scholarly journals A patient–clinician James Lind Alliance partnership to identify research priorities for hyperemesis gravidarum

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041254
Author(s):  
Caitlin R Dean ◽  
Hyke Bierma ◽  
Ria Clarke ◽  
Brian Cleary ◽  
Patricia Ellis ◽  
...  
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Hyperemesis Gravidarum ◽  
Research Priorities ◽  
Developed Countries ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
James Lind Alliance ◽  
Research Questions

ObjectiveThere are many uncertainties surrounding the aetiology, treatment and sequelae of hyperemesis gravidarum (HG). Prioritising research questions could reduce research waste, helping researchers and funders direct attention to those questions which most urgently need addressing. The HG priority setting partnership (PSP) was established to identify and rank the top 25 priority research questions important to both patients and clinicians.MethodsFollowing the James Lind Alliance (JLA) methodology, an HG PSP steering group was established. Stakeholders representing patients, carers and multidisciplinary professionals completed an online survey to gather uncertainties. Eligible uncertainties related to HG. Uncertainties on nausea and vomiting of pregnancy and those on complementary treatments were not eligible. Questions were verified against the evidence. Two rounds of prioritisation included an online ranking survey and a 1-hour consensus workshop.Results1009 participants (938 patients/carers, 118 professionals with overlap between categories) submitted 2899 questions. Questions originated from participants in 26 different countries, and people from 32 countries took part in the first prioritisation stage. 66 unique questions emerged, which were evidence checked according to the agreed protocol. 65 true uncertainties were narrowed via an online ranking survey to 26 unranked uncertainties. The consensus workshop was attended by 19 international patients and clinicians who reached consensus on the top 10 questions for international researchers to address. More patients than professionals took part in the surveys but were equally distributed during the consensus workshop. Participants from low-income and middle-income countries noted that the priorities may be different in their settings.ConclusionsBy following the JLA method, a prioritised list of uncertainties relevant to both HG patients and their clinicians has been identified which can inform the international HG research agenda, funders and policy-makers. While it is possible to conduct an international PSP, results from developed countries may not be as relevant in low-income and middle-income countries.

scholarly journals Primary care financing: a systematic assessment of research priorities in low- and middle-income countries

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001483 ◽  
Author(s):  
Felicity Goodyear-Smith ◽  
Andrew Bazemore ◽  
Megan Coffman ◽  
Richard Fortier ◽  
Amanda Howe ◽  
...  
Keyword(s):  
Primary Care ◽  
Research Priorities ◽  
Knowledge Gaps ◽  
Middle Income ◽  
Policy Makers ◽  
Diverse Range ◽  
Middle Income Countries ◽  
Delphi Round ◽  
Research Questions ◽  
Low And Middle Income

IntroductionFinancing of primary healthcare (PHC) is the key to the provision of equitable universal care. We aimed to identify and prioritise the perceived needs of PHC practitioners and researchers for new research in low- and middle-income countries (LMIC) about financing of PHC.MethodsThree-round expert panel consultation using web-based surveys of LMIC PHC practitioners, academics and policy-makers sampled from global networks. Iterative literature review conducted in parallel. First round (Pre-Delphi survey) elicited possible research questions to address knowledge gaps about financing. Responses were independently coded, collapsed and synthesised to two lists of questions. Round 2 (Delphi Round 1) invited panellists to rate importance of each question. In Round 3 (Delphi Round 2), panellists ranked questions in order of importance.ResultsA diverse range of PHC practitioners, academics and policy-makers in LMIC representing all global regions identified 479 knowledge gaps as potentially critical to improving PHC financing. Round 2 provided 31 synthesised questions on financing for rating. The top 16 were ranked in Round 3e to produce four prioritised research questions.ConclusionsThis novel exercise created an expansive and prioritised list of critical knowledge gaps in PHC financing research questions. This offers valuable guidance to global supporters of primary care evaluation and implementation, including research funders and academics seeking research priorities. The source and context specificity of this research, informed by LMIC practitioners and academics on a global and local basis, should increase the likelihood of local relevance and eventual success in implementing the findings.

