Monitoring equity and research policy

Pressure to publish is choking the academic profession
Vale P; Karataglidis S: The Conversation, 6 July 2016

The regime of publication pervades contemporary academic life across countries. The obligation that academic staff must publish is invariably presented as a virtuous thing. It is right and proper for academics to expand and extend the boundaries of their respective disciplines by publishing in outlets, as approved by their peers. Moreover, a public that is often sceptical of the usefulness of universities is often told that academics publish in “the public good”. But, the authors ask, if academic publishing is so significant in the profession, why is it that the young and talented in the academy increasingly resist it, calling it formulaic, at best, and, at worst, a sweatshop? And they ask, why is it that old academic hands are simply no longer interested in contributing to the peer-review system that is at the heart of the system and without which the standing of the entire industry will falter? For one thing, the authors argue, there is a dark side in the ceaseless pressure to publish. Funding agencies use publication records to distribute money or rank scholars and academic managers use the publication record as a means to manage people. For another, the current system privileges the journal over the book, which is argued to be damaging to the humanities. They argue for the need to recognise that “slow scholarship” is as important as it is necessary, and that deep research – especially, but not exclusively in the humanities – requires what strategic theorist Albert Wohlstetter once called a high thought to publication ratio. Research and publishing is the oxygen of academic life, but the authors suggest that the regimes of control that surround contemporary approaches to publishing are choking creativity and, with it, the profession itself.

Research Fairness Initiative Website
Council on Health Research for Development (COHRED): Geneva, 2016.

Hosted by COHRED, the Research Fairness Initiative aims to create a reporting system that encourages governments, business, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. The RFI prioritises its application in global health because there are so many urgent health-related issues, but it can be applied to other settings as well. By providing a guide to high quality reporting on measures and conditions that promote fair research partnerships, the RFI encourages all stakeholders in research and innovation for health to describe what is done within their organisation to promote fair partnerships. Through an extensive global consultative process, the RFI have identified 17 key areas of relevance to effective and lasting partnerships. The RFI acknowledges that successful partnerships often start at personal level but are then continued at institutional or national levels. While mutual admiration, respect and friendship are essential to create the foundation of effective partnerships – it is the institutional and national dimensions of research collaboration that define how, ultimately, benefits are shared.

Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia
Letebo M; Shiferaw F: Globalization and Health 12(26), June 2016

Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organised and comprehensive response to NCDs. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardisation of patient and program monitoring tools. In this cross-sectional qualitative study the authors assessed existing monitoring and evaluation tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, they explored the tools being used in the program and analysed how they might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. The authors findings indicate the apparent lack of information systems for NCD services, including the absence of standardised patient and program monitoring tools to support the services. They identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardised tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardising patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.

Metrics in Urban Health: Current Developments and Future Prospects
Prasad A; Gray C; Ross A; Kano M: Annual Review of Public Health 37, 113-133, 2016

The research community has shown increasing interest in developing and using metrics to determine the relationships between urban living and health. In particular, the authors have seen a recent exponential increase in efforts aiming to investigate and apply metrics for urban health, especially the health impacts of the social and built environments as well as air pollution. A greater recognition of the need to investigate the impacts and trends of health inequities is also evident through more recent literature. Data availability and accuracy have improved through new affordable technologies for mapping, geographic information systems and remote sensing. However, less research has been conducted in low- and middle-income countries where quality data are not always available, and capacity for analysing available data may be limited. For this increased interest in research and development of metrics to be meaningful, the best available evidence must be accessible to decision makers to improve health impacts through urban policies.

5th Annual East African Health and Scientific Conference and Exhibition Concludes in Kampala, Uganda
East African Community Headquarters, Kampala, Uganda, March 2015

The EAC Sectoral Council of Health Ministers Regional Health Sector Strategic Plan (2015-2020) is a roadmap for improving and strengthening of the regional health sector through implementation of the various approaches, interventions and innovation in the region. The 5th EAC Health and Scientific Conference contributes to and is a catalyst for strengthening regional cooperation in the health sector especially with regard to the improvement of health care service delivery and patient care outcomes. It is a platform for synthesizing, sharing and dissemination of research findings to inform policy makers, scientists and programmers on evidence-based decision-making and mobilization of political will and resources for the Health Sector.

