In this paper, the authors discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. The authors further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. The authors limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years but they also recognize that targeted investments in other scientific disciplines could also foster further development in African countries.
Monitoring equity and research policy
Biomedical research, a tool to address the health issues that affect African populations
Peprah E and Wonkam A: Globalization and Health 9(50): 21 October 2013
Building research capacity in Africa: equity and global health collaborations
Chu KM, Jayaraman S, Kyamanywa P, Ntakiyiruta G: PLoS Med. 11;11(3)March 2014
The authors discuss the impact of high-income country investigators conducting research in low- and middle-income countries and explore lessons from the effective and equitable relationships that exist. Global health has increased the number of high-income country (HIC) investigators conducting research in low- and middle-income countries (LMICs). They note that partnerships with local collaborators rather than extractive research are needed. They conclude that LMICs have to take an active role in leading or directing these research collaborations in order to maximize the benefits and minimize the harm of inherently inequitable relationships.
Adaptation and implementation of local maternity dashboards in a Zimbabwean hospital to drive clinical improvement
Crofts J, Moyo J, Ndebele W, Mhlanga S, Draycotta T, Sibanda T: Bull World Health Organ 2014;92:146–152
The Commission on Information and Accountability for Women’s and Children’s Health of the World Health Organization (WHO) reported that national health outcome data were often of questionable quality and “not timely enough for practical use by health planners and administrators”. Delayed reporting of poor-quality data limits the ability of front-line staff to identify problems rapidly and make improvements. Clinical “dashboards” based on locally available data offer a way of providing accurate and timely information. A dashboard is a simple computerized tool that presents a health facility’s clinical data graphically using a traffic-light coding system to alert front-line staff about changes in the frequency of clinical outcomes. It provides rapid feedback on local outcomes in an accessible form and enables problems to be detected early. Until now, dashboards have been used only in high-resource settings. An overview maternity dashboard and a maternal mortality dashboard were designed for, and introduced at, a public hospital in Zimbabwe. A midwife at the hospital was trained to collect and input data monthly. Implementation of the maternity dashboards was feasible and 28 months of clinical outcome data were summarized using common computer software. Presentation of these data to staff led to the rapid identification of adverse trends in outcomes and to suggestions for actions to improve health-care quality. Implementation of maternity dashboards was feasible in a low-resource setting and resulted in actions that improved health-care quality locally. Active participation of hospital management and midwifery staff was crucial to their success.
The parameters of the current legal framework for health research: Forms of health research which are regulated and obligations imposed on researchers
Strode AE: South African Journal of Bioethics and Law, 6(2):69-71, November, 2013
On 1 March 2012, the South African Minister of Health operationalised section 71 of the National Health Act (NHA), ushering in a new phase of research regulation. When read with sections 1, 11 and 16 of the NHA, section 71 describes the legal norms for undertaking various forms of health research in South Africa. Three key terms used in the NHA now set the parameters of the legal framework for regulating health research: ‘health research’ (section 1), ‘research or experimentation on a living person’ (section 71), and the provision of a ‘health service for research or experimental purposes’ (section 11). Importantly, these three concepts delineate (i) what forms of health research are regulated by the legal framework, and (ii) the nature of the obligations placed on health researchers and others. The author argues that researchers and members of research ethics committees need to be aware that the NHA assigns different legal obligations to different forms of health research. This article describes the parameters of the new legal framework and the obligations that flow from each of the three categories of health research. It shows how the restrictions the framework imposes are not evenly spread across all forms of research, and concludes by identifying some of its strengths, weaknesses and anomalies. It further suggests that more conceptual elaboration is required to ascertain whether the differences are coherent and justified.
A Namibian version of the 28 item General Health Questionnaire
Haidula L, Shino E, Plattner I, Feinstein A: S Afr Psychiatry Rev, 6:23-25, 2003
Namibia faces a daunting array of mental health problems. However, there is no Namibian screening instrument for psychological distress. The papers reports on work to develop a Namibian version of the 28 item General Health Questionnaire (GHQ-28) with a consecutive sample of 159 Oshiwambo speaking patients attending rural health clinics in the north of Namibia. The Oshiwambo version of the 28 item GHQ is presented as a valid screening instrument for psychological distress in clinic attendees.