Migraine and Stress – An Explorative Cross-Country Study of External Stress Factors

2020 ◽  
Author(s):  
Irene van Staveren
Keyword(s):  
Low Income ◽  
Developed Countries ◽  
Ordinary Least Squares ◽  
External Stress ◽  
Stress Factors ◽  
Middle Income ◽  
Middle Income Countries ◽  
Proxy Variables ◽  
Modifiable Factors ◽  
Cross Country

Abstract BackgroundAccording to the Global Burden of Disease 2016 project, migraine ranks first for 15-49 years and second for all ages. The project has reported no significant relation with socio-economic status of a country. To the contrary, migraine ranks first for all ages in low- and middle-income countries suffering from civic unrest and conflict. This raises the question whether external stress factors may be correlated with migraine years lived with disability (YLD).MethodsIn the absence of cross-country studies on migraine and stress, this is a unique exploratory study. The analysis uses two country groups: developed countries (including some middle-income countries) and developing (middle- and low-income) countries. For the first group, proxy variables for stress are included that relate to flexible and highly competitive labour markets (productivity and unemployment), whereas for the second group, proxy variables are used that relate to conflict and migration. The data were analysed with multiple ordinary least squares cross-section regressions.ResultsThe results show a positive relationship between the stress variables on the one hand and migraine YLD on the other hand for both country groups. Almost all results are statistically significant at p<0.01.ConclusionsThe findings from the exploratory cross-country analysis suggest that societal stress factors may be potential candidates for modifiable factors for the prevalence and severity of migraine at the country level.

The Evolution of the Digital Divide across Developing Countries

2013 ◽  
pp. 1554-1570
Author(s):  
Nicoletta Corrocher ◽  
Anna Raineri
Keyword(s):  
Developing Countries ◽  
Digital Divide ◽  
Low Income ◽  
Competition Policy ◽  
Developed Countries ◽  
Policy Implications ◽  
Effective Strategy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emerging Patterns

This chapter aims at investigating the evolution of the digital divide within a set of developing countries between the years 2000 and 2005. In doing so, it moves away from the traditional analysis of the digital divide, which compares developed countries and developing countries, and examines the existing gap within a relatively homogeneous group of countries. On the basis of the theoretical and empirical contributions from scholars in different disciplines, we select a series of socioeconomic and technological indicators and provide an empirical assessment of the digitalization patterns in a set of 51 low income and lower-middle income countries. By means of cluster analysis techniques, we identify three emerging patterns of the digital divide and derive a series of policy implications, related to the implementation of an effective strategy to reduce digital backwardness. The characteristics of each pattern of digitalization can be also usefully employed to understand whether past interventions, especially in the area of competition policy, have been successful in addressing country-specific issues.

scholarly journals Advancing research on emergency care systems in low-income and middle-income countries: ensuring high-quality care delivery systems

2019 ◽  
Vol 4 (Suppl 6) ◽  
pp. e001265 ◽  
Author(s):  
Rachel T Moresky ◽  
Junaid Razzak ◽  
Teri Reynolds ◽  
Lee A Wallis ◽  
Benjamin W Wachira ◽  
...  
Keyword(s):  
Health Systems ◽  
Emergency Care ◽  
Low Income ◽  
Communicable Diseases ◽  
Middle Income ◽  
Care Research ◽  
Middle Income Countries ◽  
Emergency Care Systems ◽  
Care Systems ◽  
Research Questions

Emergency care systems (ECS) address a wide range of acute conditions, including emergent conditions from communicable diseases, non-communicable diseases, pregnancy and injury. Together, ECS represent an area of great potential for reducing morbidity and mortality in low-income and middle-income countries (LMICs). It is estimated that up to 54% of annual deaths in LMICs could be addressed by improved prehospital and facility-based emergency care. Research is needed to identify strategies for enhancing ECS to optimise prevention and treatment of conditions presenting in this context, yet significant gaps persist in defining critical research questions for ECS studies in LMICs. The Collaborative on Enhancing Emergency Care Research in LMICs seeks to promote research that improves immediate and long-term outcomes for clients and populations with emergent conditions. The objective of this paper is to describe systems approaches and research strategies for ECS in LMICs, elucidate priority research questions and methodology, and present a selection of studies addressing the operational, implementation, policy and health systems domains of health systems research as an approach to studying ECS. Finally, we briefly discuss limitations and the next steps in developing ECS-oriented interventions and research.

scholarly journals Governing multisectoral action for health in low-income and middle-income countries: an agenda for the way forward

