In recent decades there has been increasing evidence of a relationship between self-reported racism and health. Although a plethora of instruments to measure racism have been developed, very few have been described conceptually or psychometrically. Furthermore, this research field has been limited by a dearth of instruments that examine reactions/responses to racism and by a restricted focus on African American populations. In response to these limitations, the 31-item Measure of Indigenous Racism Experiences (MIRE) was developed to assess self-reported racism for Indigenous Australians. This paper describes the development of the MIRE together with an opportunistic examination of its content, construct and convergent validity in a population health study involving 312 Indigenous Australians. The MIRE has considerable utility as an instrument that can assess multiple facets of racism together with responses/reactions to racism among indigenous populations and, potentially, among other ethnic/racial groups.
Monitoring equity and research policy
In light of increased access to policy dialogue about the reform of the international aid architecture, this paper explores ways in which southern researchers can maximise their input in to the debate. The authors argue that the current aid system is changing significantly, not only in terms of the increasing amounts of money which are likely to flow through the system, but also because of the range of new donors and funding vehicles which are joining it. This change is making the system more complex, and could potentially reduce the effectiveness of the aid that flows through it, but it also offers significant opportunities for reform. Specifically a number of decision-making fora have recently opened up which offer the chance for greater participation by southern organisations, particularly research institutes and think-tanks. To aid southern researchers’ affect on the debate the authors propose that they: target the content of the research; ensure it is in an appropriate medium and tailor it to the policy-makers; identify which international aid policy fora are most likely to take up their research; and increase focus on effective communication – researchers need to prepare a communications strategy to help to target their limited resources and capacity more effectively.
The new South African National Health Act has clarified that children may take part in ‘non-therapeutic' research (NTR) and the age at which they may provide independent consent to such research, viz. at legal majority. However, the Act will require consent from the Minister of Health for all research classed as NTR and involving minors regardless of the level of risk. This requirement is overly broad. It will require that low-risk research without direct benefits, which might be adequately reviewed by an accredited research ethics committee (REC), must also be reviewed by the Minister. As it currently stands this requirement is argued to serve no plausible ethical purpose, to cause delays and discourage essential research on the needs of children, and may inspire researchers and RECs alike to ‘foil the system'. The authors argue that in the long term there should be comprehensive law reform for child research. However, in the short term, amendments should be made to the Act to narrow the scope of this provision.
The complex evidence-policy interface in low and middle income country settings is receiving increasing attention. Future Health Systems (FHS): Innovations for Equity, is a research consortium conducting health systems explorations in six Asian and African countries: Bangladesh, India, China, Afghanistan, Uganda, and Nigeria. Three key activities were undertaken during the initial phase of this five-year project: key considerations in strengthening evidence-policy linkages in health system research were developed through workshops and electronic communications; four considerations were applied to research proposals in each of the six countries to highlight features in the research plans that potentially strengthen the research-policy interface and opportunities for improvement; and utility of the approach for setting research priorities in health policy and systems research was reflected upon. Developmental consideration with four dimensions a poverty, vulnerabilities, capabilities, and health shocks a provides an entry point in examining research-policy interfaces in the six settings. Research plans focused upon on the ground realities in specific countries strengthens the interface. Focusing on research prioritised by decision-makers, within a politicised health arena, enhances chances of research influencing action. Early and continued engagement of multiple stakeholders, from local to national levels, is conducive to enhanced communication at the interface.
This paper presents the methodology and findings from a proof-of-concept study undertaken to explore the viability of conducting a systematic, largely qualitative synthesis of evaluation reports emanating from Community Based Rehabilitation (CBR) projects in developing countries. Computer assisted thematic qualitative analysis was conducted on recommendation sections from 37 evaluation reports, arising from 36 disability and development projects in 22 countries. Quantitative overviews and qualitative summaries of the data were developed. The application of the synthesis methodology utilised in this proof-of-concept study was found to be potentially very beneficial for future research in CBR, and indeed in any area within health services or international development in which evaluation reports rather than formal research evidence is the primary source material. The proof-of-concept study identified a number of limitations which are outlined. Based on the conclusions of 37 evaluation reports, future policy frameworks and implementation strategies in CBR should include a stronger emphasis on technical, organisational, administrative and personnel aspects of management and strategic leadership.
Primary health care (PHC) in South Africa forms an integral part of both the country's health policies and health system and has been prioritised as a major strategy in achieving health for all. On the eve of the 30th anniversary of the Alma Ata Declaration, PHC is once again in the spotlight. How far have we come in the last 30 years? How far in the last three? The third edition of the District Health Barometer, the 2006/07 report sheds some light by monitoring the trend of key health and financial indicators in PHC over the last three years by district and province.
Primary health care (PHC) in South Africa forms an integral part of both the country's health policies and health system and has been prioritised as a major strategy in achieving health for all. On the eve of the 30th anniversary of the Alma Ata Declaration, PHC is once again in the spotlight. How far have we come in the last 30 years? How far in the last three? The third edition of the District Health Barometer, the 2006/07 report sheds some light by monitoring the trend of key health and financial indicators in PHC over the last three years by district and province.
Research plays a crucial role in developing solutions to the health problems suffered by the populations of low and middle income countries. Most health research for and in low and middle income countries is funded from external sources. And most of this externally funded research takes the form of 'vertical' - condition-specific - programmes. This paper begins by highlighting four important problems that result from reliance on this type of funding; including an unduly narrow focus of research on conditions for which international funding is available (mostly HIV and AIDS, tuberculosis, and malaria); lack of interest in leaving behind sustainable capacity in research after the research projects have ended; and loss of interest in the local programme at the time when research findings should be translated into action.
While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description in this study looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem. In two very different, but connected projects, the authors demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice.
This report and summary deals with the findings of the survey that deal with the District Health Barometer (DHB) publication. The DHB aims at improving the quality of and access to primary health care through monitoring important aspects of the health system at a district level by analysing and comparing a carefully selected range of health indicators.