This strategy document acknowledges that research is central to economic development and global health security and recognises that, in order to be effective, research has to be multidisciplinary and intersectoral in nature. In the face of current and emerging health threats – such as those posed by pandemics, chronic diseases, food insecurity, the impact on health of climate change, and fragile health systems – the document affirms that the Secretariat, member states and World Health Organization (WHO) partners have a joint responsibility to ensure that research and evidence help to achieve health-related development goals and improve health outcomes. It recommends an approach that involves all government departments so that health is reflected in all government policies. It identifies five interrelated goals that will help realise the draft strategy’s vision: the strengthening of research culture across WHO; the reinforcement of research that responds to priority health needs; improving capacity to strengthen national health research systems; the promotion of good practice in research, drawing on WHO’s core function of setting norms and standards; and strengthening of links between the policy, practice and products of research.
Monitoring equity and research policy
The World Health Statistics series is the World Health Organization's annual compilation of health-related data for its 193 member states, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. As with previous versions, World Health Statistics 2010 has been compiled using publications and databases produced and maintained by the technical programmes and regional offices of WHO. Indicators have been included on the basis of their relevance to global public health; the availability and quality of the data; and the reliability and comparability of the resulting estimates. Taken together, these indicators provide a comprehensive summary of the current status of national health and health systems in the following nine areas: mortality and burden of disease; cause-specific mortality and morbidity; selected infectious diseases; health service coverage; risk factors; health workforce, infrastructure and essential medicines; health expenditure; health inequities; and demographic and socioeconomic statistics. With only five years remaining to 2015, the report notes that there are signs of progress in many countries in achieving the health-related MDGs. In other countries, progress has been limited because of conflict, poor governance, economic or humanitarian crises, and lack of resources. The effects of the global food, energy, financial and economic crises on health are still unfolding, and action is needed to protect the health spending of governments and external funders alike.
This article begins by acknowledging that numerous obstacles exist to improving on current development assistance indices, including: attribution across multiple donors, long time lags between aid and results with unknown lag times, the micro-macro paradox (where donor projects are deemed successful but results are not translated to macro indicators) and difficulties in aggregating across different components of 'development' such as poverty reduction, service delivery and economic growth. The article puts forward a model for measuring quality of development assistance and recommends benchmarking against specific quality indicators, based on literature, with a focus on aid processes not outcomes. It states that the index should require that large number of donors are compared to establish the 'best in class'. Quantitative indices and indices that measure change over time should also be developed and linked to changes in management decisions in aid agencies. Four indices are proposed to measure different aspects of aid effectiveness: maximising impact; reducing burden; foster institutions; and transparency.
The Commitment to Development Index (CDI) rates 22 rich countries on how much they help poor countries build prosperity, good government, and security. Each rich country gets scores in seven policy areas, which are averaged for an overall score. The policy areas include foreign aid, commerce, migration, the environment and military affairs. This website provides an interactive resource for determining scores. You can browse the charts by clicking bars, country names and policy components and explore the data maps to see results in another way. In 2009, Sweden, Denmark, the Netherlands, Norway and New Zealand ranked highest, while South Korea, Japan, Switzerland and Greece ranked lowest.
This study presents the Corrected Sibling Survival (CSS) method, which addresses both the survival and recall biases that have plagued the use of survey data to estimate adult mortality. It applies the method to generate estimates of and trends in adult mortality for 44 countries with District Health Survey sibling survival data. Findings suggest that levels of adult mortality prevailing in many developing countries are substantially higher than previously suggested by other analyses of sibling history data. Generally, estimates here show the risk of adult death between the ages of 15 and 60 to be about 20–35% for females and 25–45% for males in sub-Saharan African populations largely unaffected by HIV. In southern African countries, where the HIV epidemic has been most pronounced, as many as eight out of ten men alive at the age of fifteen will be dead by age 60, as will six out of ten women. The results of this study represent an expansion of direct knowledge of levels and trends in adult mortality in the developing world. The study recommends that governments use the CSS method for more accurate tracking of adult mortality rates.
