Browsing by Author "Rudan, Igor"

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    Evidence-based priority setting for health care and research : tools to support policy in maternal, neonatal, and child health in Africa
    (Public Library of Science, 2010-07-13) Rudan, Igor; Kapiriri, Lydia; Tomlinson, Mark; Balliet, Manuela; Cohen, Barney; Chopra, Mickey
    Priority setting is required in every health care system. It guides investments in health care and health research, and respects resource constraints. It happens continuously, with or without appropriate tools or processes. Although priority-setting decisions have been described as difficult, value laden, and political, only a few research groups are focused on advancing the theory of priority setting and the development and validation of priority setting tools. These groups advocate the use of their tools, but their work is often not widely recognized, especially among the policy makers in developing countries, where these tools would be most helpful. Our primary objective in this essay is to present the available tools for priority setting that could be used by policy makers in low-resource settings. We also provide an assessment of the applicability and strengths of different tools in the context of maternal and child health in sub-Saharan Africa. The analyses of investments in neglected diseases showed that they lack transparent priority-setting processes. This persisting situation results in remarkable levels of inequity between investments in different health priorities. Therefore, our secondary objective is to advocate for the use of the tools that could lead to more rational priority setting in sub-Saharan Africa. An optimal tool should be able to draw on the best local evidence and guide policy makers and governments to identify, prioritize, and implement evidence-based health interventions for scale-up and delivery.
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    A review of selected research priority setting processes at national level in low and middle income countries : towards fair and legitimate priority setting
    (BioMed Central, 2011-05) Tomlinson, Mark; Chopra, Micky; Hoosain, Naeema; Rudan, Igor
    Abstract. Background. It is estimated that more than $130 billion is invested globally into health research each year. Increasingly, there is a need to set priorities in health research investments in a fair and legitimate way, using a sound and transparent methodology. In this paper we review selected priority setting processes at national level in low and middle income countries. We outline a set of criteria to assess the process of research priority setting and use these to describe and evaluate priority setting exercises that have taken place at country level. Based on these insights, recommendations are made regarding the constituents of a good priority setting process. Methods. Data were gathered from presentations at a meeting held at the World Health Organization (WHO) in 2008 and a web-based search. Based on this literature review a number of criteria were developed to evaluate the priority setting processes. Results. Across the countries surveyed there was a relative lack of genuine stakeholder engagement; countries varied markedly in the extent to which the priority setting processes were documented; none of the countries surveyed had a systematic or operational appeals process for outlined priorities; and in all countries (except South Africa) the priorities that were outlined described broad disease categories rather than specific research questions. Conclusions. Country level priority setting processes differed significantly in terms of the methods used. We argue that priority setting processes must have in-built mechanisms for publicizing results, effective procedures to enforce decisions as well as processes to ensure that the revision of priorities happens in practice.
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    Setting health research priorities using the CHNRI method : VII. A review of the first 50 applications of the CHNRI method
    (Edinburgh University Global Health Society, 2017-06) Rudan, Igor; Yoshida, Sachiyo; Chan, Kit Yee; Sridhar, Devi; Wazny, Kerri; Nair, Harish; Sheikh, Aziz; Tomlinson, Mark; Lawn, Joy E.; Bhutta, Zulfiqar A.; Bahl, Rajiv; Chopra, Mickey; Campbell, Harry; Arifeen, Shams E. l.; Black, Robert E.; Cousens, Simon
    Background: Several recent reviews of the methods used to set research priorities have identified the CHNRI method (acronym derived from the “Child Health and Nutrition Research Initiative”) as an approach that clearly became popular and widely used over the past decade. In this paper we review the first 50 examples of application of the CHNRI method, published between 2007 and 2016, and summarize the most important messages that emerged from those experiences. Methods: We conducted a literature review to identify the first 50 examples of application of the CHNRI method in chronological order. We searched Google Scholar, PubMed and so–called grey literature. Results: Initially, between 2007 and 2011, the CHNRI method was mainly used for setting research priorities to address global child health issues, although the first cases of application outside this field (eg, mental health, disabilities and zoonoses) were also recorded. Since 2012 the CHNRI method was used more widely, expanding into the topics such as adolescent health, dementia, national health policy and education. The majority of the exercises were focused on issues that were only relevant to low– and middle–income countries, and national–level applications are on the rise. The first CHNRI–based articles adhered to the five recommended priority–setting criteria, but by 2016 more than two–thirds of all conducted exercises departed from recommendations, modifying the CHNRI method to suit each particular exercise. This was done not only by changing the number of criteria used, but also by introducing some entirely new criteria (eg, “low cost”, “sustainability”, “acceptability”, “feasibility”, “relevance” and others). Conclusions: The popularity of the CHNRI method in setting health research priorities can be attributed to several key conceptual advances that have addressed common concerns. The method is systematic in nature, offering an acceptable framework for handling many research questions. It is also transparent and replicable, because it clearly defines the context and priority–setting criteria. It is democratic, as it relies on “crowd–sourcing”. It is inclusive, fostering “ownership” of the results by ensuring that various groups invest in the process. It is very flexible and adjustable to many different contexts and needs. Finally, it is simple and relatively inexpensive to conduct, which we believe is one of the main reasons for its uptake by many groups globally, particularly those in low– and middle–income countries.
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    Setting priorities in child health research investments for South Africa
    (Public Library of Science, 2007) Tomlinson, Mark; Chopra, Mickey; Sanders, Mickey; Bradshaw, Debbie; Hendricks, Michael; Greenfield, David; Black, Robert E.; Arifeen, Shams El; Rudan, Igor
    This paper aims to define health research priorities in South Africa, where it is estimated that nearly 100,000 children under 5 years of age still die each year.The authors applied the methodology for setting priorities in health research investments recently developed by Child Health and Nutrition Research Initiative (CHNRI).The predominant research priorities identified within the existing South African context were health policy and systems research activities to generate new knowledge on improving delivery of the simplest and most cost-effective existing interventions.Vitamin A supplementation was ranked first, followed by hand washing, antibiotics for pneumonia, prevention of mother-to-child HIV transmission (PMTCT), and exclusive breast-feeding.The CHNRI methodology has the power to discriminate among many competing research options using a simple conceptual framework.