This research aimed to elaborate a theory of knowledge translation (KT) in Uganda that could also serve as a reference for other low- and middle income countries. The researchers employed qualitative approaches to examine the principal barriers and facilitating factors to KT. A review of the literature revealed that the most common factors facilitating knowledge uptake included institutional strengthening, research characteristics, dissemination processes, partnerships and political context. The analysis of interviews conducted by the researchers, however, showed that policymakers and researchers ranked institutional strengthening for KT, research characteristics and partnerships as the most important. Respondents rasied the importance of mainstreamed structures within the Ministry of Health to coordinate and disseminate research, the separation of roles between researchers and policymakers, and the role of communities and civil society in KT. The study tests a framework that can be more widely used in empirical research on the process of KT on specific policy issues.
Monitoring equity and research policy
As there is little published evidence about processes in research-policy partnerships in different contexts, this paper aims to help fill this research gap by analysing experiences of research-policy partnerships between Ministries of Health and research organisations for the implementation of the Mental Health and Poverty Project in Ghana, South Africa, Uganda and Zambia. The authors developed a conceptual framework for understanding and assessing research-policy partnerships to guide the study and collected data via semi-structured interviews with Ministry of Health Partners (MOHPs) and Research Partners (RPs) in each country. The principles of trust, openness, equality and mutual respect were identified by respondents as constituting the core of partnerships. The MOHPs and RPs had clearly defined roles, with the MOHPs largely providing political support and RPs leading the research agenda. The authors also found that taking account of influences on the partnership at individual, organisation and contextual/system levels can increase its effectiveness. A common understanding of mutually-agreed goals and objectives of the partnership is essential. Although partnerships are often established for a specific purpose, such as carrying out a particular project, the effects of partnership go beyond a particular initiative.
The authors outline a comprehensive approach for developing a cross-sectoral, multi-dimensional and dynamic understanding of resilience. This underpins the message of the Sustainable Development Goals (SDGs) that development is multi-faceted and the achievement of many of the individual development goals is dependent on the accomplishment of other goals. It also acknowledges that shocks and stresses can reverse years of development gains and efforts to eradicate poverty by 2030. The authors argue that this approach to understanding resilience draws on data that countries will collect for the SDGs anyway and entails only a small additional burden.
A series of recommendations focuses on improving ethics review of protocols, reforming the informed consent process, improving access to information by participants and those responsible for review and monitoring of protocols,enhancing safety monitoring, compensating those who are harmed as a result of their participation in research; and developing a standard of quality.
In this conceptual article, the authors compare and contrast the evolution of climate change and AIDS research. They demonstrate how scholarship and response in these two seemingly disparate areas share certain important similarities, such as the "globalisation" of discourses and associated masking of uneven vulnerabilities, the tendency toward techno-fixes, and the polarisation of debates within these fields. They also examine key divergences, noting in particular that climate change research has tended to be more forward-looking and longer-term in focus than AIDS scholarship. Suggesting that AIDS scholars can learn from these key parallels and divergences, the paper offers four directions for advancing AIDS research: focusing more on the differentiation of risk and responsibility within and among AIDS epidemics; taking (back) on board social justice approaches; moving beyond polarised debates; and shifting focus from reactive to forward-looking and proactive approaches.
There are few systematically developed national research priorities for child health that exist in sub-Saharan Africa. Children's interests may be distorted in prioritisation processes that combine all age groups. Future development of priorities requires a common reporting framework and specific consideration of childhood priorities, according to a review of national priorities for child health research published in Health Research Policy and Systems 2005. The research reviewed existing national child health research priorities in Sub-Saharan Africa, and the processes used to determine them.
Despite improved supply of health care services in low-income countries in the recent past, their uptake continues to be lower than anticipated. This has made it difficult to scale-up those interventions which are not only cost-effective from supply perspectives but that might have substantial impacts on improving the health status of these countries. Understanding demand-side barriers is therefore critically important.
Despite improved supply of health care services in low-income countries in the recent past, their uptake continues to be lower than anticipated. This has made it difficult to scale-up those interventions which are not only cost-effective from supply perspectives but that might have substantial impacts on improving the health status of these countries. Understanding demand-side barriers is therefore critically important. This commentary argues that more research on demand-side barriers needs to be carried out and that the stated-preference (SP) approach to such research might be helpful.
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) emphasised 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), conceptualising 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. The challenges faced by LMICs include rapid urbanisation, 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).
This issue of the Lancet publishes two papers of critical interest to child survival. Unfortunately, both have stirred concerns about misuse of data by UN agencies. Here, they review the allegations and try to draw lessons about the place of independent scientific inquiry in the arena of global health policymaking. Greg Fegan and colleagues report the success of an expanded insecticide-treated bednet programme in Kenya . The full paper reveals the strengths and limitations of the study, and provides important estimates of uncertainty. No such statistical caution was expressed in the WHO statement about these data, released on Aug 16. Indeed, WHO claimed that this finding "ends the debate about how to deliver long-lasting insecticidal nets". Yet communications between the Kenyan research team and WHO suggest an ill-considered rush by WHO against the advice of wiser scientific minds.