scholarly journals Health priority-setting for official development assistance in low-income and middle-income countries: a Best Fit Framework Synthesis study with primary data from Ethiopia, Nigeria and Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoxiao Jiang Kwete ◽  
Yemane Berhane ◽  
Mary Mwanyika-Sando ◽  
Ayo Oduola ◽  
Yuning Liu ◽  
...  
Keyword(s):  
Decision Making ◽  
Low Income ◽  
Priority Setting ◽  
Development Assistance ◽  
Official Development Assistance ◽  
Healthcare Sector ◽  
Primary Data ◽  
Decision Making Process ◽  
Middle Income ◽  
Middle Income Countries

Abstract Background Decision making process for Official Development Assistance (ODA) for healthcare sector in low-income and middle-income countries involves multiple agencies, each with their unique power, priorities and funding mechanisms. This process at country level has not been well studied. Methods This paper developed and applied a new framework to analyze decision-making process for priority setting in Ethiopia, Nigeria, and Tanzania, and collected primary data to validate and refine the model. The framework was developed following a scoping review of published literature. Interviews were then conducted using a pre-determined interview guide developed by the research team. Transcripts were reviewed and coded based on the framework to identify what principles, players, processes, and products were considered during priority setting. Those elements were further used to identify where the potential capacity of local decision-makers could be harnessed. Results A framework was developed based on 40 articles selected from 6860 distinct search records. Twenty-one interviews were conducted in three case countries from 12 institutions. Transcripts or meeting notes were analyzed to identify common practices and specific challenges faced by each country. We found that multiple stakeholders working around one national plan was the preferred approach used for priority setting in the countries studied. Conclusions Priority setting process can be further strengthened through better use of analytical tools, such as the one described in our study, to enhance local ownership of priority setting for ODA and improve aid effectiveness.

scholarly journals Distributing development assistance for health: simulating the implications of 11 criteria

2017 ◽  
Vol 12 (2) ◽  
pp. 245-263
Author(s):  
Trygve Ottersen ◽  
Suerie Moon ◽  
John-Arne Røttingen
Keyword(s):  
Low Income ◽  
Economic Transition ◽  
Development Assistance ◽  
National Income ◽  
Low Income Countries ◽  
Economic Downturn ◽  
Middle Income ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Almost All

AbstractAfter years of unprecedented growth in development assistance for health (DAH), the DAH system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases and by the economic transition and rise of the middle-income countries. Central to any potent response is a fair and effective allocation of DAH across countries. A myriad of criteria has been proposed or is currently used, but there have been no comprehensive assessment of their distributional implications. We simulated the implications of 11 quantitative allocation criteria across countries and country categories. We found that the distributions varied profoundly. The group of low-income countries received most DAH from needs-based criteria linked to domestic capacity, while the group of upper-middle-income countries was most favoured by an income-inequality criterion. Compared to a baseline distribution guided by gross national income per capita, low-income countries received less DAH by almost all criteria. The findings can inform funders when examining and revising the criteria they use, and provide input to the broader debate about what criteria should be used.

scholarly journals Double standards in healthcare innovations: the case of mosquito net mesh for hernia repair

2020 ◽  
pp. bmjinnov-2020-000535
Author(s):  
Mark Skopec ◽  
Alessandra Grillo ◽  
Alvena Kureshi ◽  
Yasser Bhatti ◽  
Matthew Harris
Keyword(s):  
Hernia Repair ◽  
Low Income ◽  
Low Cost ◽  
Surgical Care ◽  
Biomechanical Properties ◽  
Double Standard ◽  
Healthcare Sector ◽  
Mosquito Net ◽  
Middle Income ◽  
Middle Income Countries

With over two decades of evidence available including from randomised clinical trials, we explore whether the use of low-cost mosquito net mesh for inguinal hernia repair, common practice only in low-income and middle-income countries, represents a double standard in surgical care. We explore the clinical evidence, biomechanical properties and sterilisation requirements for mosquito net mesh for hernia repair and discuss the rationale for its use routinely in all settings, including in high-income settings. Considering that mosquito net mesh is as effective and safe as commercial mesh, and also with features that more closely resemble normal abdominal wall tissue, there is a strong case for its use in all settings, not just low-income and middle-income countries. In the healthcare sector specifically, either innovations should be acceptable for all contexts, or none at all. If such a double standard exists and worse, persists, it raises serious questions about the ethics of promoting healthcare innovations in some but not all contexts in terms of risks to health outcomes, equitable access, and barriers to learning.

