scholarly journals Global Justice and Health Systems Research in Low- and Middle-Income Countries

2015 ◽  
Vol 43 (1) ◽  
pp. 143-161 ◽  
Author(s):  
Bridget Pratt ◽  
Adnan A. Hyder
Keyword(s):  
Global Health ◽  
International Research ◽  
Global Justice ◽  
High Income ◽  
Ethical Framework ◽  
Middle Income ◽  
Middle Income Countries ◽  
Systems Research ◽  
Health Justice ◽  
Low And Middle Income

More than a decade ago, Solomon Benatar and Peter Singer argued that “a new, proactive research ethics…must ultimately be concerned with reducing inequities in global health and achieving justice in health research and health care.” Towards this objective, a limited amount of recent scholarship has started to consider whether a theoretical basis exists for the position that international research should help promote global health equity and, if so, what the implications are for its conduct. Theories of justice from political philosophy establish obligations for parties in high-income countries to improve the health of parties in low- and middle-income countries (LMICs). These theories have been shown to provide grounds for the claim that international research should be conducted to advance justice in global health. What this means for research actors from high-income countries is the focus of a recently proposed ethical framework: “research for health justice.”

scholarly journals Alzheimer’s Disease Diagnostics Must Be Globally Accessible

2021 ◽  
pp. 1-3
Author(s):  
Nicholas Clute-Reinig ◽  
Suman Jayadev ◽  
Kristoffer Rhoads ◽  
Anne-Laure Le Ny
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Low Cost ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disease Diagnostics ◽  
Low And Middle Income

Dementia and Alzheimer’s disease (AD) are global health crises, with most affected individuals living in low- or middle-income countries. While research into diagnostics and therapeutics remains focused exclusively on high-income populations, recent technological breakthroughs suggest that low-cost AD diagnostics may soon be possible. However, as this disease shifts onto those with the least financial and structural ability to shoulder its burden, it is incumbent on high-income countries to develop accessible AD healthcare. We argue that there is a scientific and ethical mandate to develop low-cost diagnostics that will not only benefit patients in low-and middle-income countries but the AD field as a whole.

scholarly journals Is Independent Clinical Research Possible in Low- and Middle-Income Countries? A Roadmap to Address Persistent and New Barriers and Challenges

2021 ◽  
pp. 1-10
Author(s):  
Carlos H. Barrios ◽  
Max S. Mano
Keyword(s):  
Clinical Research ◽  
Academic Research ◽  
High Income ◽  
Ethical Framework ◽  
Middle Income ◽  
Ongoing Research ◽  
Middle Income Countries ◽  
Important Challenge ◽  
Barriers And Challenges ◽  
Low And Middle Income

Cancer is an increasing and significant problem for both high- and low- and middle-income countries. Basic, translational, and clinical research efforts have been instrumental in generating the outstanding improvements we have witnessed over the last few decades, answering important questions, and improving patient outcomes. Arguably, a substantial portion of currently ongoing research is sponsored by the pharmaceutical industy and specifically addresses questions under industry interests, most of which apply to high-income countries, leaving behind problems related to the much larger and underserved population of patients with cancer in low- and middle-income countries. In this scenario, discussing independent academic research is an important challenge, particularly for these countries. Although different countries and institutions face different problems while establishing independent research agendas, some generalizable barriers can be identified. A solid regulatory and ethical framework, a strong and sustainable technical supporting infrastructure, and motivated and experienced investigators are all paramount to build a viable and productive academic research program. Securing funding for research, although not the only hurdle, is certainly one of the most basic hurdles to overcome. Noticeably, and as an added impediment, public and governmental support for cancer research has been decreasing in high-income countries and is almost nonexistent in the rest of the world. We propose an initial careful diagnostic assessment of the research resource scenario of each institution/country and adjustment of the strategic development plan according to four different research resource restriction levels. Although not necessarily applicable to all situations, this model can be helpful if adjusted to each local or regional situation.

Linking Participatory Action Research on Health Systems to Justice in Global Health: A Case Study of the Maternal and Neonatal Implementation for Equitable Health Systems Project in Rural Uganda

2017 ◽  
Vol 13 (1) ◽  
pp. 74-87 ◽  
Author(s):  
Bridget Pratt ◽  
Adnan A. Hyder
Keyword(s):  
Health Systems ◽  
Ethical Framework ◽  
Participatory Action ◽  
Middle Income ◽  
Makerere University ◽  
Middle Income Countries ◽  
Systems Research ◽  
Study Sites ◽  
Health Justice

An ethical framework called “research for health justice” provides initial guidance on how to link health systems research in low- and middle-income countries to health equity. To further develop the largely conceptual framework, we tested its guidance against the experience of the Maternal and Neonatal Implementation for Equitable Health Systems (Manifest) project, which was performed in rural Uganda by researchers from Makerere University. We conducted 21 in-depth interviews with investigators and research implementers, directly observed study sites, and reviewed study-related documents. Our analysis identifies where alignment exists between the framework’s guidance and the Manifest project, providing initial lessons on how that was achieved. It also identifies where nonalignment occurred and gaps in the framework’s guidance. Suggestions are then made for revising and expanding “research for health justice.”

scholarly journals Clinical stroke research in resource limited settings: Tips and hints

2017 ◽  
Vol 13 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Jeyaraj D Pandian ◽  
Hueiming Liu ◽  
Dorcas BC Gandhi ◽  
Richard I Lindley
Keyword(s):  
Global Health ◽  
Research Training ◽  
Research Question ◽  
Research Capacity ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Regulatory Processes ◽  
Stroke Research ◽  
Low And Middle Income

