scholarly journals Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 231 ◽  
Author(s):  
Ryan Li ◽  
Francis Ruiz ◽  
Anthony J. Culyer ◽  
Kalipso Chalkidou ◽  
Karen J Hofman
Keyword(s):  
Capacity Building ◽  
Priority Setting ◽  
Health Priorities ◽  
Economic Evaluations ◽  
Middle Income ◽  
Relevant Evidence ◽  
Trade Offs ◽  
Wide Range ◽  
The Media ◽  
Institutional Capacity Building

Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders – not only the technical capacity to “do” research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE) framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values); academics need to understand and respond to decision-makers’ needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England’s National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand) and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country) to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to their own capacity development in order to sustain and improve impact.

scholarly journals The cost-effectiveness of hypertension management in low-income and middle-income countries: a review

2020 ◽  
Vol 5 (9) ◽  
pp. e002213
Author(s):  
Deliana Kostova ◽  
Garrison Spencer ◽  
Andrew E Moran ◽  
Laura K Cobb ◽  
Muhammad Jami Husain ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Low Income ◽  
Disease Risk ◽  
National Income ◽  
Economic Evaluations ◽  
Health Improvement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
The Cost

Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertension interventions in LMICs is varied across geographical, clinical and evaluation contexts. We conducted a comprehensive search for published economic evaluations of hypertension treatment programmes in LMICs. The search identified 71 articles assessing a wide range of hypertension intervention designs and cost components, of which 42 studies across 15 countries reported estimates of cost-effectiveness. Although comparability of results was limited due to heterogeneity in the interventions assessed, populations studied, costs and study quality score, most interventions that reported cost per averted disability-adjusted life-year (DALY) were cost-effective, with costs per averted DALY not exceeding national income thresholds. Programme elements that may reduce cost-effectiveness included screening for hypertension at younger ages, addressing prehypertension, or treating patients at lower cardiovascular disease risk. Cost-effectiveness analysis could provide the evidence base to guide the initiation and development of hypertension programmes.

scholarly journals Foreword: Health Economic Evaluations in Low- and Middle-income Countries: Methodological Issues and Challenges for Priority Setting

2016 ◽  
Vol 25 ◽  
pp. 1-5 ◽  
Author(s):  
Catherine Pitt ◽  
Anna Vassall ◽  
Yot Teerawattananon ◽  
Ulla K. Griffiths ◽  
Lorna Guinness ◽  
...  
Keyword(s):  
Health Economic ◽  
Priority Setting ◽  
Economic Evaluations ◽  
Methodological Issues ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Analysis of the Health Product Profile Directory — a new tool to inform priority-setting in global public health

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
R. F. Terry ◽  
A. Plasència ◽  
J. C. Reeder
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Communicable Disease ◽  
Safety Information ◽  
Target Population ◽  
Health Priorities ◽  
Health Product ◽  
Global Public Health ◽  
Middle Income ◽  
Product Profile

Abstract Background The Health Product Profile Directory (HPPD) is an online database describing 8–10 key characteristics (such as target population, measures of efficacy and dosage) of product profiles for medicines, vaccines, diagnostics and other products that are intended to be accessed by populations in low- and middle-income countries. The HPPD was developed by TDR on behalf of WHO and launched on 15 May 2019. Methods The contents of the HPPD were downloaded into an Excel™ spreadsheet via the open access interface and analysed to identify the number of health product profiles by type, disease, year of publication, status, author organization and safety information. Results The HPPD contains summaries of 215 health product profiles published between 2008 and May 2019, 117 (54%) of which provide a hyperlink to the detailed publication from which the summary was extracted, and the remaining 98 provide an email contact for further information. A total of 55 target disease or health conditions are covered, with 210 profiles describing a product with an infectious disease as the target. Only 5 product profiles in the HPPD describe a product for a non-communicable disease. Four diseases account for 40% of product profiles in the HPPD; these are tuberculosis (33 profiles, 15%), malaria (31 profiles, 14%), HIV (13 profiles, 6%) and Chagas (10 profiles, 5%). Conclusion The HPPD provides a new tool to inform priority-setting in global health — it includes all product profiles authored by WHO (n = 51). There is a need to standardise nomenclature to more clearly distinguish between strategic publications (describing research and development (R&D) priorities or preferred characteristics) compared to target product profiles to guide a specific candidate product undergoing R&D. It is recommended that all profiles published in the HPPD define more clearly what affordability means in the context where the product is intended to be used and all profiles should include a statement of safety. Combining the analysis from HPPD to a mapping of funds available for R&D and those products in the R&D pipeline would create a better overview of global health priorities and how they are supported. Such analysis and increased transparency should take us a step closer to measuring and improving coordination of efforts in global health R&D.

scholarly journals Monitoring and evaluating capacity building activities in low and middle income countries: challenges and opportunities