Although global under-five mortality is declining, this paper argues that it is unlikely that Millennium Development Goal 4 will be reached by 2015. The researchers used data about all children born and dead children extracted from 169 Demographic and Health Surveys covering 70 countries to develop four new methods to estimate under-five mortality. Their findings suggest that application of the new methods developed by the researchers could significantly improve the accuracy of estimates of under-five mortality based on summary birth history data. The researchers warn that although their methods can provide accurate estimates of recent under-five mortality, they might not capture rapid fluctuations in mortality such as those that occur during wars. However, they suggest, the two questions needed to generate the data required to apply these new methods could easily be included in existing survey programmes and in routine censuses. Consequently, systematic application of the methods proposed in this study should provide policy makers with the information about levels, recent trends, and inequalities in child mortality that they need to accelerate efforts to reduce the global toll of childhood deaths.
This paper reviewed 29 public expenditure tracking surveys (PETS) and related literature produced since the mid-1990s to identify common problems and lessons learned to improve the quality of public spending in the social sectors via civil society oversight and involvement. It examines ten of the most commonly reported problems in public expenditure management in the social sectors, like the limitations imposed by highly earmarked budgets, which do not allow for reallocation towards priorities, and public monies that do not reach the poor or are 'leaked' to unintended uses. Other problems include corruption, incomplete information and inefficient transfer and expenditure operations, health workers who face perverse incentives, and inefficient, low-quality and unresponsive health services that result in wastage. User fees and informal payments are also to blame for a lack demand from the population for health services. The paper argues that civil society organisations may have a critical role to play in improving the quality of social spending in developing countries. It recommends generating and disseminating information on flows of public spending and materials, advocating for and participating in organisational structures that incorporate citizens in oversight, preparing and disseminating citizen report cards, and carrying out PETS.
Researchers are designing a new model for determining the demographic impact of HIV and AIDS in South Africa. Modelers Leigh Johnson of the Centre for Infectious Disease Epidemiology and Research and Rob Dorrington of the Centre for Actuarial Research at the University of Cape Town have launched the ASSA 2008 model, which has replaced the ASSA 2003 model for estimating HIV prevalence, HIV-related deaths, the numbers of those in need ofanti-retrovirals (ARVs) and the impact of HIV interventions. According to Johnson, the reason the model needed to be updated was because the prevalence data projected was no longer correct because of the new data that emerged from South Africa’s antenatal HIV-prevalence survey. The survey increased the number of women who were tested for HIV and was thus more representative, although there was very little difference in the HIV prevalence results across the board from the ASSA 2003 and 2008 models. ASSA 2008 takes into account new epidemiological data to allow for more accurate projections of HIV prevalence and impact of interventions. It includes the ARV rollout data for up to the end of 2008. Because data shows that two-thirds of people starting ARVs are females, the ASSA 2008 model allows for different rates of ARV initiation in males and females, as well as for children and adults.
Scoping is a novel methodology for systematically assessing the breadth of a body of literature in a particular research area. The objectives of this review were to showcase the scoping review methodology in the review of health system quality reporting, and to report on the extent of the literature in this area. A scoping review was performed based on the York methodology. The researchers searched fourteen peer-reviewed and grey literature databases, specific websites, reference lists and key journals for relevant material and also solicited input from key stakeholders. A total of 1,222 articles were included. These were categorised and catalogued according to the inclusion criteria, and further subcategories were identified through the charting process. Topic areas represented by this review included the effectiveness of health system report cards (194 articles), methodological issues in their development (815 articles), stakeholder views on report cards (144 articles), and ethical considerations around their development (69 articles). The review concluded that the scoping review methodology allowed for the convenient characterisation and cataloguing of the extensive body of literature pertaining to health system report cards. The resulting literature repository from this review could prove useful to researchers and health system stakeholders interested in the topic of health system quality measurement and reporting.
This guide provides an overview of peer review and an assessment of the practice to date. It begins by discussing the main concepts related to peer reviewing of research papers before it outlines the peer review process generally, and specifically with relation to grant applications. It assesses the peer review process by addressing some of its shortcomings. For example, instances of malpractice and misconduct continue and, as reviewers themselves are fallible, peer review cannot provide a guarantee against the publication of bad research. So a number of published papers are retracted each year for a variety of reasons, and there is evidence that the number is rising. The core issues of transparency and subjectivity are discussed in the guide under the idea that peer review should foster fairness. However, financing the high costs of peer review mechanisms still proves problematic. On the positive side, major new opportunities in digital technology, such as the internet, have improved connectivity between stakeholders of the process.