res 2018; 1:3. [DOI: 10.12688/aasopenres.12832.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: The Human Heredity and Health in Africa consortium (H3Africa) was conceived to facilitate the application of genomics technologies to improve health across Africa. Here, we describe how the Collaborative African Genomics Network (CAfGEN) of the H3Africa consortium is using genomics to probe host genetic factors important to the progression of HIV and HIV-tuberculosis (TB) coinfection in sub-Saharan Africa. Methods: CAfGEN is an H3Africa collaborative centre comprising expertise from the University of Botswana; Makerere University; Baylor College of Medicine Children’s Clinical Centers of Excellence (COEs) in Botswana, Uganda, and Swaziland; as well as Baylor College of Medicine, Texas. The COEs provide clinical expertise for community engagement, participant recruitment and sample collection while the three University settings facilitate processing and management of genomic samples and provide infrastructure and training opportunities to sustain genomics research. Results: The project has focused on utilizing whole-exome sequencing to identify genetic variants contributing to extreme HIV disease progression phenotypes in children, as well as RNA sequencing and integrated genomics to identify host genetic factors associated with TB disease progression among HIV-positive children. These cohorts, developed using the COEs’ electronic medical records, are exceptionally well-phenotyped and present an unprecedented opportunity to assess genetic factors in individuals whose HIV was acquired by a different route than their adult counterparts in the context of a unique clinical course and disease pathophysiology. Conclusions: Our approach offers the prospect of developing a critical mass of well-trained, highly-skilled, continent-based African genomic scientists. To ensure long term genomics research sustainability in Africa, CAfGEN contributes to a wide range of genomics capacity and infrastructure development on the continent, has laid a foundation for genomics graduate programs at its institutions, and continues to actively promote genomics research through innovative forms of community engagement brokered by partnerships with governments and academia to support genomics policy formulation.
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28
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Bell L, Calder B, Hiller R, Klein A, Soares NC, Stoychev SH, Vorster BC, Tabb DL. Challenges and Opportunities for Biological Mass Spectrometry Core Facilities in the Developing World. J Biomol Tech 2018; 29:4-15. [PMID: 29623005 DOI: 10.7171/jbt.18-2901-003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The developing world is seeing rapid growth in the availability of biological mass spectrometry (MS), particularly through core facilities. As proteomics and metabolomics becomes locally feasible for investigators in these nations, application areas associated with high burden in these nations, such as infectious disease, will see greatly increased research output. This article evaluates the rapid growth of MS in South Africa (currently approaching 20 laboratories) as a model for establishing MS core facilities in other nations of the developing world. Facilities should emphasize new services rather than new instruments. The reduction of the delays associated with reagent and other supply acquisition would benefit both facilities and the users who make use of their services. Instrument maintenance and repair, often mediated by an in-country business for an international vendor, is also likely to operate on a slower schedule than in the wealthiest nations. A key challenge to facilities in the developing world is educating potential facility users in how best to design experiments for proteomics and metabolomics, what reagents are most likely to introduce problematic artifacts, and how to interpret results from the facility. Here, we summarize the experience of 6 different institutions to raise the level of biological MS available to researchers in South Africa.
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Affiliation(s)
- Liam Bell
- Centre for Proteomic and Genomic Research, Observatory, Cape Town 7925, South Africa
| | - Bridget Calder
- University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Reinhard Hiller
- Centre for Proteomic and Genomic Research, Observatory, Cape Town 7925, South Africa
| | - Ashwil Klein
- University of the Western Cape, Bellville, Cape Town 7925, South Africa
| | - Nelson C Soares
- University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Stoyan H Stoychev
- Council for Scientific and Industrial Research, Pretoria 0001, South Africa
| | - Barend C Vorster
- Centre for Human Metabolomics, North-West University, Potchefstroom 2520, South Africa; and
| | - David L Tabb
- Department of Science and Technology/National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa
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29
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Research gaps and emerging priorities in sexual and reproductive health in Africa and the eastern Mediterranean regions. Reprod Health 2018; 15:39. [PMID: 29506534 PMCID: PMC5838932 DOI: 10.1186/s12978-018-0484-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/20/2018] [Indexed: 12/02/2022] Open
Abstract
Background In-country research capacity is key to creating improvements in local implementation of health programs and can help prioritize health issues in a landscape of limited funding. Research prioritization has shown to be particularly useful to help answer strategic and programmatic issues in health care, including sexual and reproductive health (SRH). The purpose of this paper is to present the results of a priority setting exercise that brought together researchers and program managers from the WHO Africa and Eastern Mediterranean regions to identify key SRH issues. Methods In June 2015, researchers and program managers from the WHO Africa and Eastern Mediterranean regions met for a three-day meeting to discuss strategies to strengthen research capacity in the regions. A prioritization exercise was carried out to identify key priority areas for research in SRH. The process included five criteria: answerability, effectiveness, deliverability and acceptability, potential impact of the intervention/program to improve reproductive, maternal and newborn health substantially, and equity. Results The six main priorities identified include: creation and investment in multipurpose prevention technologies, addressing adolescent violence and early pregnancy (especially in the context of early marriage), improved maternal and newborn emergency care, increased evaluation and improvement of adolescent health interventions including contraception, further focus on family planning uptake and barriers, and improving care for mothers and children during childbirth. Conclusion The setting of priorities is the first step in a dynamic process to identify where research funding should be focused to maximize health benefits. The key elements identified in this exercise provides guidance for decision makers to focus action on identified research priorities and goals. Prioritization and identifying/acting on research gaps can have great impact across multiple sectors in the regions for improved reproductive, maternal and children health.