2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000890 ◽  
Author(s):  
Kumanan Rasanathan ◽  
Vincent Atkins ◽  
Charles Mwansambo ◽  
Agnès Soucat ◽  
Sara Bennett
Keyword(s):  
Low Income ◽  
Implementation Research ◽  
Conflicts Of Interest ◽  
Health Sector ◽  
Middle Income ◽  
Policy Makers ◽  
Implementation Processes ◽  
Existing Structures ◽  
Middle Income Countries ◽  
The Way

Drawing on experiences reviewed in the accompanying supplement and other literature, we present an agenda for the way forward for policy-makers, managers, civil society and development partners to govern multisectoral action for health in low-income and middle-income countries and consider how such an agenda might be realised. We propose the following key strategies: understand the key actors and political ecosystem, including type of multisectoral action required and mapping incentives, interests and hierarchies; frame the issue in the most strategic manner; define clear roles with specific sets of interventions according to sector; use existing structures unless there is a compelling reason not to do so; pay explicit attention to the roles of non-state sectors; address conflicts of interest and manage tradeoffs; distribute leadership; develop financing and monitoring systems to encourage collaboration; strengthen implementation processes and capacity; and support mutual learning and implementation research. To support countries to strengthen governance for multisectoral action, the global community can assist by further developing technical tools and convening peer learning by policy-makers (particularly from beyond the health sector), supporting knowledge management and sharing of experiences in multisectoral action beyond health, developing an agenda for and execution of implementation research and, finally, driving multilateral and bilateral development partners to transcend their own silos and work in a more multisectoral manner.

scholarly journals Identifying health policy and systems research priorities on multisectoral collaboration for health in low-income and middle-income countries

2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000970 ◽  
Author(s):  
Douglas Glandon ◽  
Ankita Meghani ◽  
Nasreen Jessani ◽  
Mary Qiu ◽  
Sara Bennett
Keyword(s):  
Low Income ◽  
Health Sector ◽  
Research Priorities ◽  
Implementation Strategies ◽  
Health Coverage ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Systems Research ◽  
Review Articles

IntroductionWhile efforts to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) have reinvigorated interest in multisectoral collaborations (MSCs) among the global health and development community, there remains a plethora of questions about how best to conceptualise, plan, implement, evaluate and sustain MSCs. The objective of this paper is to present research priorities on MSC for health from researchers and policymakers around the globe, with an emphasis on low-income and middle-income countries.MethodsThe authors identified 30 priority research questions from two sources: (1) 38 review articles on MSC for health, and (2) interviews and focus groups with a total of 81 policymakers, including government officials (largely from ministries of health and state/provincial departments of health, but also offices of planning, public service, social development, the prime minister and others), large multilateral or bilateral organisations, and non-governmental organisations. In a third phase, questions were refined and ranked by a diverse group of researchers from around the globe using an online voting platform.ResultsThe top-ranked questions focused predominantly on pragmatic questions, such as how best to structure, implement and sustain MSCs, as well as how to build stakeholder capacity and community partnerships. Despite substantial variation between review articles, policymakers’ reflections and online ranking by researchers, two topics emerged as research priorities for all three: (1) leadership, partnership and governance structures for MSCs; and (2) MSC implementation strategies and mechanisms. The review articles underscored the need for more guidance on appropriate study designs and methods for investigating MSCs, which may be a prerequisite for other identified research priorities.ConclusionThese findings could inform efforts within and beyond the health sector to better align research objectives and funding with the evidence needs of policymakers grappling with questions about how best to leverage MSCs to achieve UHC and the SDGs.

scholarly journals Do combination HIV prevention programmes result in increased empowerment, inclusion and agency to demand equal rights for marginalised populations in low-income and middle-income countries? A systematic review

2019 ◽  
Vol 4 (5) ◽  
pp. e001560
Author(s):  
Carinne Brody ◽  
Say Sok ◽  
Sovannary Tuot ◽  
Marija Pantelic ◽  
Enrique Restoy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Low Income ◽  
Equal Rights ◽  
Middle Income ◽  
Policy Makers ◽  
Combination Prevention ◽  
Middle Income Countries ◽  
Registration Number ◽  
Prevention Programmes

