35 research outputs found
A bibliometric analysis of COVID-19 research in Africa
No full textBackground The COVID-19 pandemic has led to an unprecedented global research effort to build a body of knowledge that can inform mitigation strategies. We carried out a bibliometric analysis to describe the COVID-19 research output in Africa in terms of setting, study design, research themes and author affiliation.Methods We searched for articles published between 1 December 2019 and 3 January 2021 from various databases including PubMed, African Journals Online, medRxiv, Collabovid, the WHO global research database and Google. All article types and study design were included.Results A total of 1296 articles were retrieved. 46.6% were primary research articles, 48.6% were editorial-type articles while 4.6% were secondary research articles. 20.3% articles used the entire continent of Africa as their study setting while South Africa (15.4%) was the most common country-focused setting. The most common research topics include ‘country preparedness and response’ (24.9%) and ‘the direct and indirect health impacts of the pandemic’ (21.6%). However, only 1.0% of articles focus on therapeutics and vaccines. 90.3% of the articles had at least one African researcher as author, 78.5% had an African researcher as first author, while 63.5% had an African researcher as last author. The University of Cape Town leads with the greatest number of first and last authors. 13% of the articles were published in medRxiv and of the studies that declared funding, the Wellcome Trust was the top funding body.Conclusions This study highlights Africa’s COVID-19 research and the continent’s existing capacity to carry out research that addresses local problems. However, more studies focused on vaccines and therapeutics are needed to inform local development. In addition, the uneven distribution of research productivity among African countries emphasises the need for increased investment where needed
Uptake of COVID-19 modelling evidence to inform policy making using knowledge translation: a scoping review protocol
No full textThe COVID-19 pandemic has had and continues to have a wide range of devastating effects worldwide. According to the latest World Health Organisation’s (WHO) estimates, there have been 262,866,050 confirmed cases of COVID-19 and 5,224,519 deaths globally. The challenges governments faced in responding to the pandemic is knowing how best to respond to an emerging outbreak, when to put measures in place, how stringent they should be and when they should lift them. This has been further complicated by the scarcity of empirical evidence to support their decisions. To fill this gap, mathematical modelling has been used to assess and predict the potential impacts of the pandemic. Modeling frameworks and analytics that have been used in different ways and settings to advise the pandemic responses like lockdowns, travel restrictions curfews, mask wearing, social distancing and reallocation of funds amongst others. However, to be useful in guiding the response, evidence from mathematical models need to be effectively communicated and disseminated to policymakers through knowledge translation (KT) processes. Thus, as part of pandemic preparedness, it is necessary to understand how modeling and analytical methods can rapidly be made available and fully integrated into decision making processes during future emergencies.
One positive outcome from the pandemic has been the increased demand and uptake of research evidence during decision making. However, the challenges with translating research evidence to action through KT, such as short time frames, have been exacerbated by the pandemic context. This is a potential bottleneck to rapid, effective policy decisions, and this is especially crucial in emergency situations like the ongoing pandemic. This is of greater concern in lower-and middle-income countries (LMICs), whose health systems have already been under a lot of strain and there are significant resource constraints. There is therefore a need to improve the KT process to better respond to the pandemic context. A review of the current KT strategies to share COVID-19 modeling evidence is needed to guide future KT strategies in such contexts.
This review aims to describe and bring together the different KT strategies used to share modeling evidence with policy makers during the COVID-19 pandemic. It will identify the barriers and facilitators of uptake of modeling evidence and share learnings from these processes
A bibliometric analysis of COVID-19 research in Africa
No full textBackground: The ongoing COVID-19 pandemic has led to an unprecedented global research effort to build a body of knowledge that can inform mitigation strategies. We carried out a bibliometric analysis to describe the COVID-19 research output in Africa.
Methods: We searched for articles published between 1st December 2019 and 3rd January 2021 from various databases including PubMed, African Journals Online, MedRxiv, BioRxiv, Collabovid, the World Health Organisation global research database and Google for grey literature. Editorial type publications and papers reporting original research done in Africa and were included. Data analysis was done using Microsoft Excel.
Results: A total of 1296 articles were retrieved. 46.6% were primary research articles, 48.6% were editorials type articles while 4.6% were secondary research articles. 20.3% articles used the entire continent of Africa as their study setting while South Africa (15.4%) was the most common country focused setting. 90.3% of the articles had at least one African researcher as author, 78.5% had an African researcher as first author, while 63.5% had an African researcher as last author. The University of Cape Town tops the list with the greatest number of first and last authors. Over 13% of the articles were published in MedRxiv and of the studies that declared funding, the Wellcome Trust was the top funding body. The most common research topics include “country preparedness and response” (24.9%) and “the direct and indirect health impacts of the pandemic” (21.6%). However, only 1.0% of articles focus on therapeutics and vaccines.