2016 ◽  
Vol 3 ◽  
Author(s):  
M. Schneider ◽  
T. van de Water ◽  
R. Araya ◽  
B. B. Bonini ◽  
D. J. Pilowsky ◽  
...  
Keyword(s):  
Mental Health ◽  
Capacity Building ◽  
Middle Income ◽  
Middle Income Countries ◽  
Grant Applications ◽  
Wide Range ◽  
Challenges And Opportunities ◽  
Building Activities ◽  
Training And Support ◽  
Global Population

BackgroundLower and middle income countries (LMICs) are home to >80% of the global population, but mental health researchers and LMIC investigator led publications are concentrated in 10% of LMICs. Increasing research and research outputs, such as in the form of peer reviewed publications, require increased capacity building (CB) opportunities in LMICs. The National Institute of Mental Health (NIMH) initiative, Collaborative Hubs for International Research on Mental Health reaches across five regional ‘hubs’ established in LMICs, to provide training and support for emerging researchers through hub-specific CB activities. This paper describes the range of CB activities, the process of monitoring, and the early outcomes of CB activities conducted by the five research hubs.MethodsThe indicators used to describe the nature, the monitoring, and the early outcomes of CB activities were developed collectively by the members of an inter-hub CB workgroup representing all five hubs. These indicators included but were not limited to courses, publications, and grants.ResultsResults for all indicators demonstrate a wide range of feasible CB activities. The five hubs were successful in providing at least one and the majority several courses; 13 CB recipient-led articles were accepted for publication; and nine grant applications were successful.ConclusionsThe hubs were successful in providing CB recipients with a wide range of CB activities. The challenge remains to ensure ongoing CB of mental health researchers in LMICs, and in particular, to sustain the CB efforts of the five hubs after the termination of NIMH funding.

Tools of the trade: a comparative analysis of approaches to priority setting in healthcare

2003 ◽  
Vol 16 (2) ◽  
pp. 96-105 ◽  
Author(s):  
C. Mitton ◽  
C. Donaldson
Keyword(s):  
Comparative Analysis ◽  
Needs Assessment ◽  
Priority Setting ◽  
Quality Adjusted Life Year ◽  
Health Priorities ◽  
Economic Evaluations ◽  
Marginal Costs ◽  
League Tables ◽  
Theoretical Perspectives ◽  
Quality Adjusted Life

In many countries, local managers and clinicians have been given responsibility to set health priorities and allocate resources accordingly. Although tools have been suggested for use in aiding this process, knowledge of these tools within health regions is lacking and comparative analysis in the literature is limited. Several approaches to priority setting are critiqued from both practical and theoretical perspectives, and a tangible way forward for such activity is provided. The approaches analysed include: needs assessment, core services, economic evaluation including quality-adjusted life year league tables, and programme budgeting and marginal analysis (PBMA). Needs assessment fails to recognize underlying economic principles of opportunity cost and the margin, while core services ignores the margin and has had limited impact in practice. Economic evaluations can consider marginal costs and benefits, but cannot always be used to inform decisions in a timely manner. PBMA is based on underlying economic principles and can pragmatically respond to objectives related to both efficiency and equity. Although PBMA is not without challenges, from an economic perspective, it does seem to 'get the thinking right', and, importantly, as a process, can incorporate some of the other approaches to priority setting discussed in this paper.

scholarly journals Research, education and capacity building priorities for violence, abuse and mental health in low- and middle-income countries: an international qualitative survey

2021 ◽  
Author(s):  
Roxanne C. Keynejad ◽  
Abigail Bentley ◽  
Urvita Bhatia ◽  
Oliva Nalwadda ◽  
Fikru Debebe Mekonnen ◽  
...  
Keyword(s):  
Mental Health ◽  
Capacity Building ◽  
Voluntary Sector ◽  
Sub Saharan Africa ◽  
World Health ◽  
Health Priorities ◽  
Middle Income ◽  
Research Education ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Purpose Despite the World Health Organization and United Nations recognising violence, abuse and mental health as public health priorities, their intersection is under-studied in low- and middle-income countries (LMICs). International violence, abuse and mental health network (iVAMHN) members recognised the need to identify barriers and priorities to develop this field. Methods Informed by collaborative discussion between iVAMHN members, we conducted a pilot study using an online survey to identify research, education and capacity building priorities for violence, abuse and mental health in LMICs. We analysed free-text responses using thematic analysis. Results 35 senior (29%) and junior researchers (29%), non-government or voluntary sector staff (18%), health workers (11%), students (11%) and administrators (3%) completed the survey. Respondents worked in 24 LMICs, with 20% working in more than one country. Seventy-four percent of respondents worked in sub-Saharan Africa, 37% in Asia and smaller proportions in Latin America, Eastern Europe and the Middle East. Respondents described training, human resource, funding and sensitivity-related barriers to researching violence, abuse and mental health in LMICs and recommended a range of actions to build capacity, streamline research pathways, increase efficiency and foster collaborations and co-production. Conclusion The intersection between violence, abuse and mental health in LMICs is a priority for individuals with a range of expertise across health, social care and the voluntary sector. There is interest in and support for building a strong network of parties engaged in research, service evaluation, training and education in this field. Networks like iVAMHN can act as hubs, bringing together diverse stakeholders for collaboration, co-production and mutually beneficial exchange of knowledge and skills.

scholarly journals QALYs vs DALYs vs LYs gained: What are the differences, and what difference do they make for health care priority setting?