IntroductionThis systematic review aims to determine if combination HIV prevention programmes include outcome measures for empowerment, inclusion and agency to demand equal rights and measure the relationship between empowerment and HIV prevention outcomes.MethodsAn electronic literature search of PubMed, POPLINE, Index Medicus and Google Scholar was conducted between August and October 2018. We included studies that evaluated combination prevention programmes that had all three types of intervention components and that specifically serve members of populations disproportionately affected by HIV published from 2008 to 2018. The selected studies were screened for inclusion, and relevant data abstracted, assessed for bias and synthesised.ResultsThis review included a total of 15 studies. Findings indicate that combination HIV prevention programmes for marginalised populations have delivered a variety of theory-based behavioural and structural interventions that support improvements in empowerment, inclusion and agency. However, empowerment, inclusion and least of all agency are not measured consistently or in a standardised way. In addition, analysis of their relationships with HIV prevention outcomes is rare. Out of our 15 included studies, only two measured a relationship between an empowerment, inclusion or agency outcome and an HIV prevention outcome.ConclusionThese findings suggest that policy-makers, programme planners and researchers might need to consider the intermediate steps on the pathway to increased condom use and HIV testing so as to explain the ‘how’ of their achievements and inform future investments in HIV prevention. This will support replication and expansion of programmes and ensure sustainability of the programmes.PROSPERO registration numberCRD42018106909

The Evolution of the Digital Divide across Developing Countries

2010 ◽  
pp. 58-74
Author(s):  
Nicoletta Corrocher ◽  
Anna Raineri
Keyword(s):  
Developing Countries ◽  
Digital Divide ◽  
Low Income ◽  
Competition Policy ◽  
Developed Countries ◽  
Policy Implications ◽  
Effective Strategy ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emerging Patterns

This chapter aims at investigating the evolution of the digital divide within a set of developing countries between the years 2000 and 2005. In doing so, it moves away from the traditional analysis of the digital divide, which compares developed countries and developing countries, and examines the existing gap within a relatively homogeneous group of countries. On the basis of the theoretical and empirical contributions from scholars in different disciplines, we select a series of socioeconomic and technological indicators and provide an empirical assessment of the digitalization patterns in a set of 51 low income and lower-middle income countries. By means of cluster analysis techniques, we identify three emerging patterns of the digital divide and derive a series of policy implications, related to the implementation of an effective strategy to reduce digital backwardness. The characteristics of each pattern of digitalization can be also usefully employed to understand whether past interventions, especially in the area of competition policy, have been successful in addressing country-specific issues.

Internet Use around the World: An Empirical Assessment

2017 ◽  
Vol 16 (6) ◽  
pp. 683-699
Author(s):  
Minh Dao
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Internet Use ◽  
Developed Countries ◽  
Computer Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Internet Application ◽  
Developing And Developed Countries

Abstract This paper empirically assesses the effect of the determinants of Internet use, using several samples of both developed and developing countries. Based on a sample of 23 low-income economies in 2015, we find that Internet use depends upon computer access. Using a sample of 38 lower middle-income countries we find that Internet use depends upon Internet quality and Internet affordability. Using a sample of 41 upper middle-income countries, we find that computer access and Internet affordability influence Internet use. From a sample of 45 high-income countries, we are able to show that computer access, Internet quality, and affordability do affect Internet use. Using a sample of thirty oecd countries, we find that Internet use depends upon computer access and Internet quality. When a sample of 150 developing and developed countries is used, results show that Internet use is influenced by computer access, Internet quality, Internet affordability, and Internet application.

scholarly journals Product Space Perspective on Structural Change in Morocco

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Israel Osorio Rodarte ◽  
Hans Lofgren
Keyword(s):  
Low Income ◽  
Product Space ◽  
High Growth ◽  
High Tech ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Moderate Growth ◽  
Manufactured Products ◽  
Space Approach

AbstractDrawing on international trade data, this paper uses the product space approach to analyze changes in Morocco’s goods exports in 1990–2010 and future export priorities. The level and moderate growth of Morocco’s gross domestic product match the predictions of product space analysis, informed by changes in the income potential of Morocco’s export basket, reflecting relatively strong capabilities in products with a relatively low potential to contribute to income growth and diversification. Morocco’s peripheral position in the product space points to the difficulty of diversification into more sophisticated products. Encouraging changes since 1990 include the development of a revealed comparative advantage in medium- and high-tech manufactures. However, the number of goods involved is relatively small and this transformation has not sufficed to raise per capita growth to the average for middle-income countries. Among sectors, high growth is likely for phosphate-based fertilizer exports. However, phosphates are hampered by low income and diversification potentials. Along with various other manufactured products, electronics and the automotive industry are promising sectors that may offer more lasting positive contributions. Beyond goods, policy makers should also consider the potential contributions of service exports, which in recent years have enjoyed rapid growth.

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