Rapid assessment of institutional research ethics capacity: a case study from Zambia / Evaluación rápida de la capacidad institucional de investigación ética: un estudio de caso en Zambia / Avaliação rápida da capacidade institucional de ética em pesquisa: um estudo de caso na Zâmbia

Abstract: Recently, there has been a remarkable increase in biomedical research being conducted in low and middle-income countries. This increase has brought attention to the need for high quality research ethics systems within these countries and a greater focus on research ethics training. Though most programs tend to concentrate on training individuals, less attention has focused on institutions as the target of such training. In this paper we demonstrate a rapid approach to evaluating institutional research capacity. The method adapts the Octagon Model, which evaluates institutional research ethics using eight domains: basic values and identity, organization of activities, implementation, relevance, proper skills, financing and administration, target groups, and working environment. The framework was applied to the University of Zambia in order to conduct a baseline assessment of university research ethics capacity. Internal and external assessments were conducted. The domains of working environment and proper skills scored highest, while relevance, target groups and identity scored lower. Consistent with previous work, a systems approach to evaluating institutional research development capacity can provide a rapid assessment of an institutional bioethics program. This case study reveals the strengths and weaknesses of the university's research ethics program and provides a framework for future capacity growth.

Resumen: Recientemente, ha habido un notable aumento en la investigación biomédica en países de ingresos bajos y medianos. Este aumento ha llamado la atención sobre la necesidad de sistemas éticos de investigación de alta calidad en estos países y un mayor enfoque en la formación en ética de la investigación. Aunque la mayoría de los programas tienden a concentrarse en la formación de los individuos, menos atención se ha centrado en las instituciones como objetivo de dicha formación. En este trabajo se demuestra un enfoque rápido para evaluar la capacidad de investigación institucional. El método adapta el modelo Octagon, que evalúa la ética institucional de la investigación utilizando ocho dominios: valores básicos e identidad, organización de actividades, implementación, relevancia, habilidades adecuadas, financiamiento y administración, grupos objetivo y ambiente de trabajo. El marco se aplicó a la Universidad de Zambia, con el fin de realizar una evaluación inicial de la capacidad de ética de la investigación universitaria. Se realizaron evaluaciones internas y externas. Los ámbitos del entorno de trabajo y de las competencias apropiadas obtuvieron el puntaje más alto, mientras que la relevancia, los grupos objetivo y la identidad obtuvieron calificaciones más bajas. De acuerdo con trabajos previos, un enfoque sistémico para evaluar la capacidad de desarrollo institucional de la investigación puede proporcionar una evaluación rápida de un programa institucional de bioética. Este estudio de caso revela las fortalezas y debilidades del programa de ética de la investigación de la universidad y proporciona un marco para el futuro crecimiento de la capacidad.

Resumo: Recentemente, tem havido um notável aumento na investigação biomédica em países de renda baixa e média. Este aumento tem chamado a atenção para a necessidade de sistemas éticos de pesquisa de alta qualidade nesses países e um maior foco na formação em ética em pesquisa. Embora a maioria dos programas tende a se concentrar na formação dos indivíduos, menos atenção centrou-se em instituições como objetivo dessa formação. Este trabalho demonstra uma aproximação rápida para avaliar a capacidade de pesquisa institucional. O método adapta o modelo Octagon, que avalia a ética institucional de pesquisa usando oito domínios: valores básicos e identidade, organização das atividades, implementação, pertinência, competências adequadas, financiamento e administração, os grupos-alvo e ambiente de trabalho. O quadro foi aplicado para a Universidade da Zâmbia, a fim de fazer uma primeira avaliação da capacidade de ética em pesquisa universitária. Foram realizadas avaliações internas e externas. Os campos do ambiente trabalho e competências adequadas, obtiveram a maior pontuação, enquanto a relevância, grupos-alvo e identidade obtiveram qualificações inferiores. De acordo com trabalhos anteriores, uma abordagem sistêmica para avaliar a capacidade dedesenvolvimento institucional de pesquisa pode fornecer uma avaliação rápida de um programa institucional de bioética. Este estudo de caso revela os pontos fortes e pontos fracos do programa de ética em pesquisa da Universidade e fornece uma estrutura para o crescimento futuro da capacidade.

Ethical Guidelines for Military-Based Health Research: an Unmet Need in Africa?

"Background: Achieving the highest standards of ethics in military health research is a challenging but crucial undertaking. The military environment is complex and African military health professionals struggle to maintain a balance between ethics and military ethos. The objective of this paper is to review ten existing research ethics guidelines for their application to the military context; and describe the need for guidance in military research ethics in sub-Saharan Africa.Method: To achieve this; five prominent international research ethics guidelines and five African guidelines were selected using some inclusion/exclusion criteria. Thereafter; designed topics were used in analyzing them for their strengths and weaknesses in providing protection for military research participants.Results: Out of the five international guidelines reviewed; only the Council for International Organization of Medical Sciences (CIOMS) mentions the ""armed forces"". Similarly; the only African national guideline that specifically mentions the ""armed forces"" is the Ugandan national guideline.Conclusions: We conclude that national and international guidelines for human subject research may be too general and not suitable for research with military populations. There is a need for additional guidance in research ethics for militaries in sub-Saharan Africa."