Conclusions: This study sheds light on the contribution of African researchers to COVID-19 research in Africa and highlights Africa’s existing capacity to carry out research that addresses local problems. However, the uneven distribution of research productivity amongst African countries emphasizes the need for increased investment where needed
Task sharing and task shifting: optimizing the primary health care workforce for improved delivery of noncommunicable disease services in Kenya
No full textIntegration of noncommunicable disease (NCD) care into primary health care (PHC) is crucial in addressing the NCD burden: this could improve health promotion and access to early NCD diagnosis and facilitate continuous management of NCDs at the population level. Successful NCD integration requires both investment in the health system and refocusing of PHC from an infectious disease emphasis to a system approach inclusive of NCD care. Strengthening the health workforce (HWF) is key in reorganizing the PHC system: availability and adequate capacity and distribution of health workers are crucial. Task sharing and task shifting (TSS) is an effective intervention to address HWF challenges: sharing clinical tasks with non-physician health workers (NPHWs) such as nurses and community health workers (CHWs) or shifting some tasks to them could help strengthen HWF to accommodate NCD care at the PHC level. An enabling legal and regulatory framework and adequate training of NPHWs are required to support TSS: the key enablers for successful TSS are training and on-the-job support for NPHWs. The barriers include the lack of a legal and regulatory framework for the new roles NPHWs assume such as prescribing medicines and other health system responsibilities
Point-of-care tests detecting HIV nucleic acids for diagnosis of HIV-1 or HIV-2 infection in infants and children aged 18 months or less
No full textBACKGROUND: The standard method of diagnosing HIV in infants and children less than 18 months is with a nucleic acid amplification test reverse transcriptase polymerase chain reaction test (NAT RT-PCR) detecting viral ribonucleic acid (RNA). Laboratory testing using the RT-PCR platform for HIV infection is limited by poor access, logistical support, and delays in relaying test results and initiating therapy in low-resource settings. The use of rapid diagnostic tests at or near the point-of-care (POC) can increase access to early diagnosis of HIV infection in infants and children less than 18 months of age and timely initiation of antiretroviral therapy (ART). OBJECTIVES: To summarize the diagnostic accuracy of point-of-care nucleic acid-based testing (POC NAT) to detect HIV-1/HIV-2 infection in infants and children aged 18 months or less exposed to HIV infection. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (until 2 February 2021), MEDLINE and Embase (until 1 February 2021), and LILACS and Web of Science (until 2 February 2021) with no language or publication status restriction. We also searched conference websites and clinical trial registries, tracked reference lists of included studies and relevant systematic reviews, and consulted experts for potentially eligible studies. SELECTION CRITERIA: We defined POC tests as rapid diagnostic tests conducted at or near the patient site. We included any primary study that compared the results of a POC NAT to a reference standard of laboratory NAT RT-PCR or total nucleic acid testing to detect the presence or absence of HIV infection denoted by HIV viral nucleic acids in infants and children aged 18 months or less who were exposed to HIV-1/HIV-2 infection. We included cross-sectional, prospective, and retrospective study designs and those that provided sufficient data to create the 2 × 2 table to calculate sensitivity and specificity. We excluded diagnostic case control studies with healthy controls. DATA COLLECTION AND ANALYSIS: We extracted information on study characteristics using a pretested standardized data extraction form. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool to assess the risk of bias and applicability concerns of the included studies. Two review authors independently selected and assessed the included studies, resolving any disagreements by consensus. The unit of analysis was the participant. We first conducted preliminary exploratory analyses by plotting estimates of sensitivity and specificity from each study on forest plots and in receiver operating characteristic (ROC) space. For the overall meta-analyses, we pooled estimates of sensitivity and specificity using the bivariate meta-analysis model at a common threshold (presence or absence of infection). MAIN RESULTS: We identified a total of 12 studies (15 evaluations, 15,120 participants). All studies were conducted in sub-Saharan Africa. The ages of included infants and children in the evaluations were as follows: at birth (n = 6), ≤ 12 months (n = 3), ≤ 18 months (n = 5), and ≤ 24 months (n = 1). Ten evaluations were field evaluations of the POC NAT test at the point of care, and five were laboratory evaluations of the POC NAT tests.The POC NAT tests evaluated included Alere q HIV-1/2 Detect qualitative test (recently renamed m-PIMA q HIV-1/2 Detect qualitative test) (n = 6), Xpert HIV-1 qualitative test (n = 6), and SAMBA HIV-1 qualitative test (n = 3). POC NAT pooled sensitivity and specificity (95% confidence interval (CI)) against laboratory reference standard tests were 98.6% (96.1 to 99.5) (15 evaluations, 1728 participants) and 99.9% (99.7 to 99.9) (15 evaluations, 13,392 participants) in infants and children ≤ 18 months. Risk of bias in the included studies was mostly low or unclear due to poor reporting. Five evaluations had some concerns for applicability for the index test, as they were POC tests evaluated in a laboratory setting, but there was no difference detected between settings in sensitivity (-1.3% (95% CI -4.1 to 1.5)); and specificity results were similar. AUTHORS' CONCLUSIONS: For the diagnosis of HIV-1/HIV-2 infection, we found the sensitivity and specificity of POC NAT tests to be high in infants and children aged 18 months or less who were exposed to HIV infection
