Health Research Policy and Systems最新文献

{"title":"Landscape analyses of gaps in reproductive, maternal, newborn, child, and adolescent health policies and guidelines to catalyse policy implementation improvement in Uganda.","authors":"Charles Ibingira, Josaphat Byamugisha, Elizeus Rutebemberwa, Lynn Atuyambe, Richard Mugahi, Emmanuel Odongo","doi":"10.1186/s12961-025-01302-2","DOIUrl":"10.1186/s12961-025-01302-2","url":null,"abstract":"<p><strong>Background: </strong>Despite many improvements in maternal, newborn, sexual, and reproductive health (RMNCAH) in sub-Saharan Africa, the overall progress remains inadequate and uneven. Some of the reasons for this include fragmented healthcare systems, gaps in evidence-based policy, inadequate investment and funding for health, and weaknesses in policy dissemination and implementation. Current stakeholder views on RMNCAH policy formulation and policy implementation in Uganda has not been exhaustively studied to help inform adjustments in policy formulation approaches and implementation strategies. The objective was to conduct a situation analysis to identify gaps in RMNCAH policies and guidelines formulation, dissemination, and implementation in Uganda to be able to recommend strategies to address these gaps, and catalyse policy formulation and implementation.</p><p><strong>Methods: </strong>This was an exploratory qualitative study conducted among RMNCAH stakeholders at central level and four district local governments in Uganda. Data were collected through review of RMNCAH policies and guideline documents using a document review guide, two guided small-group discussions (SGDs) with central government stakeholders and partners, four SGDs with district health teams (DHTs), eight key informant interviews (KIIs), and four focus group discussions (FGDs) with women 20-35 years of age. The interviews and group discussions were conducted using pretested interview guides, audio-recorded and transcribed verbatim. The transcripts were analysed by thematic analysis using open code software.</p><p><strong>Results: </strong>It was established that the policy and guideline documents addressing most of RMNCAH components existed. However, the indicators have not improved adequately to meet the international targets. The main policy implementation gaps reported revolved around policy leadership and coordination such as weaknesses in district and facility leadership and management, insufficient monitoring and evaluation, inadequate community engagement in policy formulation and implementation, inadequate policy and guidelines dissemination, limited multisectoral approach, and insufficient resource allocation to implement the policies and guidelines.</p><p><strong>Conclusion: </strong>Policies and guidelines covering all RMNCAH components are in place, but implementing and translating these into improved indicators has been the major challenge. A strategic framework should be developed to test interventions to address these gaps to catalyse policy implementation in selected districts and later be rolled out to cover the whole country to cause wholesome policy impact.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"46"},"PeriodicalIF":3.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare providers' implementation of severe acute malnutrition guidelines and the factors associated with it among healthcare providers working at public health facilities of South Wollo Zone, Northeast Ethiopia, in 2024.","authors":"Mohamed Yimam, Asnakew Molla Mekonen, Mengistu Mera Mihiretu, Dagnachew Melak, Shbre Tsegaw, Fanos Yeshanew Ayele","doi":"10.1186/s12961-025-01304-0","DOIUrl":"10.1186/s12961-025-01304-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Health workers must implement severe acute malnutrition (SAM) guidelines to provide quality services for acutely malnourished children. Healthcare providers must adhere to the national severe acute malnutrition guidelines while treating patients. However, limited data are available on the healthcare providers' implementation of severe acute malnutrition guidelines and the contributing factors in Ethiopia. Previous research on the topic focused on document reviews and small sample size. Therefore, this study aims to investigate the implementation of severe acute malnutrition guidelines and the factors associated with it among healthcare providers working in public health facilities in South Wollo Zone, Northeast Ethiopia, in 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A facility-based cross-sectional study was conducted from 1 March to 30 April 2024. Data were collected from 611 randomly selected healthcare providers using an observation checklist and structured questionnaire and using a multi-stage sampling technique. Data entry was done using EpiData version 4.6, and data were exported to SPSS version 27 for analysis. Logistic regression was utilized to identify factors affecting the implementation of severe acute malnutrition guidelines. In bivariable analysis, variables with a P-value less than 0.2 were considered for multivariable analysis. The significance level was determined in the final multivariable