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30
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Steenhoff AP, Crouse HL, Lukolyo H, Larson CP, Howard C, Mazhani L, Pak-Gorstein S, Niescierenko ML, Musoke P, Marshall R, Soto MA, Butteris SM, Batra M. Partnerships for Global Child Health. Pediatrics 2017; 140:peds.2016-3823. [PMID: 28931576 DOI: 10.1542/peds.2016-3823] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 11/24/2022] Open
Abstract
Child mortality remains a global health challenge and has resulted in demand for expanding the global child health (GCH) workforce over the last 3 decades. Institutional partnerships are the cornerstone of sustainable education, research, clinical service, and advocacy for GCH. When successful, partnerships can become self-sustaining and support development of much-needed training programs in resource-constrained settings. Conversely, poorly conceptualized, constructed, or maintained partnerships may inadvertently contribute to the deterioration of health systems. In this comprehensive, literature-based, expert consensus review we present a definition of partnerships for GCH, review their genesis, evolution, and scope, describe participating organizations, and highlight benefits and challenges associated with GCH partnerships. Additionally, we suggest a framework for applying sound ethical and public health principles for GCH that includes 7 guiding principles and 4 core practices along with a structure for evaluating GCH partnerships. Finally, we highlight current knowledge gaps to stimulate further work in these areas. With awareness of the potential benefits and challenges of GCH partnerships, as well as shared dedication to guiding principles and core practices, GCH partnerships hold vast potential to positively impact child health.
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Affiliation(s)
- Andrew P Steenhoff
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania; .,Department of Paediatric and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Heather L Crouse
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Heather Lukolyo
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Charles P Larson
- British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Cynthia Howard
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Loeto Mazhani
- Department of Paediatric and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Suzinne Pak-Gorstein
- Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, Washington
| | - Michelle L Niescierenko
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Philippa Musoke
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Roseda Marshall
- Department of Pediatrics, Dogliotti School of Medicine, University of Liberia, Monrovia, Liberia
| | - Miguel A Soto
- Department of Pediatrics, Hospital Nacional Pedro Bethancourt, La Antigua, Guatemala; and
| | - Sabrina M Butteris
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Maneesh Batra
- Department of Pediatrics, Seattle Children's Hospital and University of Washington, Seattle, Washington
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31
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Ali F, Shet A, Yan W, Al-Maniri A, Atkins S, Lucas H. Doctoral level research and training capacity in the social determinants of health at universities and higher education institutions in India, China, Oman and Vietnam: a survey of needs. Health Res Policy Syst 2017; 15:76. [PMID: 28865472 PMCID: PMC5581921 DOI: 10.1186/s12961-017-0225-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/28/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Research capacity is scarce in low- and middle-income country (LMIC) settings. Social determinants of health research (SDH) is an area in which research capacity is lacking, particularly in Asian countries. SDH research can support health decision-makers, inform policy and thereby improve the overall health and wellbeing of the population. In order to continue building this capacity, we need to know to what extent training exists and how challenges could be addressed from the perspective of students and staff. This paper aims to describe the challenges involved in training scholars to undertake research on the SDH in four Asian countries - China, India, Oman and Vietnam. METHODS In-depth interviews were conducted with research scholars, research supervisors and principal investigators (n = 13) at ARCADE partner institutions, which included eight universities and research institutes. In addition, structured questionnaires (n = 70) were used to collect quantitative data relating to the courses available, teaching and supervisory capacity, and related issues for students being trained in research on SDH. Simple descriptive statistics were calculated from the quantitative data and thematic analysis applied to the qualitative data. RESULTS We identified a general lack of training courses focusing on SDH. Added to this, PhD students studying related areas reported inadequate supervision, with limited time allocated to meetings and poor interpersonal communication. Supervisors cited interpersonal communication problems and student lack of skills to perform high quality research as challenges to research training. Further challenges reported included a lack of research funding to include SDH-related topics. Finally, it was suggested that there was a need for institutions to define clear and appropriate standards regarding admission and supervision of students to higher education programs awarding doctoral degrees. CONCLUSIONS There are gaps in training for research on the SDH at the surveyed universities and research institutes, which are likely to also be present in other Asian countries and their higher education institutions. Some of the barriers to high quality research and research training can be addressed by improved training for supervisors, clearly defined standards of supervision, finances for student stipends, and increased use of information and communication technology to increase access to teaching materials. Increased opportunities for online learning could be provided.