scholarly journals Burden, risk factors and outcomes of hyperemesis gravidarum in low-income and middle-income countries (LMICs): systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025841 ◽  
Author(s):  
Mesfin Tadese Dinberu ◽  
Mohammed Akibu Mohammed ◽  
Tesfalidet Tekelab ◽  
Nigus Bililign Yimer ◽  
Melaku Desta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Low Income ◽  
Fixed Effects ◽  
Hyperemesis Gravidarum ◽  
Meta Analysis ◽  
Primary Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Patient Consent

IntroductionHyperemesis gravidarum (HG) is a pregnancy condition characterised by excessive nausea and vomiting resulting in dehydration, weight loss and serious adverse pregnancy outcomes including termination of pregnancies. Even though evidence in low-income and middle-income countries (LMICs) is limited, the prevalence of HG in pregnancy ranges from 0.3% to 10.8%. With this systematic review and meta-analysis, we aim to determine the prevalence/burden, risk factors, and maternal and perinatal outcomes of HG in LMICs.MethodsPubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS databases will be searched. Reference lists of selected articles will be assessed in order to identify other potential studies of interest. Observational studies and (non) randomised controlled trials conducted from January 2000 to September 2018 in LMIC will be included. A weighted inverse-variance meta-analysis using fixed-effects and random-effects model will be done to generate a pooled estimate. Funnel plot and Egger’s regression statistical test will be applied to check publication bias. Heterogeneity among studies will be checked using Τ2 to determine dispersion. Moreover, meta-regression analysis will be performed to investigate the source of heterogeneity. STATA V.14 will be used to analyse the data.Ethics and disseminationFormal ethical approval and patient consent are not required; as primary data collection will not be employed. The result will be published in a peer-reviewed scientific journal and will be presented at scientific conferences and public press.PROSPERO registration numberCRD42018096284.

scholarly journals Local ownership of health policy and systems research in low-income and middle-income countries: a missing element in the uptake debate

2019 ◽  
Vol 4 (4) ◽  
pp. e001523 ◽  
Author(s):  
Kudakwashe Paul Vanyoro ◽  
Kate Hawkins ◽  
Matthew Greenall ◽  
Helen Parry ◽  
Lynda Keeru
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Health Systems ◽  
Low Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Systems Research ◽  
Research Findings ◽  
Health Policy And Systems

Health policy and systems researchers (HPSRs) in low-income and middle-income countries (LMICs) aim to influence health systems planning, costing, policy and implementation. Yet, there is still much that we do not know about the types of health systems evidence that are most compelling and impactful to policymakers and community groups, the factors that facilitate the research to decision-making process and the real-world challenges faced when translating research findings into practice in different contexts. Drawing on an analysis of HPSR from LMICs presented at the Fifth Global Symposium on Health Systems Research (HSR 2018), we argue that while there is a recognition in policy studies more broadly about the role of co-production, collective ownership and the value of localised HPSR in the evidence-to-policy discussion, ‘ownership’ of research at country level is a research uptake catalyst that needs to be further emphasised, particularly in the HPSR context. We consider embedded research, participatory or community-initiated research and emergent/responsive research processes, all of which are ‘owned’ by policymakers, healthcare practitioners/managers or community members. We embrace the view that ownership of HPSR by people directly affected by health problems connects research and decision-making in a tangible way, creating pathways to impact.

scholarly journals Improving resource mobilisation for global health R&D: a role for coordination platforms?

2019 ◽  
Vol 4 (1) ◽  
pp. e001209 ◽  
Author(s):  
Naomi Beyeler ◽  
Sara Fewer ◽  
Marcel Yotebieng ◽  
Gavin Yamey
Keyword(s):  
Global Health ◽  
Low Income ◽  
Priority Setting ◽  
Low Income Countries ◽  
Global Health Research ◽  
Investment Strategies ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Development Goals