analysis on the basis of the adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a P-value of less than 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 611 healthcare providers were included in the study, resulting in a 92.6% response rate. The study revealed that 62% (95% CI 58.2, 66.1) of healthcare providers implemented the severe acute malnutrition guidelines effectively. Factors such as training on guidelines (AOR = 7.49; 95% CI 4.29, 13.08), the presence of guidelines in the work room (AOR = 3.87; 95% CI 2.38, 6.33) and the job satisfaction of healthcare providers (AOR = 2.3; 95% CI 1.32, 4.03) were determinants associated with healthcare providers' implementation of the severe acute malnutrition guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Less than two thirds of healthcare providers successfully implemented severe acute malnutrition guidelines. This will contribute to further complications, increased default rates, longer stays on treatment and poor SAM treatment outcomes. Factors that influenced the implementation of these guidelines included job satisfaction among healthcare providers, training on guideline updates and the availability of guidelines in the workplace. Healthcare providers working on SAM treatment should implement SAM guidelines according to the guideline standards to improve better outcomes of SAM treatment. To improve adherence to severe acute malnutrition guidelines, district health offices, zonal health departments and regional health bureaus should provide training on ","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"47"},"PeriodicalIF":3.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing research capacity in Canadian community hospitals: an intrinsic descriptive case study.","authors":"Elaina Orlando, Alexandra Binnie, Jennifer Tsang","doi":"10.1186/s12961-025-01318-8","DOIUrl":"10.1186/s12961-025-01318-8","url":null,"abstract":"<p><strong>Background: </strong>Canada's clinical research landscape is limited by minimal community hospital engagement. However, research participation in community hospitals may increase the speed of trial enrolment, enhance the generalizability of results and accelerate knowledge translation to community hospitals, where most Canadians receive care. Two identified barriers to community hospital participation are limited financial support and a lack of research mentorship.</p><p><strong>Methods: </strong>This study is an intrinsic descriptive case study describing the impact of 1 year of research funding from the Canadian Critical Care Trials Group (CCCTG) and creation of a community of practice on research participation in 19 community hospitals. Thematic analysis was used to systematically identify themes from semistructured interviews and documents.</p><p><strong>Results: </strong>A total of nine individuals (physician research lead, n = 7; research staff, n = 2) participated in semistructured interviews between April and September 2023. Community of practice meeting minutes (n = 7), emails (n = 22), status reports (n = 21) and field notes (n = 7) were analysed alongside interview transcripts. Funding enabled community hospitals to hire research staff, sustain research programs, increase the number of clinical trials they were running and develop research policies. The community of practice facilitated reciprocal learning and networking that positively impacted research programs and produced a tangible output: a toolkit to help community hospitals build clinical research programs. Contextual influences on community hospital research activities were identified as: (1) system characteristics, (2) clinical trial design, (3) local context and (4) individual characteristics.</p><p><strong>Conclusions: </strong>The perception of participants was that the CCCTG funding and community of practice positively influenced research activities in community hospitals. Lessons learned include the need to: (1) leverage the power of connections among community hospitals to expand linkages, enabling further knowledge transfer, (2) work with trialists on clinical trial design to facilitate implementation and (3) create resources to support community hospitals with building and sustaining research programs, including resources to foster engagement in hospitals without historic research participation. Our findings highlight the importance of context, including local populations, organizational research culture, provincial health systems and research funding structures, which need to be considered during research program implementation.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"44"},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment.","authors":"Edward Ou Jin Lee, Thai-Son Tang, Javi Fuentes-Bernal, Katie MacEntee, Juddy Wachira, Edith Apondi, Alex Abramovich, Abe Oudshoorn, David Ayuku, Reuben Kiptui, Amy Van Berkum, Sue-Ann MacDonald, Olli Saarela, Paula Braitstein","doi":"10.1186/s12961-025-01309-9","DOIUrl":"10.1186/s12961-025-01309-9","url":null,"abstract":"<p><strong>Background: </strong>We sought to adapt a peer navigator (PN) model to increase uptake of human immunodeficiency virus (HIV) prevention, testing and treatment of street-involved youth (SIY) in Canada and Kenya. This article presents key findings on the optimal characteristics of the PN model for SIY across and between sites, prior to intervention implementation.