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Affiliation(s)
- Farhad Ali
- Health Advisor, Save the Children, Delhi, India
| | - Arun Shet
- Hematology Research Division, St. Johns Research Institute Department of Medical Oncology, St. Johns Medical College and Hospital, Sarjapur Road, Bangalore, 560034 India
| | - Weirong Yan
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden
| | | | - Salla Atkins
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden
- Faculty of Medicine and Life Sciences, University of Tampere, PO Box 100, Tampere, Finland
| | - Henry Lucas
- Institute of Development Studies, UK Library Road, Brighton, BN1 9RE United Kingdom
| | - for the ARCADE consortium
- Health Advisor, Save the Children, Delhi, India
- Hematology Research Division, St. Johns Research Institute Department of Medical Oncology, St. Johns Medical College and Hospital, Sarjapur Road, Bangalore, 560034 India
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden
- Road Safety Research Programme The Research Council, Muscat, Oman
- Institute of Development Studies, UK Library Road, Brighton, BN1 9RE United Kingdom
- Faculty of Medicine and Life Sciences, University of Tampere, PO Box 100, Tampere, Finland
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González-Alcaide G, Park J, Huamaní C, Ramos JM. Dominance and leadership in research activities: Collaboration between countries of differing human development is reflected through authorship order and designation as corresponding authors in scientific publications. PLoS One 2017; 12:e0182513. [PMID: 28792519 PMCID: PMC5549749 DOI: 10.1371/journal.pone.0182513] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Scientific collaboration is an important mechanism that enables the integration of the least developed countries into research activities. In the present study, we use the order of author signatures and addresses for correspondence in scientific publications as variables to analyze the interactions between countries of very high (VHHD), high (HHD), medium (MHD), and low human development (LHD). Methodology We identified all documents published between 2011 and 2015 in journals included in the Science Citation Index-Expanded categories’ of Tropical Medicine, Infectious Diseases, Parasitology, and Pediatrics. We then classified the countries participating in the publications according to their Human Development Index (HDI), analyzing the international collaboration; positioning and influence of some countries over others in cooperative networks; their leadership; and the impact of the work based on the HDI and the type of collaboration. Results We observed a high degree of international collaboration in all the areas analyzed, in the case of both LHD and MHD countries. We identified numerous cooperative links between VHHD countries and MHD/LHD countries, reflecting the fact that cooperative links are an important mechanism for integrating research activities into the latter. The countries with large emerging economies, such as Brazil and China stand out due to the dominance they exert in the collaborations established with the United States, the UK, and other European countries. The analysis of the leadership role of the countries, measured by the frequency of lead authorships, shows limited participation by MHD/LHD countries. This reduced participation among less developed countries is further accentuated by their limited presence in the addresses for correspondence. We observed significant statistical differences in the degree of citation according to the HDI of the participating countries. Conclusions The order of signatures and the address for correspondence in scientific publications are bibliographic characteristics that facilitate a precise, in-depth analysis of cooperative practices and their associations with concepts like dominance or leadership. This is useful to monitor the existing balance in research participation in health research publications.
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Affiliation(s)
- Gregorio González-Alcaide
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain
- * E-mail:
| | - Jinseo Park
- Korea Institute of Science and Technology Information (KISTI), Daejeon, South Korea
| | - Charles Huamaní
- Servicio de Neurología, Hospital Nacional Guillermo Almenara, La Victoria, Perú
| | - José M. Ramos
- Department of Clinical Medicine, Miguel Hernández University of Elche de Elche, Alicante, Spain
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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Nakanjako D, Akena D, Kaye DK, Tumwine J, Okello E, Nakimuli A, Kambugu A, McCullough H, Mayanja-Kizza H, Kamya MR, Sewankambo NK. A need to accelerate health research productivity in an African University: the case of Makerere University College of Health Sciences. Health Res Policy Syst 2017; 15:33. [PMID: 28431554 PMCID: PMC5399829 DOI: 10.1186/s12961-017-0196-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 04/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the last decade, Makerere University College of Health Sciences (MakCHS) has taken strides in research and training to improve healthcare through collaborative training and research programs. However, there is limited data on the trends of MakCHS faculty contributions to research and on faculty growth to take leading roles in health research. This paper reviews MakCHS faculty research publications over 15.5 years and outlines possible strategies to enhance faculty research outputs. METHODS We used a mixed methods approach. A systematic review of research publications by faculty at MakCHS (PubMed and Google Scholar from January 1, 2000, to June 30, 2015) to quantify the number of research articles, areas researched, authorship contribution by MakCHS faculty, source of funding, as well as affiliated local and international collaborations. Graphs were used to shown trends in publications and leadership of authorship by faculty. Annual individual faculty research productivity was presented as publication per capita. Qualitative data on high priority needs to improve research outputs was collected through focus group discussions (FGDs) with faculty members, and analysed manually into emerging themes. RESULTS Of 298 faculty at MakCHS at 2015, 89 (30%) were female and 229 (77%) were junior and mid-level faculty (senior lecturer and below). The PubMed and Google Scholar searches yielded 6927 published articles, of which 3399 (49%) full-text articles were downloaded for analysis, 426/3825 (11%) available as titles/abstracts only, and 598/4423 (14%) were excluded. Only 614 articles were published in 2014, giving a publication per capita of 2.1 for any authorship, and 0.3 for first and last authorship positions. MakCHS faculty increasingly contributed as first, second, third, and last authors. Up to 57% of research was in infectious diseases, followed by non-communicable diseases (20%) and non-communicable maternal child health (11%). Priority needs to improve research outputs, as expressed by faculty, were (1) an institutionally led faculty career development program, (2) skills building in research methods and scientific writing, (3) protected time for research related activities, (4) opportunities for collaborative research, and (5) use of individual development plans. CONCLUSION Faculty research productivity was low and dominated by infectious diseases and non-communicable disease research. There is a need for structured institutional support to optimise faculty research outputs. Only with increased research productivity will MakCHS and other academic institutions be able to make a significant contribution in addressing national health challenges.