Resilience in the SDGs: Developing an indicator for Target 1.5 that is fit for purpose
Bahadur A; Lovell E; Wilkinson E; Tanner T: Overseas Development Institute, 2015

The authors outline a comprehensive approach for developing a cross-sectoral, multi-dimensional and dynamic understanding of resilience. This underpins the message of the Sustainable Development Goals (SDGs) that development is multi-faceted and the achievement of many of the individual development goals is dependent on the accomplishment of other goals. It also acknowledges that shocks and stresses can reverse years of development gains and efforts to eradicate poverty by 2030. The authors argue that this approach to understanding resilience draws on data that countries will collect for the SDGs anyway and entails only a small additional burden.

Towards environmental justice success in mining resistances: An empirical investigation
Özkaynak B; Rodríguez-Labajos B; Aydın C: Environmental Justice Organisations, Liabilities and Trade (EJOLT) Report No. 14, 2015

This report explores evidence of success in environmental justice (EJ) activism on socio-environmental mining conflicts by applying a collaborative statistical approach, combining qualitative and quantitative methods. The empirical evidence covers 346 mining cases from around the world in the EJOLT Atlas of Environmental Justice, and is enriched by an interactive discussion of results with activists and experts. The authors used a social network analysis to study the nature of the relationships both among corporations involved in the mining activity, on the one hand, and among EJ organisations, on the other. Multivariate analysis methods were used to examine the defining factors in achieving EJ success and qualitative analysis, based on descriptive statistics, was conducted to investigate factors that configure the perception of success for EJ and incorporate activist knowledge into the theory of EJ. The authors argue that overall, such analytical exercises, coproduced with activists, should be seen as a source of engaged knowledge creation, which is increasingly being recognised as a pertinent method to inform scientific debate with policy implications, and that it can also be insightful and relevant for activism.

SDGs indicators: more about politics than statistics
Vandemoortele J: Deliver 2030, February 2016

In his book Damned Lies and Statistics (2001), Best points out that ‘people who bring statistics to our attention have reasons for doing so’. Some statistics are manufactured and manipulated as ammunition for political struggles, although their purpose is hidden behind assertions of objectivity and accuracy. The author argues that numbers often get amplified in the echo chamber of mainstream media and that one should never accept on face value that statistics always reveal truths. He argues that they are often used to manage perceptions more than to help analysis and understanding of complex realities. He thus urges people to be involved in reviewing and commenting on the work of and proposals from the UN Statistical Commission as they develop indicators for the SDGs.

The West African Health Organization’s experience in improving the health research environment in the ECOWAS region
Aidam J; Sombié I: Health Research Policy and Systems14(30), 20 April 2016

The West African Health Organization (WAHO) implemented a research development program in West Africa during 2009–2013 with components of stewardship, financing, sustainable resourcing and research utilization. This paper describes how programme and lessons learnt, triangulating activity reports, an independent evaluation and the authors’ experiences with stakeholders. WAHO and major stakeholders validated these findings during a regional meeting. All 15 ECOWAS countries benefited from this regional research development programme. WAHO provided technical and financial support to eight countries to develop their policies, priorities and plans for research development to improve their research governance and organised capacity-strengthening training in health systems research methodology, resource mobilization, ethical oversight and on HRWeb, a research information management platform. WAHO helped launch a regional network of health research institutions to improve collaboration between regional participating institutions and mobilised funding for the programme. It supported 24 health research projects. High staff turnover, weak institutional capacities and ineffective collaboration were some of the challenges encountered during implementation. The regional collaborative approach to health research was found to be effective given the challenges in the region, and with research partnerships and funding helped strengthen local health research environments.

Framework for monitoring equity in access and health systems issues in antiretroviral therapy Programmes in southern Africa
Kalanda B; Kemp J; Makwiza I: Malawi Medical Journal19(1) 20–24, 2007

Universal provision of antiretroviral therapy (ART), while feasible, is expensive. In light of this limitation, the World Health Organisation (WHO) has launched the 3 × 5 initiative, to provide ART to 3 million people by the end of the year 2005. In Southern Africa, large-scale provision of ART will likely be achieved through fragile public health systems. ART programmes should therefore be developed and expanded in ways that will not aggravate inequities or result in the inappropriate withdrawal of resources from other health interventions or from other parts of the health system. This paper, proposes a framework for monitoring equity in access and health systems issues in ART programmes in Southern Africa. It proposes that an equity monitoring system should comprise seven thematic areas. These thematic areas encompass a national monitoring system which extends beyond one agency or single data collection method. Together with monitoring of targets in terms of numbers treated, there should also be monitoring of health systems impacts and issues in ART expansion, with reporting both nationally and to a regional body.

Pages