</p><p><strong>Methods: </strong>Using an integrated mixed methods approach, eligible participants included SIY aged 16-29 years, healthcare providers and community stakeholders. Data collection tools drew from the CATIE (Canada) PN practice guidelines related to: PN role and responsibilities, training, supervision and integration into sites, among others. During interviews (n = 53) or focus groups (n = 11) with participants, a 39-item PN components checklist was administered (quantitative data), followed immediately by a semi-structured interview protocol with questions that allowed for deeper exploration into the acceptability and appropriateness of the PN intervention (qualitative data). The checklist enabled participants to identify PN characteristics and/or activities as core (essential) or peripheral (adaptable and less important). Spearman's rank correlations (ρ) were used to quantify agreement across sites and participant groups. Qualitative data were inductively coded and analysed using a single codebook.</p><p><strong>Results: </strong>Quantitative data analysis revealed that out of 39 checklist items, 31 (79%) were considered core. These primarily pertained to host organization, PN characteristics and PN activities. For example, it was agreed that core PN activities included outreach to out-of-care SIY and providing health and social service referrals. There were mixed opinions about asking the PN to declare previous experience with drug use and HIV status, but there was agreement that the PN should have previous experience of street-involvement. Qualitative data analysis suggested that although all participant groups across sites agreed that the PN intervention was acceptable and appropriate, the participants from each site also identified specific adaptations related to their host organization and target SIY.</p><p><strong>Conclusions: </strong>Our findings indicate high agreement among participant groups across all sites on some optimal PN intervention characteristics, particularly host organization characteristics, the PN themselves and their activities. However, context-specific adaptations are necessary to successfully scale-up the PN intervention. This model is applicable in diverse regions and organizational contexts.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"45"},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do not attempt cardiopulmonary resuscitation practice and policy in Ireland: a mixed-methods study of service user and advocacy group perspectives.","authors":"John Lombard, Hope Davidson, Owen Doody","doi":"10.1186/s12961-025-01315-x","DOIUrl":"10.1186/s12961-025-01315-x","url":null,"abstract":"<p><strong>Background: </strong>Cardiopulmonary resuscitation offers the potential to save a person's life. However, this highly invasive medical treatment is not always appropriate, and the likelihood of success is relatively low. In Ireland, the Health Service Executive (HSE) National Consent Policy establishes the national guidance in respect of DNACPR decisions, and this was supplemented by HSE Guidance Regarding Cardiopulmonary Resuscitation and DNAR Decision-Making during the COVID-19 Pandemic. Previous research on DNACPR practice in Ireland concentrated on the perspective of the medical and nursing professions and was completed prior to publication of the supplementary guidance. In contrast, this article reports on research which investigates service user and advocacy group perspectives on DNACPR practice and policy in Ireland.</p><p><strong>Methods: </strong>The research utilized mixed methods design to collect quantitative and qualitative data. A questionnaire with close-ended and open-ended questions was distributed via Qualtrics, targeting the public while explicitly excluding healthcare workers to focus on patient and caregiver experiences. Recruitment involved identifying relevant advocacy and state organizations and leveraging professional networks and social media to maximize participation and minimize selection bias. Recruitment was conducted through collaboration with organizations that advocate for individuals affected by DNACPR decisions. Survey data were analysed in SPSS for closed questions and thematic analysis for open responses. Four semi-structured interviews with representatives of advocacy groups were completed, transcribed and analysed using thematic analysis. The qualitative and quantitative data's reporting rigour was guided by the CROSS and SRQR guidelines.</p><p><strong>Results: </strong>A total of 148 participants completed the survey, and 4 interviews were completed with representatives of advocacy groups; 70.5% (n = 98) selected the correct definition of a DNACPR decision. Many survey participants overestimated the rate of survival for both in-hospital and out-of-hospital cardiac arrest. There was a strong desire for involvement and support in the decision-making process. Interviewees drew attention to poor awareness of national policy, uncertainty as to the decision-making authority of family members and difficulties in communication. Interviewees also highlighted the need for additional information concerning the nature of DNACPR and CPR.