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Affiliation(s)
- Damalie Nakanjako
- Department of Internal Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda. .,Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Dickens Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Dan K Kaye
- Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda
| | - James Tumwine
- Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Elialilia Okello
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Andrew Kambugu
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hazel McCullough
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Harriet Mayanja-Kizza
- Department of Internal Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Moses R Kamya
- Department of Internal Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Nelson K Sewankambo
- Department of Internal Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
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Mlotshwa BC, Mwesigwa S, Mboowa G, Williams L, Retshabile G, Kekitiinwa A, Wayengera M, Kyobe S, Brown CW, Hanchard NA, Mardon G, Joloba M, Anabwani G, Mpoloka SW. The collaborative African genomics network training program: a trainee perspective on training the next generation of African scientists. Genet Med 2017; 19:826-833. [PMID: 28383545 PMCID: PMC5509501 DOI: 10.1038/gim.2016.177] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 09/19/2016] [Indexed: 11/09/2022] Open
Abstract
Purpose: The Collaborative African Genomics Network (CAfGEN) aims to establish sustainable genomics research programs in Botswana and Uganda through long-term training of PhD students from these countries at Baylor College of Medicine. Here, we present an overview of the CAfGEN PhD training program alongside trainees’ perspectives on their involvement. Background: Historically, collaborations between high-income countries (HICs) and low- and middle-income countries (LMICs), or North–South collaborations, have been criticized for the lack of a mutually beneficial distribution of resources and research findings, often undermining LMICs. CAfGEN plans to address this imbalance in the genomics field through a program of technology and expertise transfer to the participating LMICs. Methods: An overview of the training program is presented. Trainees from the CAfGEN project summarized their experiences, looking specifically at the training model, benefits of the program, challenges encountered relating to the cultural transition, and program outcomes after the first 2 years. Conclusion: Collaborative training programs like CAfGEN will not only help establish sustainable long-term research initiatives in LMICs but also foster stronger North–South and South–South networks. The CAfGEN model offers a framework for the development of training programs aimed at genomics education for those for whom genomics is not their “first language.” Genet Med advance online publication 06 April 2017
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Affiliation(s)
- Busisiwe C Mlotshwa
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | - Savannah Mwesigwa
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gerald Mboowa
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Lesedi Williams
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | - Gaone Retshabile
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
| | | | - Misaki Wayengera
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Samuel Kyobe
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Chester W Brown
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.,Current affiliation: Genetics Division, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Neil A Hanchard
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.,ARS/USDA/Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Graeme Mardon
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030
| | - Moses Joloba
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gabriel Anabwani
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone
| | - Sununguko W Mpoloka
- Department of Biological Sciences, Faculty of Sciences, University of Botswana, Gaborone, Botswana
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African emergency care providers' attitudes and practices towards research. Afr J Emerg Med 2017; 7:9-14. [PMID: 30456100 PMCID: PMC6234192 DOI: 10.1016/j.afjem.2017.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/18/2016] [Accepted: 01/10/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction Emergency care research in Africa is not on par with other world regions. The study aimed to assess the perceptions and practices towards research among current emergency care providers in Africa. Methods A survey was sent to all individual members of the African Federation of Emergency Medicine. The survey was available in English and French. Results One hundred and sixty-eight responses were analysed (invited n = 540, responded n = 188, 34.8%, excluded n = 20). Responders’ mean age was 36.3 years (SD = 9.1); 122 (72.6%) were male, 104 (61.9%) were doctors, and 127 (75.6%) were African trained. Thirty-seven (22%) have never been involved in research; 33 (19.6%) have been involved in ⩾5 research projects. African related projects were mostly relevant to African audiences (n = 106, 63.1%). Ninety-four (56%) participants have never published. Forty-one (24.4%) were not willing to publish in open access journals requesting a publication fee; 65 (38.7%) will consider open access journals if fees are sponsored. Eighty responders (47.6%) frequently experienced access block to original articles due to subscription charges. Lack of research funding (n = 108, 64.3%), lack of research training (n = 86, 51.2%), and lack of allocated research time (n = 76, 45.2%) were the main barriers to research involvement. Improvement of research skills (n = 118, 70.2%) and having research published (n = 117, 69.6%) were the top motivational factors selected. Responders agreed that research promotes critical thinking (n = 137, 81.5%) and serve as an important educational tool (n = 134, 80.4%). However, 134 (79.8%) feel that emergency care workers need to be shown how to use research to improve clinical practice. Most agreed that insufficient emergency care research is being conducted in Africa (n = 113, 67.3%). Discussion There is scope to increase research involvement in emergency care in Africa, but solutions need to be find to address lack of research-related funding, training and time.
