The individual household method (IHM) provides estimates of household income, with detailed information on household assets, demography and specific income sources. This data can be used to support the design and evaluation of programmes, and seeks to collect information on actual households directly from their members. This enables IHM studies to identify more complex variation across populations and to model the impact of changes on a much wider range of population groups, with data disaggregated by demographics (gender and age), income levels and other chosen characteristics.
Monitoring equity and research policy
The individual household method
Evidence for Development: UK, 2015
The intersecting paradigms of naturopathic medicine and public health: Opportunities for naturopathic medicine
Wardle J and Oberg EB: Journal of Alternative and Complementary Medicine 17(11): 1079-1084, November 2011
Complementary medicine research, including naturopathic medicine research, is plagued with many methodological challenges, the authors of this paper argue. Many of these challenges have also been experienced in public health research. Public health research has met these challenges with a long history of multidisciplinary, multimethod, and whole systems approaches to research that may better resonate with the “real world” clinical settings of naturopathic medicine. Additionally, many of the underlying principles of naturopathic medicine are analogous to the underlying principles and activities of public health, specifically in such areas as health promotion, prevention, patient education, and proactive rather than reactive approaches to disease management and treatment. Future research in the field of naturopathic medicine may benefit from adopting public health research models rather than focusing exclusively on biomedical models, the authors argue. A complementary and collaborative relationship between these fields may provide an opportunity to deliver research that more accurately reflects naturopathic medicine practice, as well as providing the opportunity to improve health outcomes more generally.
The material and political bases of lived poverty in Africa: Insights from the Afrobarometer
Bratton M (editor): Afrobarometer 2008
The Afrobarometer has developed an experiential measure of lived poverty called the Lived Poverty Index (LPI). It measures how frequently people go without basic necessities during the course of a year. This is a portion of the central core of the concept of poverty not captured by existing objective or subjective measures. The Lived Poverty Index is strongly related to the measurement of political freedoms, according to this study. It concludes that this measure does well at measuring the experiential core of poverty, and capturing it in a way that other widely used international development indicators do not.
The meaning and measurement of acute malnutrition in emergencies
Humanitarian Practice Network Paper 56, November 2006
The recent humanitarian reform agenda, which aims to make the humanitarian system more accountable, has led to a surge in interest in acute malnutrition as an indicator of humanitarian crisis. WHO and UNICEF, as UN cluster leads in health and nutrition, have put forward a proposal for a ‘Humanitarian Health and Nutrition Tracking Service’to help track humanitarian outcomes and performance on request from the Inter-Agency Standing Committee. This is not only a technical challenge, but also an institutional one, as it is often institutional constraints that hamper the implementation of, and response to, nutrition surveys. This paper seeks to link the technical issues with a more pragmatic understanding of the institutional constraints to collecting and using information.
The National Health Care Facilities Baseline Audit: National Summary Report
Health Systems Trust: 2013
From May 2011 to May 2012, with funding from the South Africa’s national Department of Health, an audit of every health facility in the public health sector was conducted by a consortium of partners. The audit assessed infrastructure, classification of facilities, compliance to priority areas of quality and function, human resources, access and range of services offered, and geographic positioning (GPS) for location of facilities and photographs. The overall objective of the audit was to collect baseline data from all public health facilities in the country using standardised and existing measurement tools provided by the national Department of Health. The data collected were captured into the National Core Standards database established by the national Department of Health. Data collected from each of the facilities were aggregated to sub-district, district and national averages that are presented by theme in a variety of dashboards and can be accessed centrally from the web-based reporting database. This national summary report provides a succinct and high level interpretation of the results and summary of the findings of the audit. This information is essential to identify health system strengths and gaps, to assess current and future needs and for planning investments and future services such as the National Health Insurance.
The parameters of the current legal framework for health research: Forms of health research which are regulated and obligations imposed on researchers
Strode AE: South African Journal of Bioethics and Law, 6(2):69-71, November, 2013
On 1 March 2012, the South African Minister of Health operationalised section 71 of the National Health Act (NHA), ushering in a new phase of research regulation. When read with sections 1, 11 and 16 of the NHA, section 71 describes the legal norms for undertaking various forms of health research in South Africa. Three key terms used in the NHA now set the parameters of the legal framework for regulating health research: ‘health research’ (section 1), ‘research or experimentation on a living person’ (section 71), and the provision of a ‘health service for research or experimental purposes’ (section 11). Importantly, these three concepts delineate (i) what forms of health research are regulated by the legal framework, and (ii) the nature of the obligations placed on health researchers and others. The author argues that researchers and members of research ethics committees need to be aware that the NHA assigns different legal obligations to different forms of health research. This article describes the parameters of the new legal framework and the obligations that flow from each of the three categories of health research. It shows how the restrictions the framework imposes are not evenly spread across all forms of research, and concludes by identifying some of its strengths, weaknesses and anomalies. It further suggests that more conceptual elaboration is required to ascertain whether the differences are coherent and justified.