Background Most stroke research is conducted in high income countries, yet most stroke occurs in low- and middle-income countries. There is an urgent need to build stroke research capacity in low- and middle-income countries. Aims To review the global health literature on how to improve research capacity in low- and middle-income countries, provide additional data from the recently completed ATTEND Trial and provide examples from our own experience. Summary of review The main themes from our literature review were: manpower and workload, research training, research question and methodology and research funding. The literature and our own experience emphasized the importance of local stakeholders to ensure that the research was appropriate, that there were robust local ethics and regulatory processes, and research was conducted by trained personnel. Research training opportunities can be developed locally, or internationally, with many international schemes available to help support new researchers from low- and middle-income country settings. International collaboration can successfully leverage funding from high income countries that not only generate data for the local country, but also provide new data appropriate to high income countries. Conclusions Building stroke research capacity in low- and middle-income countries will be vital in improving global health given the huge burden of stroke in these countries.

scholarly journals The Global Cohort of Doctoral Students: Building Shared Global Health Research Capacity in High-Income and Low- and Middle-Income Countries

2021 ◽  
Vol 87 (1) ◽  
Author(s):  
Semira Abdelmenan ◽  
Christopher T. Andersen ◽  
Fentabil Getnet ◽  
Hari S. Iyer ◽  
Kesaobaka Molebatsi ◽  
...  
Keyword(s):  
Global Health ◽  
Doctoral Students ◽  
Health Research ◽  
Research Capacity ◽  
High Income ◽  
Global Health Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Towards Ethical International Research Partnerships in Gender-Based Violence Research: Insights From Research Partners in Kenya

2021 ◽  
pp. 107780122110357
Author(s):  
Sanne Weber ◽  
Margaret Hardiman ◽  
Wangu Kanja ◽  
Siân Thomas ◽  
Nicole Robinson-Edwards ◽  
...  
Keyword(s):  
International Research ◽  
High Income ◽  
Ethical Challenges ◽  
Gender Based Violence ◽  
Research Partnerships ◽  
Middle Income ◽  
Safety Concerns ◽  
Middle Income Countries ◽  
Gender Based ◽  
Low And Middle Income

Research with survivors of gender-based violence in low- and middle-income countries is important to improve understanding of experiences of violence and the policies that can help combat it. But this research also implies risks for survivors, such as re-traumatization, safety concerns, and feelings of exploitation. These risks are magnified if research is undertaken by researchers from high-income countries, whose positionality produces power inequalities affecting both participants and research partners. This article describes the ethical challenges of international gender-based violence research from the perspective of Kenyan researchers and organizations and identifies recommendations about how to prevent them.

Abstract 32: Global Burden and Control of Hypertension in 2010: Analysis of Population-Based Studies from 89 Countries

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Katherine T Mills ◽  
Joshua D Bundy ◽  
Tanika N Kelly ◽  
Jennifer E Reed ◽  
Patricia M Kearney ◽  
...  
Keyword(s):  
Global Health ◽  
Population Based ◽  
High Income ◽  
Global Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Preventable Risk Factor ◽  
High Prevalence ◽  
And Control ◽  
Low And Middle Income

Background: Hypertension is an important global health challenge due to its high prevalence and resulting cardiovascular disease and chronic kidney disease. Hypertension is the leading preventable risk factor for premature death and disability worldwide. Objective: We estimated the prevalence, awareness, treatment and control of hypertension worldwide in 2010 and compared the global burden of hypertension in 2000 and 2010. Methods: We searched MEDLINE for published reports from January 1, 2001 to June 30, 2014 and supplemented with manual searches of references from retrieved articles. We included population-based studies and applied sex-age-specific prevalence of hypertension from each country to population data to assess the number of hypertensive adults in each region and globally. Proportions of awareness, treatment and control from each country were applied to hypertensive populations to obtain regional and global estimates. Results: An estimated 29.8% (95% confidence interval 29.6-30.0%) of the world’s adult population in 2010 had hypertension (30.7% [30.4-31.0%] in men and 28.8% [28.6-29.0%] in women). The estimated total number of hypertensive adults in 2010 was 1.33 billion (1.32-1.34 billion); 346 million (336-356 million) in high-income and 985 million (977-994 million) in low- and middle-income countries. From 2000 to 2010, the age-standardized prevalence of hypertension increased by 2.5% worldwide. The hypertension prevalence decreased 3.5% in high-income countries, whereas the prevalence increased 4.5% in low- and middle-income countries. In addition, from 2000 to 2010 the number of hypertensive adults increased by 354 million (334 million in low- and middle-income countries compared to 19 million in high-income countries). Proportions of hypertension awareness, treatment and control worldwide in 2010 were 43.5% (43.1-44.0%), 33.8% (33.3-34.2%), and 12.3% (12.1-12.6%), respectively. The proportion of hypertension control was 27.7% (27.0-28.3%) in high-income and 6.9% (6.7-7.1) in low- and middle-income countries. Conclusions: Prevention and treatment of hypertension should be a global health priority due to its high prevalence and low control rate globally, especially in low- and middle-income countries.

scholarly journals Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1038
Author(s):  
Ana Carolina B. Leme ◽  
Sophia Hou ◽  
Regina Mara Fisberg ◽  
Mauro Fisberg ◽  
Jess Haines
Keyword(s):  
English Language ◽  
Economic Status ◽  
High Income ◽  
Dietary Guidelines ◽  
Systemic Review ◽  
Healthy Children ◽  
Future Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

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