Pratt Bridget, Allen Katharine A, Hyder Adnan A
Dev World Bioeth. 2016 Dec;16(3):148-157. doi: 10.1111/dewb.12116. Epub 2016 Mar 16.
Health systems research is widely identified as an indispensable means to achieve the goal of health equity between and within countries. Numerous health systems research consortia comprised of institutions from high-income countries and low and middle-income countries (LMICs) are currently undertaking programs of research in LMICs. These partnerships differ from collaborations that carry out single projects in the multiplicity of their goals, scope of their activities, and nature of their management. Recent conceptual work has explored what features might be necessary for health systems research consortia and their research programs to promote health equity. Identified features include selecting research priorities that focus on improving access to high-quality health services and/or financial protection for disadvantaged populations in LMICs and conducting research capacity strengthening that promotes the independent conduct of health systems research in LMICs. Yet, there has been no attempt to investigate whether existing consortia have such characteristics. This paper describes the results of a survey undertaken with health systems research consortia leaders worldwide to assess how consistent current practice is with the proposed ethical guidance. The findings suggest that consortia may be fairly well organised to promote health equity, but have scope for improvement, particularly in terms of achieving inclusive priority-setting.
卫生系统研究被广泛认为是在国家间及国家内部实现卫生公平目标的不可或缺的手段。目前,许多由高收入国家以及低收入和中等收入国家(LMICs)的机构组成的卫生系统研究联盟正在低收入和中等收入国家开展研究项目。这些伙伴关系与那些开展单个项目的合作不同,它们在目标的多样性、活动范围和管理性质方面存在差异。最近的概念性研究探讨了卫生系统研究联盟及其研究项目促进卫生公平可能需要哪些特征。确定的特征包括选择侧重于改善低收入和中等收入国家弱势群体获得高质量卫生服务和/或经济保护的研究重点,以及开展加强研究能力的工作,以促进低收入和中等收入国家独立开展卫生系统研究。然而,尚未有人尝试调查现有联盟是否具备这些特征。本文描述了一项对全球卫生系统研究联盟领导人进行的调查结果,以评估当前实践与提议的伦理指导的一致性程度。研究结果表明,联盟在促进卫生公平方面可能组织得相当好,但仍有改进的空间,特别是在实现包容性的优先事项设定方面。