Reframing Knowledge translation for health policy making
No full textThis is a scoping review of existing knowledge translation theories, models and frameworks that have been applied to knowledge translation studies on health policy-making
Beyond evidence: how actor dynamics and power shape knowledge translation for health policy in Kenya
No full textEfforts to strengthen knowledge translation (KT) for policy-making often call for greater engagement with the policy process and its actors. Yet, existing KT approaches often focus on communication and dissemination of evidence and undertheorise the role and influence of policy actors on KT. As such, this study examines how, why, and to what effect policy actors shape KT. Our findings address a critical gap in the KT literature regarding the relational dimensions of KT for policy-making in low-middle-income countries. We utilised purposive and snowball sampling to identify participants who are involved in health policy-making and KT in Kenya. This included policy-makers, academics/researchers, knowledge intermediaries, and external partners (development and implementation partners). Data were collected through in-depth interviews (n = 32), observations (n = 52 h), and document reviews (n = 34). Data analysis was informed by a theoretical framework that combined perspectives from actor-centred institutionalism, Gaventa's PowerCube, boundary work, and coproduction. Our findings reveal how actor influence in KT is shaped by institutional mandates and roles, which, in turn, shape how actors perceive their position and authority in KT processes. While some actors viewed themselves as constrained to the role of evidence provision, others acted as boundary spanners across policy spaces, enabled by their institutional flexibility and financial resources. In addition, actor interests shaped when and how they exercised power to support or resist KT. Furthermore, access to policy spaces determined whose evidence was visible and perceived as legitimate, reflecting deeper power structures. These dynamics frame KT as a relational process mediated by political and institutional structures. As such, this study highlights the need to reconceptualise KT to integrate relational and structural dimensions, moving beyond evidence dissemination to addressing actor and power dynamics. It contributes novel insights into the interplay between actors, context, and power in shaping KT outcomes
Humanitarian and Development Aid in the Third World - The Somali Case
No full textIn this paper the author describes its experience as a volunteer in the refugee programme in the early 1980s, pointing out the full support and cooperation of the Somali authorities.Qoruhu wuxuu maqaalkani ku soo bandhigayaa khibraddiisi xagga gargaarka qaxootiga ee uu ka qabtay sannadihii ugu horreeyey ee 1980, isagoo hoosta ka xarriiqayo taageerada iyo wadada shaqaynta uu ka helay dowladda soomaaliyeed.In questo articolo l'autore descrive la sua esperienza come volontario nel programma per i rifugiati nei primi anni 1980, sottolineando il pieno sostegno e la cooperazione da parte delle autorità somale.Labahn, Thomas (ed.
Examining the development and utilisation of Community-Based Health Information Systems (CBHIS) in Africa: A Scoping Review.
No full textIntroductionThe community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development.ObjectiveThis scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilization of CBHIS data, community accessibility to the data and use of the data to empower communities.MethodsWe utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesized findings using a thematic approach.ResultsOur review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches.ConclusionCBHIS utilizes both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on its digitization and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.</p
Examining the development and utilisation of Community-Based Health Information Systems (CBHIS) in Africa: A Scoping Review [version 1; peer review: 2 approved]
No full textIntroduction The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. Objective This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilization of CBHIS data, community accessibility to the data and use of the data to empower communities. Methods We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesized findings using a thematic approach. Results Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. Conclusion CBHIS utilizes both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on its digitization and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment
