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Clarence C, Shiras T, Zhu J, Boggs MK, Faltas N, Wadsworth A, Bradley SE, Sadruddin S, Wazny K, Goodman C, Awor P, Bhutta ZA, Källander K, Hamer DH. Setting global research priorities for private sector child health service delivery: Results from a CHNRI exercise. J Glob Health 2021; 10:021201. [PMID: 33403107 PMCID: PMC7750021 DOI: 10.7189/jogh.10.021201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The private health sector is an important source of sick child care, yet evidence gaps persist in best practices for integrated management of private sector child health services. Further, there is no prioritized research agenda to address these gaps. We used a Child Health and Nutrition Research Initiative (CHNRI) process to identify priority research questions in response to these evidence gaps. CHNRI is a consultative approach that entails prioritizing research questions by evaluating them against standardized criteria. Methods We engaged geographically and occupationally diverse experts in the private health sector and child health. Eighty-nine experts agreed to participate and provided 150 priority research questions. We consolidated submitted questions to reduce duplication into a final list of 50. We asked participants to complete an online survey to rank each question against 11 pre-determined criteria in four categories: (i) answerability, (ii) research feasibility, (iii) sustainability/equity, and (iv) importance/potential impact. Statistical data analysis was conducted in SAS 9.4 (SAS Institute Inc, Cary NC, USA). We weighted all 11 evaluation criteria equally to calculate the research priority score and average expert agreement for each question. We disaggregated results by location in high-income vs low- and middle-income countries. Results Forty-nine participants (55.1%) completed the online survey, including 33 high-income and 16 low- and middle-income country respondents. The top, prioritized research question asks whether accreditation or regulation of private clinical and non-clinical sources of care would improve integrated management of childhood illness services. Four of the top ten research priorities were related to adherence to case management protocols. Other top research priorities were related to training and supportive supervision, digital health, and infant and newborn care. Research priorities among high-income and low- and middle-income country respondents were highly correlated. Conclusion To our knowledge, this is the first systematic exercise conducted to define research priorities for the management of childhood illness in the private sector. The research priorities put forth in this CHNRI exercise aim to stimulate interest from policy makers, program managers, researchers, and donors to respond to and help close evidence gaps hindering the acceleration of reductions in child mortality through private sector approaches.
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Affiliation(s)
- Catherine Clarence
- Abt Associates, International Development Division, Rockville, Maryland, USA
| | - Tess Shiras
- Abt Associates, International Development Division, Rockville, Maryland, USA
| | - Jack Zhu
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Malia K Boggs
- United States Agency for International Development, Bureau for Global Health, Office of Maternal, Child Health and Nutrition, Washington, D.C., USA
| | - Nefra Faltas
- United States Agency for International Development, Bureau for Global Health, Office of Maternal, Child Health and Nutrition, Washington, D.C., USA
| | - Anna Wadsworth
- Abt Associates, International Development Division, Rockville, Maryland, USA
| | - Sarah Ek Bradley
- Abt Associates, International Development Division, Rockville, Maryland, USA
| | | | - Kerri Wazny
- Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Catherine Goodman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Phyllis Awor
- Makerere University College of Health Sciences School of Public Health, Makerere, Uganda
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.,Institute for Global Health & Development, The Aga Khan University, Karachi, Pakistan
| | - Karin Källander
- Implementation Research & Delivery Science Unit, UNICEF, New York, New York, USA.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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Meyer SR, Yu G, Rieders E, Stark L. Child labor, sex and mental health outcomes amongst adolescent refugees. J Adolesc 2020; 81:52-60. [PMID: 32361065 DOI: 10.1016/j.adolescence.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Refugee adolescents living in camps and settlements in low and middle-income countries are a vulnerable population who face protection and psychosocial risks. This study explores prevalence of child labor amongst adolescent refugees from South Sudan in two refugee settlements in Uganda, to understand impacts of child labor on mental health outcomes, and examines the influence of sex on these impacts. METHODS Surveys were conducted in Adjumani and Kiryandongo refugee settlements, Uganda, with 470 adolescents between 13 and 17 interviewed between December 2014-February 2015. Univariate finite mixture modeling identified a two-cluster model of child labor. Logistic regression models assessed the association of child labor and mental health. RESULTS A two-cluster solution for child labor activity was determined among the 332 adolescents who self-reported engaging in any child labor (Significant child labor: n = 174, 37%; moderate child labor cluster: n = 158, 34%; no child labor cluster: n = 138, 29%. Odds of depression amongst adolescents exposed to significant vs. no child labor was 4.15 (95% CI: 2.01-8.56), in a model examining interaction of sex and child labor and controlling for socio-demographic variables. For the anxiety outcome, girls exposed to significant vs. no child labor are less likely to report higher levels of anxiety (OR: 0.29, 95% CI: 0.09-0.90). CONCLUSIONS Adolescents living in refugee settlements in Uganda report high levels of participation in child labor. Protection of adolescents from the risks involved with child labor in refugee contexts is an important and often over-looked area of child protection in humanitarian settings.
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Affiliation(s)
- Sarah R Meyer
- Mailman School of Public Health, Columbia University, 60 Haven Avenue B-4, New York, NY 10032, USA.
| | - Gary Yu
- NYU Rory Meyers College of Nursing, 433 First Avenue, 7th Floor, New York, NY 10010, USA.
| | - Eliana Rieders
- Save the Children UK, 1 St John's Lane, EC1M 4AR, London, UK.
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
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Fun WH, Sararaks S, Tan EH, Tang KF, Chong DWQ, Low LL, Sapian RA, Ismail SA, Govind SK, Mahmud SH, Murad S. Research funding impact and priority setting - advancing universal access and quality healthcare research in Malaysia. BMC Health Serv Res 2019; 19:248. [PMID: 31018843 PMCID: PMC6480746 DOI: 10.1186/s12913-019-4072-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia. METHODS Research impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search. RESULTS Seventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders' expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare. CONCLUSION The concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential.
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Affiliation(s)
- Weng Hong Fun
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.
| | - Sondi Sararaks
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Ee Hong Tan
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Kar Foong Tang
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Diane Woei Quan Chong
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Lee Lan Low
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Roslinda Abu Sapian
- National Institutes of Health Secretariat, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - S Asmaliza Ismail
- National Institutes of Health Secretariat, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Suresh Kumar Govind
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Haniza Mahmud
- Institute for Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Shahnaz Murad
- Office of Deputy Director General of Health, Research and Technical Support, Ministry of Health Malaysia, Putrajaya, Malaysia
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