The author developed this framework while conducting an in-depth case study of the safe motherhood initiative and supplemented the findings with research done on AIDS, reproductive health, and other health initiatives. At its core, the framework posits eleven factors under four key categories (actor capability, framing, political opportunities, and issue characteristics) driving the success or failure of health initiatives (i.e. polio eradication, the AIDS movement, etc).
Monitoring equity and research policy
Generating political priority for global health initiatives: A framework and case study of maternal mortality
Shiffman J: Global Center for Development, July 2007
Generating statistics from health facility data: the state of routine health information systems in Eastern and Southern Africa
Maïga A, Jiwani S, Mutua M, et al.: BMJ Global Health; 4:e001849. doi:10.1136/ bmjgh-2019-001849, 2019
Health facility data are a critical source of local and continuous health statistics. Countries have introduced web-based information systems that facilitate data management, analysis, use and visualisation of health facility data. Working with teams of Ministry of Health and country public health institutions analysts from 14 countries in Eastern and Southern Africa, the authors explored data quality using national-level and subnational-level (mostly district) data for the period 2013–2017. The focus was on endline analysis where reported health facility and other data are compiled, assessed and adjusted for data quality, primarily to inform planning and assessments of progress and performance. The analyses showed that although completeness of reporting was generally high, there were persistent data quality issues that were common across the 14 countries, especially at the subnational level. These included the presence of extreme outliers, lack of consistency of the reported data over time and between indicators (such as vaccination and antenatal care), and challenges related to projected target populations, which are used as denominators in the computation of coverage statistics. The authors propose continuous efforts to improve recording and reporting of events by health facilities, systematic examination and reporting of data quality issues, feedback and communication mechanisms between programme managers, care providers and data officers, and transparent corrections and adjustments will be critical. to improve the quality of health statistics generated from health facility data.
Geographical disparities in core population coverage indicators for roll back malaria in Malawi
Kazembe LN, Appleton CC, Kleinschmidt I: International Journal for Equity in Health, 2007, 6 : 5, 4 July 2007
Implementation of known effective interventions would necessitate the reduction of malaria burden by half by the year 2010. Identifying geographical disparities of coverage of these interventions at small area level is useful to inform where greatest scaling-up efforts should be concentrated. They also provide baseline data against which future scaling-up of interventions can be compared. However, population data are not always available at local level. This study applied spatial smoothing methods to generate maps at subdistrict level in Malawi to serve such purposes.
Geographical information system and access to HIV testing, treatment and prevention of mother-to-child transmission in conflict affected Northern Uganda
Chamla DD, Olu O, Wanyana J, Natseri N, Mukooyo E, Okware S, Alisalad A and George M: Conflict and Health 1:12, 3 December 2007
Researchers used Geographical Information System (GIS) as a tool to determine access to and gaps in providing HIV counselling and testing (VCT), treatment (ART) and mother-to-child transmission (PMTCT) services in conflict affected northern Uganda. Access to VCT, PMTCT and ART services was geographically limited due to inadequacy and heterogeneous dispersion of these services among districts and camps. GIS mapping can be effective in identifying service delivery gaps and presenting complex data into simplistic results hence can be recommended in need assessments in conflict settings.
Getting research into practice in developing countries
Lessons from medical research may take years to get through to the frontline of healthcare. This is exacerbated in developing countries where there are difficulties in dissemination and barriers that prevent healthcare providers acting on new findings. Furthermore, most biomedical research is in high-income countries, and the results are not necessarily applicable in low-income countries. This is a according to a meeting at the Royal College of Physicians in London in January that explored these issues under the topics of ‘Dynamics and barriers; Systematic reviews: do they have a role?’; and ‘Recent changes in healthcare information and emerging challenges’.
Global AgeWatch Index 2013: Insight report, summary and methodology
Global AgeWatch: October 2013
The Global AgeWatch Index is the first-ever overview of the wellbeing of older people around the world.As the number and proportion of older people increases at an unprecedented rate, this ground-breaking report illustrates how the world is adapting to this new reality by ranking more than 90 countries in terms of how their older populations are faring.