</p><p><strong>Conclusions: </strong>The research study highlights points of weakness in the DNACPR decision-making framework for service users. While there is a desire to be involved in the DNACPR decision-making process, this is challenged by deficiencies in the understanding of CPR and uncertainty surrounding decisional authority. The decision-making framework may be strengthened by the development of accessible information and educational resources.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"43"},"PeriodicalIF":3.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of national policies for dementia prevention and control in mainland China.","authors":"Jingbin Zhang, Xiaowan Wang, Shasha Yuan","doi":"10.1186/s12961-025-01314-y","DOIUrl":"10.1186/s12961-025-01314-y","url":null,"abstract":"<p><strong>Introduction: </strong>Limited knowledge has been found on the policies of dementia prevention and control from low- and middle-income (LMIC) countries. This study aims to provide comprehensive evidence of policy progress regarding dementia prevention and control in mainland China by scoping review on the basis of seven priority areas proposed in The Global Action Plan on the Public Health Response to Dementia 2017-2025.</p><p><strong>Methods: </strong>We searched the websites of China State Council, National Health Commission, Ministry of Civil Affairs, National Development and Reform Commission, National Healthcare Security Administration and National Administration of Traditional Chinese Medicine for all policies regarding dementia. The keywords included Chi Dai (dementia), A Er Ci Hai Mo (Alzheimer's), Ren Zhi Zhang Ai (cognitive impairment) and Shi Zhi (dementia), and the search covered materials published by 15 April 2023. Policy diffusion analysis, policy reference network analysis and thematic framework analysis were used to analyse the policy contents.</p><p><strong>Results: </strong>The number of national policies for dementia prevention and control in mainland China increased significantly during 2015-2022. The National Health Commission was responsible for the most policies, while the State Council was responsible for the most important ones. A total of 50 departments were involved in the development of policies for dementia prevention and control, but the stable collaborative relationship among them needs further strengthened. In terms of WHO dementia global action plan, the topic of \"dementia as a public health priority\" was strongly emphasized, while the areas of \"dementia research and innovation\" and \"information systems for dementia\" were less focussed on.</p><p><strong>Conclusions: </strong>Some policy gaps, including priority arrangement, multisectoral cooperation and policy implementation, must still be addressed in the future to support the interests of people with dementia and their caregivers more effectively.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"42"},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrated knowledge mobilization approach to substance use health.","authors":"Sheena Taha, Shea Wood, Chandni Sondagar, Eftyhia Helis, Doris Payer, Miguel Hernandez-Basurto","doi":"10.1186/s12961-025-01313-z","DOIUrl":"10.1186/s12961-025-01313-z","url":null,"abstract":"<p><p>The Canadian Centre on Substance Use and Addiction (CCSA) has a mandate to provide national leadership in evidence-informed analysis and knowledge mobilization to advance solutions that reduce substance-related harms. Doing this work effectively requires an understanding of the needs, priorities, perspectives and ideologies of multiple groups. Partnerships across various sectors support a full understanding and acknowledgement of the systems that create differential health outcomes for individuals and communities. CCSA has developed an integrated knowledge mobilization model to guide our work in supporting better substance use health outcomes. Our model begins by understanding the context a particular need (for example, research question and practice improvement) is occurring within. This involves engaging key partners with multiple viewpoints to understand the current situation, constraints and opportunities, including barriers to care, social and structural determinates of health and community strengths and assets. Based on this, the steps that follow involve determining the appropriate action and CCSA's unique role to respond in alignment with partner and community priorities to advance solutions within the given context. This leads to an iterative process of generating and mobilizing knowledge. This integrated and collaborative approach ensures that responses are relevant to the identified knowledge gap, that recommendations reflect partners' realities and that our efforts will achieve impact while minimizing the risk of harm. Through an iterative process of generating and mobilizing knowledge (for