Shared learning in an interconnected world: innovations to advance global health equity
Binagwaho A, et al: Globalization and Health 9(37): 30 August 2013
The notion of “reverse innovation”--that some insights from low-income countries might offer transferable lessons for wealthier contexts--is increasingly common in the global health and business strategy literature. Yet the perspectives of researchers and policymakers in settings where these innovations are developed have been largely absent from the discussion to date. In this Commentary, we present examples of programmatic, technological, and research-based innovations from Rwanda, and offer reflections on how the global health community might leverage innovative partnerships for shared learning and improved health outcomes in all countries.
Global AgeWatch Index 2013: Insight report, summary and methodology
Global AgeWatch: October 2013
The Global AgeWatch Index is the first-ever overview of the wellbeing of older people around the world.As the number and proportion of older people increases at an unprecedented rate, this ground-breaking report illustrates how the world is adapting to this new reality by ranking more than 90 countries in terms of how their older populations are faring.
Handbook on health inequality monitoring: with a special focus on low- and middle-income countries
WHO: 2013
The World Health Organization developed the Handbook on health inequality monitoring: with a special focus on low- and middle-income countries to provide an overview for health inequality monitoring within low- and middle-income countries, and act as a resource for those involved in spearheading, improving or sustaining monitoring systems. The aim of this handbook is to serve as a comprehensive resource to clarify the concepts associated with health inequality monitoring, illustrate the process
through examples and promote the integration of health inequality monitoring within health information systems of low- and middle-income countries.
The demographics of human and malaria movement and migration patterns in East Africa
Pindolia DK, Garcia AJ, Huang Z, Smith DL, Alegana VA, Noor AM, Snow RW and Tatem AJ: Malaria Journal 12(397), 5 November 2013
This paper explores parasite movements as a source of valuable information for planning control strategies for malaria. Mobile parasite carrying individuals can instigate transmission in receptive areas, spread drug resistant strains and reduce the effectiveness of control strategies. The identification of mobile groups, their routes of travel and how these movements connect differing transmission zones, potentially enables limited resources for interventions to be efficiently targeted over space, time and populations. National data on population and migration were linked to migration, travel, and other data to understand malaria movement patterns. Together with existing spatially referenced malaria data and mathematical models, network analysis techniques were used to quantify the demographics of human and malaria movement patterns in Kenya, Uganda and Tanzania. Patterns of human and malaria movements varied between demographic groups, within country regions and between countries. Migration rates were highest in 20–30 year olds in all three countries, but when accounting for malaria prevalence, movements in the 10–20 year age group became more important.
Assessing communities of practice in health policy: a conceptual framework as a first step towards empirical research
Bertone MP, Meessen B, Clarysse G, Hercot D, Kelley A, Kafando Y, Lange I, Pfaffmann J, Ridde V, Sieleunou I and Witter S: Health Research Policy and Systems 11(39): 20 October 2013
Communities of Practice (CoPs) are groups of people that interact regularly to deepen their knowledge on a specific topic. Thanks to information and communication technologies, CoPs can involve experts distributed across countries and adopt a ‘transnational’ membership. This has allowed the strategy to be applied to domains of knowledge such as health policy with a global perspective. CoPs represent a potentially valuable tool for producing and sharing explicit knowledge, as well as tacit knowledge and implementation practices. They may also be effective in creating links among the different ‘knowledge holders’ contributing to health policy (e.g., researchers, policymakers, technical assistants, practitioners, etc.). CoPs in global health are growing in number and activities. As a result, there is an increasing need to document their progress and evaluate their effectiveness. This paper represents a first step towards such empirical research as it aims to provide a conceptual framework for the analysis and assessment of transnational CoPs in health policy. The framework is developed based on the findings of a literature review as well as on the authors' experience, and reflects the specific features and challenges of transnational CoPs in health policy. It organizes the key elements of CoPs into a logical flow that links available resources and the capacity to mobilize them, with knowledge management activities and the expansion of knowledge, with changes in policy and practice and, ultimately, with an improvement in health outcomes. Additionally, the paper addresses the challenges in the operationalization and empirical application of the framework