2009 ◽  
Vol 15 (2) ◽  
Author(s):  
Bjarne Robberstad
Keyword(s):  
Health Care ◽  
Priority Setting ◽  
Sub Saharan Africa ◽  
Economic Evaluations ◽  
Mortality And Morbidity ◽  
Trade Offs ◽  
Life Years ◽  
Consistent Manner ◽  
Sub Saharan ◽  
Health Care Priority Setting

QALYs, DALYs and life years gained are all common outcome measures in economic evaluations of health interventions. While the latter is a pure measure of mortality, QALYs and DALYs are measures that combine mortality with morbidity in single numerical units, an exercise involving trade-offs between quantity for quality of health. Some authors have argued that mortality and morbidity are totally different dimensions, and combining them into a single numerical unit is nonsensious. Others have argued that the exercise is necessary in order to convert principles for resource allocation to criteria that can be used in a consistent manner. This paper has a two-fold objective, namely to discuss the differences between these health measures, and to explore what difference they are likely to make for health care priority setting in sub-Saharan Africa.<span style="color: #000000;"> </span><script type="text/javascript"></script>

How Scientists Communicate

2020 ◽  
Author(s):  
Alan Kelly
Keyword(s):  
Ethical Issues ◽  
Scientific Communication ◽  
Scientific Publication ◽  
Good Communication ◽  
Wide Range ◽  
Conference Presentations ◽  
Scientific Papers ◽  
History Of ◽  
The Media ◽  
Broad Overview

What is scientific research? It is the process by which we learn about the world. For this research to have an impact, and positively contribute to society, it needs to be communicated to those who need to understand its outcomes and significance for them. Any piece of research is not complete until it has been recorded and passed on to those who need to know about it. So, good communication skills are a key attribute for researchers, and scientists today need to be able to communicate through a wide range of media, from formal scientific papers to presentations and social media, and to a range of audiences, from expert peers to stakeholders to the general public. In this book, the goals and nature of scientific communication are explored, from the history of scientific publication; through the stages of how papers are written, evaluated, and published; to what happens after publication, using examples from landmark historical papers. In addition, ethical issues relating to publication, and the damage caused by cases of fabrication and falsification, are explored. Other forms of scientific communication such as conference presentations are also considered, with a particular focus on presenting and writing for nonspecialist audiences, the media, and other stakeholders. Overall, this book provides a broad overview of the whole range of scientific communication and should be of interest to researchers and also those more broadly interested in the process how what scientists do every day translates into outcomes that contribute to society.

Global Health Priority-Setting

2019 ◽  
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Health Resources ◽  
Decision Makers ◽  
Health Priorities ◽  
Health Coverage ◽  
Household Finances ◽  
Health Gains ◽  
Global Priority ◽  
Financing Gap

Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development assistance for health has plateaued and domestic funding on health in most countries is growing at rates too low to close the financing gap. National and international decision-makers face tough choices about how scarce health care resources should be spent. Should additional funds be spent on primary prevention of stroke, treating childhood cancer, or expanding treatment for HIV/AIDS? Should health coverage decisions take into account the effects of illness on productivity, household finances, and children’s educational attainment, or should they just focus on health outcomes? Does age matter for priority-setting or should it be ignored? Are health gains far in the future less important than gains in the present? Should higher priority be given to people who are sicker or poorer? This book provides a framework for how to think about evidence-based priority-setting in health. Over 18 chapters, ethicists, philosophers, economists, policymakers, and clinicians from around the world assess the state of current practice in national and global priority-setting, describe new tools and methodologies to address establishing global health priorities, and tackle the most important ethical questions that decision-makers must consider in allocating health resources.

scholarly journals Global Prevalence and Drivers of Dental Students’ COVID-19 Vaccine Hesitancy

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 566
Author(s):  
Abanoub Riad ◽  
Huthaifa Abdulqader ◽  
Mariana Morgado ◽  
Silvi Domnori ◽  
Michal Koščík ◽  
...  
Keyword(s):  
International Association ◽  
Cross Sectional Study ◽  
Dental Students ◽  
Vaccine Hesitancy ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Middle Income ◽  
Related Attitude ◽  
The Media ◽  
Acceptance Levels

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students’ acceptance levels. Methods: A global cross-sectional study was carried out in February 2021 using an online questionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data were collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experience, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO SAGE. Results: A total of 6639 students from 22 countries, representing all world regions, responded to the questionnaire properly. Their mean age was 22.1 ± 2.8 (17–40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs. 19.8%; p < 0.01). Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.

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