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Kyamanywa P, Mukara KB, Sewankambo NK. Academic Collaborations: Do’s and Don’ts. CURRENT ANESTHESIOLOGY REPORTS 2017. [DOI: 10.1007/s40140-017-0192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Okeke IN, Babalola CP, Byarugaba DK, Djimde A, Osoniyi OR. Broadening Participation in the Sciences within and from Africa: Purpose, Challenges, and Prospects. CBE LIFE SCIENCES EDUCATION 2017; 16:16/2/es2. [PMID: 28408409 PMCID: PMC5459259 DOI: 10.1187/cbe.15-12-0265] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 12/29/2016] [Accepted: 01/06/2017] [Indexed: 06/02/2023]
Abstract
Many of Africa's challenges have scientific solutions, but there are fewer individuals engaged in scientific activity per capita on this continent than on any other. Only a handful of African scientists use their skills to capacity or are leaders in their disciplines. Underrepresentation of Africans in scientific practice, discourse, and decision making reduces the richness of intellectual contributions toward hard problems worldwide. This essay outlines challenges faced by teacher-scholars from sub-Saharan Africa as we build scientific expertise. Access to tertiary-level science is difficult and uneven across Africa, and the quality of training available varies from top-range to inadequate. Access to science higher education needs to increase, particularly for female students, first-generation literates, and rural populations. We make suggestions for collaborative initiatives involving stakeholders outside Africa and/or outside academia that could extend educational opportunities available to African students and increase the chance that Africa-based expertise is globally available.
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Affiliation(s)
- Iruka N Okeke
- Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | | | - Denis K Byarugaba
- Department of Microbiology, Makerere University, Kampala 7062, Uganda
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Omolaja R Osoniyi
- Department of Biochemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
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Quaglio G, Karapiperis T, Putoto G, Delponte L, Micheletti G, Brand H, Bertinato L, Tomson G, Bonnardot L, Zanaboni P. Strengthening EU policies in support of ICT for development: Results from a survey of ICT experts. HEALTH POLICY AND TECHNOLOGY 2016. [DOI: 10.1016/j.hlpt.2016.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kumpu M, Atkins S, Zwarenstein M, Nkonki L. A partial economic evaluation of blended learning in teaching health research methods: a three-university collaboration in South Africa, Sweden, and Uganda. Glob Health Action 2016; 9:28058. [PMID: 27725076 PMCID: PMC5056980 DOI: 10.3402/gha.v9.28058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 11/27/2015] [Accepted: 12/10/2015] [Indexed: 11/23/2022] Open
Abstract
Background Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education. Objective Our goal was to evaluate the total provider costs of BL in teaching health research methods in a three-university collaboration. Design A retrospective evaluation was performed on a BL course on randomised controlled trials, which was led by Stellenbosch University (SU) in South Africa and joined by Swedish and Ugandan universities. For all three universities, the costs of the BL course were evaluated using activity-based costing with an ingredients approach. For SU, the costs of the same course delivered with a classroom learning (CL) approach were also estimated. The learning outcomes of both approaches were explored using course grades as an intermediate outcome measure. Results In this contextually bound pilot evaluation, BL had substantially higher costs than the traditional CL approach in South Africa, even when average per-site or per-student costs were considered. Staff costs were the major cost driver in both approaches, but total staff costs were three times higher for the BL course at SU. This implies that inter-institutional BL can be more time consuming, for example, due to use of new technologies. Explorative findings indicated that there was little difference in students’ learning outcomes. Conclusions The total provider costs of the inter-institutional BL course were higher than the CL course at SU. Long-term economic evaluations of BL with societal perspective are warranted before conclusions on full costs and consequences of BL in teaching global health topics can be made.
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Affiliation(s)
- Minna Kumpu
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Salla Atkins
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Ontario, Canada
| | - Lungiswa Nkonki
- Centre for Health Systems and Services Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa;
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Atkins S, Marsden S, Diwan V, Zwarenstein M. North-south collaboration and capacity development in global health research in low- and middle-income countries - the ARCADE projects. Glob Health Action 2016; 9:30524. [PMID: 27725081 PMCID: PMC5057000 DOI: 10.3402/gha.v9.30524] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/09/2016] [Accepted: 06/01/2016] [Indexed: 12/04/2022] Open
Abstract
Background Research capacity enhancement is needed in low- and middle-income countries (LMICs) for improved health, wellbeing, and health systems’ development. In this article, we discuss two capacity-building projects, the African/Asian Regional Capacity Development (ARCADE) in Health Systems and Services Research (HSSR) and Research on Social Determinants of Health (RSDH), implemented from 2011 to 2015. The two projects focussed on providing courses in HSSR and social determinants of health research, and on developing collaborations between universities, along with capacity in LMIC universities to manage research grant submissions, financing, and reporting. Both face-to-face and sustainable online teaching and learning resources were used in training at higher postgraduate levels (Masters and Doctoral level). Design We collated project meeting and discussion minutes along with project periodic reports and deliverables. We extracted key outcomes from these, reflected on these in discussions, and summarised them for this paper. Results Nearly 55 courses and modules were developed that were delivered to over 920 postgraduate students in Africa, Asia, and Europe. Junior researchers were mentored in presenting, developing, and delivering courses, and in preparing research proposals. In total, 60 collaborative funding proposals were prepared. The consortia also developed institutional capacity in research dissemination and grants management through webinars and workshops. Discussion ARCADE HSSR and ARCADE RSDH were comprehensive programmes, focussing on developing the research skills, knowledge, and capabilities of junior researchers. One of the main strengths of these programmes was the focus on network building amongst the partner institutions, where each partner brought skills, expertise, and diverse work cultures into the consortium. Through these efforts, the projects improved both the capacity of junior researchers and the research environment in Africa, Asia, and Europe.