The power of action-based dissemination
Ifakara Health Institute Spotlight: Evidence for policy and action 19.01, IHI, Tanzania, 2019
In 2018, Ifakara Health Institute disseminated results emerging from the formative study for Children In the Mining (CIM) seeking to improve access to social- economic and health services for children living in the mining areas in Bukombe, Songwe and Chunya districts of Tanzania. Using an action-based approach, members of the Kerezia community involved reflected on the findings and developed a plan of action to address the social-economic problems that face children living in the mining areas. The villagers prioritized water, roads and schooling. A while later the villagers reported to the IHI researchers: "We are happy to tell you that one of our priorities has been implemented and through the efforts of community members, we have constructed a foundation for the primary school here in our village [........] I was really wondering how I could see you and inform you about this progress." The Kerezia story is argued to highlight how scientists need to go beyond the traditional methods of sharing research findings and apply action-based dissemination where possible to influence change at the grass roots.
The problem of ‘trickle-down science’ from the Global North to the Global South
Reidpath D; Allotey P: BMJ Global Health 4(4), doi: http://dx.doi.org/10.1136/bmjgh-2019-001719, 2019
Ten years ago, Nigel Crisp observed, with respect to the healthcare workforce that ‘the global health system is characterised by an import–export business in which rich countries export the ideology of Western scientific medicine and aid predicated on this ideology to poor countries. In return, the poor countries export a portion of their preciously limited pool of trained health workers back to the rich countries’. The authors of the paper suggest that a similar situation holds in scientific research. Many of the very brightest minds from the Global South go to institutions of higher learning in the Global North, either as graduate students or as fully fledged researchers. They are attracted by better pay, resources, engagement and prestige. There are then three broad outcomes: If the move is a permanent one (which is the case 70% of the time) many turn their focus away from the concerns of the south towards the research priorities in the north, where the funding is. Others remain in the north but keep their focus on the issues of the south, albeit often with limited impact, and sometimes compromising their career progression in the north. The third outcome is the return of the researcher to the south, and frustration over the lack of an enabling environment to apply their skills. Trickle-down science as a strategy for advancing knowledge for current and future challenges has enabled an inequity in the distribution of scientific capacities. However the authors observe that there are ways to engage more effectively with the growing, if disempowered, talent in the south to build of enabling environments, leadership and a quality and volume of home grown, contextually driven knowledge.
The problem of ‘trickle-down science’ from the Global North to the Global South
Reidpath D; Allotey P: BMJ Global Health 4(4), doi: http://dx.doi.org/10.1136/bmjgh-2019-001719, 2019
Countries in the Global South continue to struggle to train and retain good researchers and practitioners to address local, regional and global health challenges. As a result, there is an ongoing reliance on the Global North for solutions to local problems and an inability to develop alternative approaches to problem solving that take local (non-northern) contexts into account. Current paradigms of scientific advancement provide no long-term models to challenge the status quo or privilege knowledge that is generated primarily in the Global South. This has major impacts on access to funding which perpetuates the problem. The authors argue that there needs to be a concerted and demonstrable shift to value and promote the development of research and scientific traditions that are borne out of the reality of local contexts that complement knowledge and evidence generated in the Global North.
The Promise of Community-Based Participatory Research for Health Equity: A Conceptual Model for Bridging Evidence With Policy
Cacari-Stone L, Wallerstein N, Garcia AP, and Minkler M: Am J Public Health. Published online ahead of print e1–e9, July 17 2014
Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particular community-based participatory research (CBPR), influences health policy to eliminate racial and ethnic health inequities. To address this gap, the authors highlighted the efforts of two CBPR partnerships to explore how these initiatives made substantial contributions to policymaking for health equity. They present a new conceptual model and two case studies to illustrate the connections among CBPR contexts and processes, policymaking processes and strategies, and outcomes. They extended the critical role of civic engagement by those communities that were most burdened by health inequities by focusing on their political participation as research brokers in bridging evidence and policymaking.