example, supporting the scale and spread of innovations, developing new tools and generating or tailoring evidence for a specific audience/context/substance/setting, among others), outputs such as increased awareness, knowledge, use of information and strengthened capacity occur. Together, these efforts contribute to the outcome of a healthier society for people living in Canada, where multiple forms of evidence advance substance use health. Meaningful engagement of partners and evaluation of our efforts are ingrained throughout the model to ensure our work has the intended effects. We share our approach for the consideration of other organizations (in the space of substance use health and otherwise) to engage partners in the development of evidence and other resources that can drive impactful programs, practice and policy.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"41"},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fitting a square peg in a round hole? A mixed-methods study on research ethics and collaborative health and social care research involving 'vulnerable' groups.","authors":"Chiara De Poli, Jan Oyebode, Mara Airoldi, Martin Stevens, Andrea Capstick, Nicholas Mays, Michael Clark, Annelieke Driessen, Carol Rivas, Bridget Penhale, James R Fletcher, Amy M Russell","doi":"10.1186/s12961-025-01290-3","DOIUrl":"10.1186/s12961-025-01290-3","url":null,"abstract":"<p><strong>Background: </strong>Current research ethics frameworks that oversee health and social care research, in the United Kingdom and internationally, originated in biomedical research, having positivist underpinnings and an orientation towards experimental research. Limitations of these frameworks have been extensively documented including with regard to health and social care research that adopts collaborative approaches. This article contributes to debates about how the research ethics system deals with collaborative research with groups labelled or potentially perceived as vulnerable, and identifies practical recommendations to ensure a better fit between principles and practices of research ethics and those of collaborative research.</p><p><strong>Methods: </strong>We conducted a two-round online Delphi study with 35 academic researchers with experience of collaborative research involving vulnerable groups and of seeking research ethics approval in England (United Kingdom), followed by a focus group with eight members of the Delphi panel. The Delphi questionnaire, organised in 12 themes, comprised 66 statements about how researchers experience research ethics review and how the research ethics system could be improved. The focus group discussed the results of the Delphi study to generate practical recommendations.</p><p><strong>Results: </strong>By the end of the second Delphi round, only one statement relating to the experience of the current research ethics system reached consensus, signalling heterogeneous experiences among researchers working in this field. A total of 32 statements on potential improvements reached consensus. The focus group discussed the 14 Delphi statements with the highest levels of consensus and generated 12 practical recommendations that we grouped into three clusters (1. Endorsing the 'collaborative' dimension of collaborative research; 2. Allowing flexibility; and 3. Strengthening the relational and ongoing nature of ethical research practice).</p><p><strong>Conclusions: </strong>This work provides further empirical evidence of how the research ethics system deals with collaborative research involving 'vulnerable' groups. It also offers practical recommendations to ensure that the collaborative dimension of such research receives proper ethical scrutiny, to introduce a degree of flexibility in research ethics processes and supporting documents, and to replace formal, one-off research ethics approvals with ongoing, situated, relational ethical processes and practices.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"40"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic impacts of community-based health insurance: evidence from Gondar Zuria District, Amhara Regional State, Ethiopia.","authors":"Melkamu Workie Tadesse, Ayenew Hailu Gebremichael, Fentahun Baylie Sendekie","doi":"10.1186/s12961-025-01294-z","DOIUrl":"10.1186/s12961-025-01294-z","url":null,"abstract":"<p><strong>Background: </strong>Healthcare insurance is one of the strategies to achieving universal health coverage and reduce health care inequality among rich and poor households. In line with this goal, the Ethiopian government launched a community-based health insurance program in 2011 to protect rural households and informal workers from catastrophic out-of-pocket medical expenditure that would increase health service quality. However, there is a dearth of evidence on the effect of this program on socio-economic spheres of the community in the study area. This study aims to assess the socio-economic impacts of community-based health insurance through a case study in Gondar Zuria district of Central Gondar Zone, north-west Ethiopia.