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Affiliation(s)
- Salla Atkins
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden
| | | | - Vishal Diwan
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain, India.,International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain, India
| | - Merrick Zwarenstein
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
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Protsiv M, Atkins S. The experiences of lecturers in African, Asian and European universities in preparing and delivering blended health research methods courses: a qualitative study. Glob Health Action 2016; 9:28149. [PMID: 27725078 PMCID: PMC5056979 DOI: 10.3402/gha.v9.28149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 02/06/2023] Open
Abstract
Background Growing demand for Global Health (GH) training and the internationalisation of education requires innovative approaches to training. Blended learning (BL, a form of e-learning combining face-to-face or real-time interaction with computer-assisted learning) is a promising approach for increasing GH research capacity in low- to middle-income countries. Implementing BL, however, requires additional skills and efforts from lecturers. This paper explores lecturers’ views and experiences of delivering BL courses within the context of two north–south collaborative research capacity building projects, ARCADE HSSR and ARCADE RSDH. Design We used a qualitative approach to explore the experiences and perceptions of 11 lecturers involved in designing and delivering BL courses collaboratively across university campuses in four countries (South Africa, Uganda, India and Sweden). Data were collected using interviews in person or via Skype. Inductive qualitative content analysis was used. Results Participants reported that they felt BL increased access to learning opportunities and made training more flexible and convenient for adult learners, which were major motivations to engage in BL. However, despite eagerness to implement and experiment with BL courses, they lacked capacity and support, and found the task time consuming. They needed to make compromises between course objectives and available technological tools, in the context of poor Internet infrastructure. Conclusions BL courses have the potential to build bridges between low- and middle-income contexts and between lecturers and students to meet the demand for GH training. Lecturers were very motivated to try these approaches but encountered obstacles in implementing BL courses. Considerable investments are needed to implement BL and support lecturers in delivering courses.
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Affiliation(s)
- Myroslava Protsiv
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden;
| | - Salla Atkins
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
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Cars O, Xiao Y, Stålsby Lundborg C, Nilsson LE, Shen J, Sun Q, Bi Z, Börjesson S, Greko C, Wang Y, Liu Y, Ottoson J, Li X, Nilsson M, Yin H, Bi Z, Zheng B, Xia X, Chen B, Ding L, Sun P, Dyar OJ, Hulth A, Tomson G. Building bridges to operationalise one health - A Sino-Swedish collaboration to tackle antibiotic resistance. One Health 2016; 2:139-143. [PMID: 28616488 PMCID: PMC5441327 DOI: 10.1016/j.onehlt.2016.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 01/21/2023] Open
Abstract
Antibiotic resistance is a complex global health challenge. The recent Global Action Plan on antimicrobial resistance highlights the importance of adopting One Health approaches that can cross traditional disciplinary boundaries. We report on the early experiences of a multisectoral Sino-Swedish research project that aims to address gaps in our current knowledge and seeks to improve the situation through system-wide interventions. Our research project is investigating antibiotic use and resistance in a rural area of China through a combination of epidemiological, health systems and laboratory investigations. We reflect here on the challenges inherent in conducting long distance cross-disciplinary collaborations, having now completed data and sample collection for a baseline situation analysis. In particular, we recognise the importance of investing in aspects such as effective communication, shared conceptual frameworks and leadership. We suggest that our experiences will be instructive to others planning to develop similar international One Health collaborations. Antibiotic resistance is a complex global health challenge One Health approaches are needed to facilitate understanding and action China is one of the largest producers and consumers of antibiotics in the world China is giving attention to antibiotic resistance at the highest political level We report on the early stages of a Sino-Swedish One Health research programme
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Affiliation(s)
- Otto Cars
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Yonghong Xiao
- First Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Cecilia Stålsby Lundborg
- Global Health - Health Systems and Policy, Dept of Public Health Sciences, Karolinska Institutet, Sweden
| | - Lennart E Nilsson
- Dept of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Jianzhong Shen
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Qiang Sun
- Center for Health Management and Policy, Shandong University, China
| | - Zhenqiang Bi
- Shandong Center for Disease Control and Prevention, Jinan, China
| | | | | | - Yang Wang
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Yuqing Liu
- Shandong Academy of Agricultural Science, Jinan, China
| | | | - Xuewen Li
- School of Public Health, Shandong University, China
| | - Maud Nilsson
- Dept of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Hong Yin
- Dept of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Zhenwang Bi
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Beiwen Zheng
- First Affiliated Hospital, College of Medicine, Zhejiang University, China
| | - Xi Xia
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Baoli Chen
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Lilu Ding
- Center for Health Management and Policy, Shandong University, China
| | - Pan Sun
- School of Public Health, Shandong University, China
| | - Oliver James Dyar
- Global Health - Health Systems and Policy, Dept of Public Health Sciences, Karolinska Institutet, Sweden
| | - Anette Hulth
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Göran Tomson
- Global Health - Health Systems and Policy, Dept of Public Health Sciences, Karolinska Institutet, Sweden.,Dept of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
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Rabbani F, Shipton L, White F, Nuwayhid I, London L, Ghaffar A, Ha BTT, Tomson G, Rimal R, Islam A, Takian A, Wong S, Zaidi S, Khan K, Karmaliani R, Abbasi IN, Abbas F. Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations? BMC Public Health 2016; 16:941. [PMID: 27604901 PMCID: PMC5015344 DOI: 10.1186/s12889-016-3616-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. MAIN TEXT The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). CONCLUSION SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.
