The economic benefits of healthcare research require study so that appropriate resources can be allocated to this research, particularly in developing countries. This study took the form of a systematic review to identify the methods used to assess the economic impact of healthcare research, and the outcomes. The initial search yielded 8,416 articles, of which 18 articles were included in the analysis, as well as eleven other reports. It found that the outcomes assessed as healthcare research payback included direct cost-savings, cost reductions in healthcare delivery systems, benefits from commercial advancement, and outcomes associated with improved health status. The study found that different methods and outcomes can be used to assess the economic impacts of healthcare research. However, none of the research from low- and middle-income countries had evaluated the economic return of research. The authors recommend a consensus on practical guidelines at international level in order to build capacity, arrange for necessary informative infrastructures and promote necessary skills for economic evaluation studies in developing countries.
Monitoring equity and research policy
This paper begins by introducing the scope of and rationale for engaging in advocacy work as part of development interventions. It notes that effective advocacy can prove to be a very powerful and empowering strategy, and contrasts this with ineffective advocacy strategies, which can be hugely wasteful of time and resources and leave stakeholders feeling bewildered, disempowered or uninterested. It then focuses on the issue of monitoring and evaluating (M&E) these efforts – offering reasons why and when these processes should be planned and implemented, what’s involved, and who should be engaged in the process. The paper discusses organisational approaches to M&E of a number of agencies in the development sector, like Oxfam and the Institute of Development Research (IDR), and offers tools and methods for M&E of advocacy projects in international and national non-governmental organisations.
Country teams from ten low- and middle-income countries (LMICs), including Tanzania, participated in the development and testing of a questionnaire to assist researchers, policymakers, and healthcare providers to describe and monitor changes in efforts to bridge the gaps among research, policy and practice. The study found that internal consistency (Cronbach's alpha) for sets of related items was very high, ranging from 0.89 to 0.96, suggesting some item redundancy. Both face and content validity were determined to be high. Assessments of construct validity using criterion-related measures showed statistically significant associations for related measures. Assessments using convergent measures also showed significant associations. In conclusion, while no direct comparison can be made to a comparable questionnaire, the findings do suggest a number of strengths of the questionnaire but also the need to reduce item redundancy and to test its capacity to monitor changes over time.
Country teams from ten low- and middle-income countries, including Tanzania, participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities related to improving their clinical practice and their awareness of, access to and use of research evidence, as well as changes in their clinical practice that they attribute to particular sources of research evidence that they have used. The study found that the questionnaire had high internal consistency, with Cronbach's alphas between 0.7 and 0.9 for 16 of 20 domains and sub-domains (identified by factor analyses). Cronbach's alphas were greater than 0.9 for two domains, suggesting some item redundancy. In conclusion, the analysis points to a number of strengths of the questionnaire – high internal consistency (reliability) and good face and content validity – but also to areas where it can be shortened without losing important conceptual domains.
The act of telling a story is a deceptively simple and familiar process, a way to evoke powerful emotions and insights. By contrast, working with stories in organisational settings – to aid reflection, build communities, transfer practical learning or capitalise experiences – is more complicated. This guide is designed to create story-telling skills and confidence. It provides ideas about development cooperation contexts in which stories can be an effective communication tool. The authors argue that story telling is not suitable for every situation. Methodologies should be selected by practitioners with due care to the wider working context and intention. Some methods, for example the systemic introduction of story into core organisational processes such as evaluation, need patience and management backing over a long period, for the right approach to be developed through trial and error.
This article explores the use of multimedia to enhance development enquiry and analysis, and the design and implementation of process interventions aimed at poverty alleviation in sub-Saharan Africa. It discusses some important interventions in Africa: the Catalyzing Access to ICT in Africa (CATIA) programme; the LINK Centre (University of the Witwatersrand); the Acacia Initiative; the African Information Society Initiative (AISI); the APC (Association for Progressive Communications); and Research ICT Africa. Despite these interventions, Africa still faces problems of access and use of these interventions and services, especially among poor and vulnerable people. The areas of weakness include: poor performance in the telecommunications sector; little e-access and use in small and medium enterprises; and absence of an equitable system of intellectual property rights that is friendly to developing countries in sub-Saharan Africa. As a result the author observes barriers to access often expensive, modern technologies.
The first target of the fifth United Nations Millennium Development Goal is to reduce maternal mortality by 75% between 1990 and 2015. According to this article, the target is critically off track. Despite difficulties inherent in measuring maternal mortality, it notes that interventions aimed at reducing it must be monitored and evaluated to determine the most effective strategies in different contexts. In some contexts, the direct causes of maternal death, such as haemorrhage and sepsis, predominate and can be tackled effectively through providing access to skilled birth attendance and emergency obstetric care. In others, indirect causes of maternal death, such as HIV and AIDS and malaria, make a significant contribution and require alternative interventions. Methods of planning and evaluating maternal health interventions that do not differentiate between direct and indirect maternal deaths may lead to unrealistic expectations of effectiveness or mask progress in tackling specific causes. The article analyses historical data from England and Wales and contemporary data from Ghana, Rwanda and South Africa.
Only 5.4% of the world's population was covered by comprehensive smoke-free laws in 2008, up from 3.1% in 2007, according to the World Health Organization’s (WHO) second report on the global tobacco epidemic. The report also describes countries' efforts to implement the tobacco control package called MPOWER, which WHO introduced in 2008 to help countries implement some of the demand reduction measures in the WHO Framework Convention and its guidelines. These measures are: monitor tobacco use and the policies to prevent it; protect people from tobacco smoke; offer people help to quit tobacco use; warn about the dangers of tobacco; enforce bans on tobacco advertising, promotion and sponsorship; and raise taxes on tobacco. Less than 10% of the world's population is covered by any one measure, the report states. The report tracks the global tobacco epidemic, giving governments and other stakeholders a tool to see where evidence-based demand reduction interventions have been implemented and where more progress is needed. It gives country-by-country tobacco use prevalence figures as well as data about cigarette taxation, bans on tobacco advertising, promotion and sponsorship, support for treatment of tobacco dependence, enforcement of tobacco-free laws and monitoring of the epidemic.
This report presents a historical reflection on research evaluation studies, their recurrent themes and challenges, and their implications. It critically examines studies of how scientific research drives innovation and socioeconomic benefits. First, it provides a predominantly descriptive historical overview of some landmark studies in the research evaluation field, from the late 1950s until the present day, and highlights some of their key contributions. Then, it reflects on the historical overview analytically, in order to discuss some of the methodological developments and recurrent themes in research evaluation studies. The report concludes by discussing the enduring challenges in research evaluation studies and their implications. The authors emphasise that this report does not address all of the key studies in the research evaluation field. The evaluation literature today is so extensive that a selective approach is necessary to focus on those studies that they feel provide the most valuable insights in the context of biomedical and health research evaluation.
Researchers should protect the welfare of research participants by providing methods to reduce their risk of acquiring HIV. This is especially important given that late-phase HIV vaccine trials enrol HIV-uninfected trial volunteers from high-risk populations. This study recommends that current normative guidance be systematically reviewed and actual practice at vaccine sites be documented. Adding new tools to the current package of prevention services will involve complex decision making with few set standards, and regulatory and scientific challenges. The paper recommends that stakeholders (including regulators) should convene to consider standards of evidence for new tools, and that decision-making processes be explicitly documented and researched. A further critical ethical task is exploring the threshold at which adding new tools will compromise the validity of trial results.