Global Forum 2015 dialogue on "From evidence to policy - thinking outside the box": perspectives to improve evidence uptake and good practices in the African Region
Kirigia J; Pannenborg C; Amore L; Ghannem H; IJsselmuiden C; Nabyonga-Orem J: BMC Health Services Research 16(Suppl 4), 18 July 2016, doi: 10.1186/s12913-016-1453-z
The Global Forum 2015 panel session dialogue entitled “From evidence to policy – thinking outside the box” was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region. The Global Forum 2015 debate attributed African Region’s low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organisations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region. The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening national health research governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of action plans for implementing research recommendations, preferably in the context of the Sustainable Development Goals; and encouragement of competition on health research strengthening and research output and uptake among the countries using a barometer or scorecard to review their performance at various regional ministerial forums and taking into account the lessons learned from the MDG period.
Global Forum for Health Research, Forum 2009: Innovating for the Health of All
Jupp S: MEDICC Review 12(3): 5–7, July 2010
This article discuss the work of the Global Forum, a global body of health decision-makers that focuses on questions of equity, advocating for more research to address the health problems of those most in need – essentially the poor and marginalised –and providing evidence to support greater investments in neglected areas. Since the Forum’s previous conference in 2009, the article notes that a paradigm shift has taken place from ‘health research’ to ‘research for health’. This new approach promotes greater understanding among all stakeholders of the impact on health of policies, programmes, processes, actions or events originating from other sectors. It also is intended to assist in developing interventions that will help prevent or mitigate any adverse impact on health and contribute to the achievement of health equity. While the number of resources, actors and efforts to address the health problems of the poor have grown signifi cantly in recent years, the range of health challenges faced by low- and middle-income countries has expanded considerably, demanding a more extensive research portfolio. Challenges include countries that are not on track to reaching the Millennium Development Goals, rising rates of chronic non-communicable diseases in low- and middle-income countries, urbanisation, demographic shifts, climate change, food security, the threat of pandemics, and the global financial crisis.
Global Forum Releases New Report on Forum 8, Mexico, November
The first report published by the Global Forum on an annual meeting, Health Research for the Millennium Development Goals, summarizes the main themes of Forum 8 from plenary presentations and includes a CD-ROM with all the presentations, media and final documentation of the meeting. The report clearly demonstrates that a great deal is known about the kinds of research that are urgently required to accelerate and intensify the efforts necessary to achieve the Millennium Development Goals (MDGs). The Global Forum for Health Research is an independent international foundation based in Geneva. The report and CD-ROM can be ordered or downloaded from the organization's website: http://www.globalforumhealth.org
Global health fund debated
A new global fund to combat HIV/AIDS, tuberculosis and malaria will be administered by the World Bank in collaboration with WHO and UNAIDS. Officially announced by UN secretary general Kofi Annan in May, discussions have so far focused on raising the US$10 billion experts say is needed. Less clear are details on how it will fit into national processes and poverty reduction strategies. Some NGOs, academics and officials are worried the fund reflects donors' priorities and the desire to apply "quick fixes" to complex problems. Welcoming the fund in principle, Save the Children, UK, and MEDACT warn in a joint report that lessons of the past 30 years must be taken into account or "billions of dollars could be wasted". "Donor led programmes that focus on specific diseases rather than taking a holistic approach to building services and resources have contributed to the collapse of developing countries' health systems," comments Regina Keith, health adviser to Save the Children, UK. The report The Bitterest Pill of All: The Collapse of Africa's Health System, argues that a significant amount of any new global health fund should be dedicated to the long term strengthening of health systems. European Commissioner for Development Poul Nielson also warns that, without efficient delivery systems, "there is a big risk of this whole discussion being hijacked by PR-politics in rich countries".