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Affiliation(s)
- Fauziah Rabbani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Leah Shipton
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Franklin White
- Pacific Health & Development Sciences Inc., Victoria, Canada
| | - Iman Nuwayhid
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Leslie London
- Division Public Health Medicine, School of Public Health and Family Medicine University of Cape Town, Cape Town, South Africa
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
| | - Bui Thi Thu Ha
- Hanoi School of Public Health, Giang Vo, Ba Dinh, Hanoi, Vietnam
| | - Göran Tomson
- Depts LIME & PHS, Karolinska Institutet Stockholm, Stockholm, Sweden
| | - Rajiv Rimal
- Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, USA
| | - Anwar Islam
- School of Health Policy and Management, York University, Toronto, Ontario Canada
| | - Amirhossein Takian
- Department of Global Health & Sustainable Development, School of Public Health-Tehran University of Medical Sciences, Tehran, Iran
| | - Samuel Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Shehla Zaidi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Kausar Khan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Rozina Karmaliani
- School of Nursing & Midwifery and Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Imran Naeem Abbasi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Farhat Abbas
- Medical College, Aga Khan University, Karachi, Pakistan
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Protsiv M, Rosales-Klintz S, Bwanga F, Zwarenstein M, Atkins S. Blended learning across universities in a South-North-South collaboration: a case study. Health Res Policy Syst 2016; 14:67. [PMID: 27589996 PMCID: PMC5010676 DOI: 10.1186/s12961-016-0136-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased health research capacity is needed in low- and middle-income countries to respond to local health challenges. Technology-aided teaching approaches, such as blended learning (BL), can stimulate international education collaborations and connect skilled scientists who can jointly contribute to the efforts to address local shortages of high-level research capacity. The African Regional Capacity Development for Health Systems and Services Research (ARCADE HSSR) was a European Union-funded project implemented from 2011 to 2015. The project consortium partners worked together to expand access to research training and to build the research capacity of post-graduate students. This paper presents a case study of the first course in the project, which focused on a meta-analysis of diagnostic accuracy studies and was delivered in 2013 through collaboration by universities in Uganda, Sweden and South Africa. METHODS We conducted a mixed-methods case study involving student course evaluations, participant observation, interviews with teaching faculty and student feedback collected through group discussion. Quantitative data were analysed using frequencies, and qualitative data using thematic analysis. RESULTS A traditional face-to-face course was adapted for BL using a mixture of online resources and materials, synchronous online interaction between students and teachers across different countries complemented by face-to-face meetings, and in-class interaction between students and tutors. Synchronous online discussions led by Makerere University were the central learning technique in the course. The learners appreciated the BL design and reported that they were highly motivated and actively engaged throughout the course. The teams implementing the course were small, with individual faculty members and staff members carrying out many extra responsibilities; yet, some necessary competencies for course design were not available. CONCLUSIONS BL is a feasible approach to simultaneously draw globally available skills into cross-national, high-level skills training in multiple countries. This method can overcome access barriers to research methods courses and can offer engaging formats and personalised learning experiences. BL enables teaching and learning from experts and peers across the globe with minimal disruption to students' daily schedules. Transforming a face-to-face course into a blended course that fulfils its full potential requires concerted effort and dedicated technological and pedagogical support.