A Framework for Addressing Implementation Gap in Global Drowning Prevention Interventions: Experiences from Bangladesh.

Drowning is the commonest cause of injury-related deaths among under-five children worldwide, and 95% of deaths occur in low- and middle-income countries (LMICs) where there are implementation gaps in the drowning prevention interventions. This article reviews common interventions for drowning prevention, introduces a framework for effective implementation of such interventions, and describes the Saving of Lives from Drowning (SoLiD) Project in Bangladesh, which is based on this framework. A review of the systematic reviews on drowning interventions was conducted, and original research articles were pulled and summarized into broad prevention categories. The implementation framework builds upon two existing frameworks and categorizes the implementing process for drowning prevention interventions into four phases: planning, engaging, executing, and evaluating. Eleven key characteristics are mapped in these phases. The framework was applied to drowning prevention projects that have been undertaken in some LMICs to illustrate major challenges to implementation. The implementation process for the SoLiD Project in Bangladesh is used as an example to illustrate the practical utilization of the framework. Drowning interventions, such as pool fencing and covering of water hazards, are effective in high-income countries; however, most of these interventions have not been tested in LMICs. The critical components of the four phases of implementing drowning prevention interventions may include: (i) planning—global funding, political will, scale, sustainability, and capacity building; (ii) engaging—coordination, involvement of appropriate individuals; (iii) executing—focused action, multisectoral actions, quality of execution; and (iv) evaluating—rigorous monitoring and evaluation. Some of the challenges to implementing drowning prevention interventions in LMICs include insufficient funds, lack of technical capacity, and limited coordination among stakeholders and implementers. The SoLiD Project in Bangladesh incorporates some of these lessons and key features of the proposed framework. The framework presented in this paper was a useful tool for implementing drowning prevention interventions in Bangladesh and may be useful for adaptation in drowning and injury prevention programmes of other LMIC settings.

Knowledge brokering for evidence-based urban health policy: a proposed framework.

This paper presents a multidimensional approach to examining the urban evidence– policy interface in low- and middle-income countries (LMICs), and applies this approach to a case study from Pakistan. Key features of urban health policy and the significance of the evidence–policy interface in rapidly changing LMICs are articulated; characteristics of evidence that has been successfully incorporated into health policy are also defined. An urban health evidence-to-policy exploratory framework for LMICs based on innovative multidisciplinary thinking and pivotal knowledge brokering is presented. Application of the framework to a case study on road transport and health in urban Pakistan underscores the opportunities and utility of knowledge brokering. Public health practitioners can become knowledge brokers at the evidence–policy interface to develop a concerted, coordinated and informed response to urban health challenges in LMICs.

Traumatismos causados por el tránsito en países en desarrollo: agenda de investigación y de acción / Road traffic injuries in developing countries: research and action agenda

Los traumatismos causados por el tránsito son la principal causa de muerte en personas de 10-24 años a nivel mundial y representan alrededor del 15% de todas las muertes en varones. La carga de enfermedad de los traumatismos causados por el tránsito está distribuida de manera desigual entre los países pues la tasa de mortalidad más alta es ochenta veces superior a las más baja. Existe una clara desigualdad en el riesgo de ocurrencia de traumatismos causados por el tránsito, siendo notoriamente mayor en los países en desarrollo. Esta desigualdad se constituye como un reto mundial importante y se debe, aunque no sean los únicos factores, a muchas razones, incluyendo la rápida motorización y la pobre infraestructura. Este artículo hace énfasis en varios aspectos fundamentales cuya finalidad es informar a los programas diseñados para prevenir los traumatismos causados por el tránsito en los países en desarrollo, donde esta situación está más extendida. En primer lugar, la seguridad vial es un tema de desarrollo; en segundo lugar, los traumatismos causados por el tránsito constituyen un problema importante para la salud; en tercer lugar, los traumatismos causados por el tránsito pueden ser prevenidos mediante la implementación de medidas científicas adecuadas; en cuarto lugar, es necesaria la atención de emergencias hospitalarias y prehospitalarias; y, finalmente, la investigación en los traumatismos causados por el tránsito está relegada en los países de ingresos bajos y medios. Se discute además la repercusión de estos avances para el Perú.

Road traffic injury (RTI) is the leading cause of death in persons aged 10-24 worldwide and accounts for about 15 per cent of all male deaths. The burden of RTI is unevenly distributed amongst countries with over eighty-fold differences between the highest and lowest death rates. Thus the unequal risk of RTI occurring in the developing world, due to many reasons, including but not limited to rapid motorization and poor infrastructure, is a major global challenge. This editorial highlights a number of key issues that must inform programs designed to prevent RTI in the developing world, where the epidemicis all the more insidious. Firstly, road safety is a development issue; secondly, road traffic injury is a major health issue; thirdly, road traffic injuries can be prevented by the implementation of scientific measures; fourthly, pre-hospital and hospital emergency care is needed; and fifthly, research on RTI is neglected in low-income and middle-income countries. The repercussion of such progress to Peru is also discussed.