</p><p><strong>Methods: </strong>A concurrent mixed-methods approach was applied, combining a comparative cross-sectional study design for the quantitative section and descriptive analysis for the qualitative part. The quantitative analysis included responses from 407 households, while the qualitative analysis was based on ten in-depth interviews and three key informant interviews (KIIs). Systematic and maximum variation sampling techniques are used to determine the sample sizes of the datasets, respectively. The quantitative data is generated from the responses of households to structured closed-ended questionnaire by trained data collectors. In-depth interviews and key informant interviews are conducted by the authors with tape-recorder to gather the qualitative data. The quantitative data is analysed by propensity score matching method using STATA-14 software. Findings from the qualitative data are generated through descriptive analysis.</p><p><strong>Results: </strong>A quantifiable positive association was found between community-based health insurance (CBHI) and welfare on the basis of quantitative data analysis. The results show that insured households have 17% and 20% lower probabilities of experiencing catastrophic health expenditure and labour absenteeism in the workplace, respectively, compared with non-insured households. Insured households are also more likely to have better vertical social capital compared with non-insured households.</p><p><strong>Conclusions: </strong>Thus, the study concludes that community-based health insurance improves both economic and social status of insured households in the study area, and hence, the program should be scaled-up to include more non-beneficiaries to improve welfare in Ethiopia.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"39"},"PeriodicalIF":3.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Resilient and Responsive Health Research Systems:Responses and the Lessons Learned from the COVID-19 Pandemic.","authors":"Mark Embrett, Andrea Carson, Meaghan Sim, Aislinn Conway, Emily Moore, Kristy Hancock, Iwona Bielska","doi":"10.1186/s12961-024-01229-0","DOIUrl":"10.1186/s12961-024-01229-0","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic highlighted the crucial role of robust health research systems (HRSs) in supporting effective public health responses. Understanding the responses and lessons learned from HRS during the pandemic is vital for future preparedness.</p><p><strong>Methods: </strong>This environmental scan examined high income Countries with a HRS that responded to the COVID-19 pandemic using both academic and grey literature sources to gather comprehensive insights into these areas. The analysis was structured using an organizing framework to facilitate systematic extraction and synthesis of relevant information. A total of 5336 sources were identified of which 3609 were screened following duplicate removal. A total of 117 full-text sources were reviewed leading to 65 being included.</p><p><strong>Findings: </strong>Effective interdisciplinary and cross-sector collaborations significantly enhanced the capacity to respond to the pandemic. Clear and streamlined governance structures were essential for coordinated efforts across various entities, facilitating swift decision-making and resource allocation. The robustness of pre-existing research infrastructures played a crucial role in the rapid mobilization of resources and execution of large-scale research projects. Knowledge mobilization efforts were vital in disseminating research findings promptly to inform public health responses. Continuous tracking and evaluation of health research activities enabled real-time adjustments and informed decision-making. Rapid identification and funding of research priorities, including vaccine and therapeutic development, were critical in addressing urgent public health needs. Effective resource allocation and capacity-building efforts ensured focused and accelerated research responses. Comprehensive strategic planning, involving stakeholder engagement and robust monitoring tools, was essential for aligning research efforts with health system needs.</p><p><strong>Conclusion: </strong>The findings underscore the necessity of flexible funding mechanisms, enhanced data-sharing practices and robust strategic planning to prepare for future health emergencies. Policy implications emphasize the need for sustained investments in health policy and systems research (HPSR) and the development of comprehensive governance frameworks. Research implications highlight the importance of community engagement and interdisciplinary partnerships. For decision-makers, the study stresses the importance of rapid response mechanisms and evidence-based policy making. Health research systems must prioritize maintaining adaptable infrastructures and strategic planning to ensure effective crisis response. Despite potential biases and the rapidly evolving context, this comprehensive analysis provides valuable lessons for strengthening HRSs to address future public health challenges.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"38"},"PeriodicalIF":3.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}