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Affiliation(s)
- Myroslava Protsiv
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Senia Rosales-Klintz
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Freddie Bwanga
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Merrick Zwarenstein
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, N6A 3K7 London, Ontario Canada
- Faculty of health sciences, Stellenbosch University, Francie Van Zijl Dr, Tygerberg Hospital, Cape Town, 7505 South Africa
| | - Salla Atkins
- Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
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Kabra R, Ali M, Gulmezoglu AM, Say L. Research capacity for sexual and reproductive health and rights. Bull World Health Organ 2016; 94:549-50. [PMID: 27429494 PMCID: PMC4933141 DOI: 10.2471/blt.15.163261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/14/2015] [Accepted: 12/21/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Rita Kabra
- Department of Reproductive Health and Research, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Moazzam Ali
- Department of Reproductive Health and Research, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - A Metin Gulmezoglu
- Department of Reproductive Health and Research, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Lale Say
- Department of Reproductive Health and Research, World Health Organization, avenue Appia 20, 1211 Geneva 27, Switzerland
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Strengthening post-graduate educational capacity for health policy and systems research and analysis: the strategy of the Consortium for Health Policy and Systems Analysis in Africa. Health Res Policy Syst 2016; 14:29. [PMID: 27072802 PMCID: PMC4830003 DOI: 10.1186/s12961-016-0097-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/24/2016] [Indexed: 11/24/2022] Open
Abstract
Background The last 5–10 years have seen significant international momentum build around the field of health policy and systems research and analysis (HPSR + A). Strengthening post-graduate teaching is seen as central to the further development of this field in low- and middle-income countries. However, thus far, there has been little reflection on and documentation of what is taught in this field, how teaching is carried out, educators’ challenges and what future teaching might look like. Methods Contributing to such reflection and documentation, this paper reports on a situation analysis and inventory of HPSR + A post-graduate teaching conducted among the 11 African and European partners of the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA), a capacity development collaboration. A first questionnaire completed by the partners collected information on organisational teaching contexts, while a second collected information on 104 individual courses (more in-depth information was subsequently collected on 17 of the courses). The questionnaires yielded a mix of qualitative and quantitative data, which were analysed through counts, cross-tabulations, and the inductive grouping of material into themes. In addition, this paper draws information from internal reports on CHEPSAA’s activities, as well as its external evaluation. Results The analysis highlighted the fluid boundaries of HPSR + A and the range and variability of the courses addressing the field, the important, though not exclusive, role of schools of public health in teaching relevant material, large variations in the time investments required to complete courses, the diversity of student target audiences, the limited availability of distance and non-classroom learning activities, and the continued importance of old-fashioned teaching styles and activities. Conclusions This paper argues that in order to improve post-graduate teaching and continue to build the field of HPSR + A, key questions need to be addressed around educational practice issues such as the time allocated for HPSR + A courses, teaching activities, and assessments, whether HPSR + A should be taught as a cross-cutting theme in post-graduate degrees or an area of specialisation, and the organisation of teaching given the multi-disciplinary nature of the field. It ends by describing some of CHEPSAA’s key post-graduate teaching development activities and how these activities have addressed the key questions.
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Capacity-building for equitable global health research from Africa: the power of two. Int J Public Health 2015; 61:389-90. [DOI: 10.1007/s00038-015-0777-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/14/2015] [Indexed: 10/22/2022] Open
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Boyce R, Rosch R, Finlayson A, Handuleh D, Walhad SA, Whitwell S, Leather A. Use of a bibliometric literature review to assess medical research capacity in post-conflict and developing countries: Somaliland 1991-2013. Trop Med Int Health 2015; 20:1507-1515. [PMID: 26293701 DOI: 10.1111/tmi.12590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Effective healthcare systems require high-quality research to guide evidence-based interventions and strategic planning. In low- and middle-income countries, especially those emerging from violent conflict, research capacity often lags behind other aspects of health system development. Here, we sought to bibliometrically review health-related research output in Somaliland, a post-conflict self-declared, autonomous nation on the Horn of Africa, as a means of assessing research capacity. METHODS We reviewed articles on health-related research conducted in Somaliland between 1991 and 2013 that included a description of the experimental design, and articles were published in either a peer-reviewed journal or as part of a scholarly programme receiving formal review. We did not include policy or social science research that did not enrol or interact with subjects from Somaliland. Using online databases, all studies meeting minimum eligibility criteria were reviewed in regard to Somaliland-based co-authorship, topic of research and specific measures of quality. RESULTS A total of 37 studies were included in this review. Of these, only 19 (51%) included co-authorship by Somaliland-based researchers. Of the 21 studies reporting ethical approval, 16 (64%) received approval from the Somalia or Somaliland Ministry of Health, while five received approval from a university or national commission. More than two-thirds of published research was limited to a few areas of investigation with most (19, 51%) following basic cross-sectional study designs. The number of articles published per year increased from 0 to 1 in the years 1991-2007 to a maximum of 8 in 2013. CONCLUSIONS Research activity in Somaliland is extremely limited. Investigators from high-income countries have largely directed the research agenda in Somaliland; only half of the included studies list co-authors from institutions in Somaliland. Leadership and governance of health research in Somaliland is required to define national priorities, promote scholarly activity and guide the responsible conduct of research. The methods used here to assess research capacity may be generalisable to other low- and middle-income countries and post-conflict settings to measure the impact of research capacity-building efforts.
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Affiliation(s)
- Ross Boyce
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Richard Rosch
- Centre for Global Health, King's Health Partners, King's College London, London, UK.,Institute of Neurology, University College London, London, UK
| | - Alexander Finlayson
- Centre for Global Health, King's Health Partners, King's College London, London, UK
| | - Djibril Handuleh
- Department of Medicine, Amoud University School of Medicine, Borama, Somaliland
| | | | - Susannah Whitwell
- Centre for Global Health, King's Health Partners, King's College London, London, UK
| | - Andy Leather
- Centre for Global Health, King's Health Partners, King's College London, London, UK
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Productive global health research from Africa: it takes more. Int J Public Health 2015; 60:755-6. [PMID: 26297479 DOI: 10.1007/s00038-015-0725-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022] Open
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Correction: enabling dynamic partnerships through joint degrees between low- and high-income countries for capacity development in global health research: experience from the Karolinska Institutet/Makerere University Partnership. PLoS Med 2015; 12:e1001816. [PMID: 25826581 PMCID: PMC4380426 DOI: 10.1371/journal.pmed.1001816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pmed.1001784.].
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