Achieving many of the health targets in the Sustainable Development Goals will not be possible without increased financing for global health research and development (R&D). Yet financing for neglected disease product development fell from 2009-2015, with the exception of a one-time injection of Ebola funding. An important cause of the global health R&D funding gap is lack of coordination across R&D initiatives. In particular, existing initiatives lack robust priority-setting processes and transparency about investment decisions. Low-income countries (LICs) and middle-income countries (MICs) are also often excluded from global investment initiatives and priority-setting discussions, leading to limited investment by these countries. An overarching global health R&D coordination platform is one promising response to these challenges. This analysis examines the essential functions such a platform must play, how it should be structured to maximise effectiveness and investment strategies for diversifying potential investors, with an emphasis on building LIC and MIC engagement. Our analysis suggests that a coordination platform should have four key functions: building consensus on R&D priorities; facilitating information sharing about past and future investments; building in accountability mechanisms to track R&D spending against investment targets and curating a portfolio of prioritised projects alongside mechanisms to link funders to these projects. Several design features are likely to increase the platform’s success: public ownership and management; separation of coordination and financing functions; inclusion of multiple diseases; coordination across global and national efforts; development of an international R&D ‘roadmap’ and a strategy for the financial sustainability of the platform’s secretariat.

scholarly journals Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046992
Author(s):  
Tolib Mirzoev ◽  
Anna Cronin de Chavez ◽  
Ana Manzano ◽  
Irene Akua Agyepong ◽  
Mary Eyram Ashinyo ◽  
...  
Keyword(s):  
Health Systems ◽  
Low Income ◽  
Empirical Studies ◽  
Grey Literature ◽  
Realist Synthesis ◽  
Vulnerable Groups ◽  
Primary Data ◽  
London School ◽  
Middle Income ◽  
Middle Income Countries

IntroductionHealth systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiality. Little is known, however, about underlying theories of health systems responsiveness, and the mechanisms through which responsiveness works. This realist synthesis contributes to bridging these two knowledge gaps.Methods and analysisIn this realist synthesis, we will use a four-step process, comprising: mapping of theoretical bases, formulation of programme theories, theory refinement and testing of programme theories using literature and empirical data from Ghana and Vietnam. We will include theoretical and conceptual pieces, reviews, empirical studies and grey literature, alongside the primary data. We will explore responsiveness as entailing external and internal interactions within health systems. The search strategy will be purposive and iterative, with continuous screening and refinement of theories. Data extraction will be combined with quality appraisal, using appropriate tools. Each fragment of evidence will be appraised as it is being extracted, for its relevance to the emerging programme theories and methodological rigour. The extracted data pertaining to contexts, mechanisms and outcomes will be synthesised to identify patterns and contradictions. Results will be reported using narrative explanations, following established guidance on realist syntheses.Ethics and disseminationEthics approvals for the wider RESPONSE (Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) study, of which this review is one part, were obtained from the ethics committees of the following institutions: London School of Hygiene and Tropical Medicine (ref: 22981), University of Leeds, School of Medicine (ref: MREC19-051), Ghana Health Service (ref: GHS-ERC 012/03/20) and Hanoi University of Public Health (ref: 020-149/DD-YTCC).We will disseminate results through academic papers, conference presentations and stakeholder workshops in Ghana and Vietnam.PROSPERO registration numberCRD42020200353. Full record: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200353.

scholarly journals Title Health Priority-Setting For Overseas Development Assistance in Low-Income and Middle-Income Countries: A Comparative Case Study of Ethiopia, Nigeria and Tanzania

2021 ◽  
Author(s):  
Xiaoxiao Jiang Kwete ◽  
Yemane Berhane ◽  
Mary Mwanyika-Sando ◽  
Ayo Oduola ◽  
Yuning Liu ◽  
...  
Keyword(s):  
Low Income ◽  
Priority Setting ◽  
Aid Effectiveness ◽  
Comparative Case Study ◽  
Priority Setting Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Setting Process ◽  
Local Decision ◽  
The One

Abstract Background Priority setting process for the health care sector in low- and middle-income countries involves multiple agencies, each with their unique power, decision-making and funding mechanisms. Methods This paper developed and applied a new framework to analyze priority setting processes in Ethiopia, Nigeria, and Tanzania, from a scoping review of literature. Interviews were then conducted using a pre-determined interview guide developed by the research team. Transcripts were reviewed and coded based on the framework to identify what principles, players, processes, and products were considered during priority setting. Those elements were further used to identify where the potential capacity of local decision-makers could be harnessed. Results a framework was developed based on 40 articles selected from 6860 distinct search records. 21 interviews were conducted in three case countries from 12 institutions. Transcripts or meeting notes were analyzed to identify common practices and specific challenges faced by each country. We found that multiple stakeholders working around one national plan was the preferred approach used for priority setting in the countries studied. Conclusions Priority setting process can be further strengthened through better use of analytical tools, such as the one described in our study, to enhance local ownership and improve aid effectiveness.

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