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Snijder M, Steege R, Callander M, Wahome M, Rahman MF, Apgar M, Theobald S, Bracken LJ, Dean L, Mansaray B, Saligram P, Garimella S, Arthurs-Hartnett S, Karuga R, Mejía Artieda AE, Chengo V, Ateles J. How are Research for Development Programmes Implementing and Evaluating Equitable Partnerships to Address Power Asymmetries? Eur J Dev Res 2023; 35:351-379. [PMID: 36852183 PMCID: PMC9947878 DOI: 10.1057/s41287-023-00578-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 06/03/2023]
Abstract
UNLABELLED The complexity of issues addressed by research for development (R4D) requires collaborations between partners from a range of disciplines and cultural contexts. Power asymmetries within such partnerships may obstruct the fair distribution of resources, responsibilities and benefits across all partners. This paper presents a cross-case analysis of five R4D partnership evaluations, their methods and how they unearthed and addressed power asymmetries. It contributes to the field of R4D partnership evaluations by detailing approaches and methods employed to evaluate these partnerships. Theory-based evaluations deepened understandings of how equitable partnerships contribute to R4D generating impact and centring the relational side of R4D. Participatory approaches that involved all partners in developing and evaluating partnership principles ensured contextually appropriate definitions and a focus on what partners value. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1057/s41287-023-00578-w.
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Affiliation(s)
- Mieke Snijder
- Tomorrow’s Cities Urban Disaster Risk Hub, Institute of Development Studies, Falmer, Brighton, UK
| | - Rosie Steege
- Tomorrow’s Cities Urban Disaster Risk Hub, Facultad Latinoamericana de Ciencias Sociales Sede (FLACSO), Quito, Ecuador
| | - Michelle Callander
- Gender and Justice Security Hub, London School of Economics and Political Science, London, UK
| | - Michel Wahome
- One Ocean Hub, University of Strathclyde, Glasgow, UK
| | - M. Feisal Rahman
- Living Deltas Hub, Northumbria University, Newcastle Upon Tyne, UK
| | - Marina Apgar
- Tomorrow’s Cities Urban Disaster Risk Hub, Institute of Development Studies, Falmer, Brighton, UK
| | - Sally Theobald
- Tomorrow’s Cities Urban Disaster Risk Hub, Facultad Latinoamericana de Ciencias Sociales Sede (FLACSO), Quito, Ecuador
| | | | - Laura Dean
- Tomorrow’s Cities Urban Disaster Risk Hub, Facultad Latinoamericana de Ciencias Sociales Sede (FLACSO), Quito, Ecuador
| | - Bintu Mansaray
- ARISE Hub, College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
| | - Prasanna Saligram
- ARISE Hub, George Institute for Global Health India, New Delhi, India
| | - Surekha Garimella
- ARISE Hub, George Institute for Global Health India, New Delhi, India
| | - Sophia Arthurs-Hartnett
- Tomorrow’s Cities Urban Disaster Risk Hub, Facultad Latinoamericana de Ciencias Sociales Sede (FLACSO), Quito, Ecuador
| | | | | | - Victoria Chengo
- Tomorrow’s Cities Urban Disaster Risk Hub, Facultad Latinoamericana de Ciencias Sociales Sede (FLACSO), Quito, Ecuador
| | - Joanes Ateles
- Tomorrow’s Cities Urban Disaster Risk Hub, African Centre for Technology Studies (ACTs), Nairobi, Kenya
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Miller R, Wafula F, Onoka CA, Saligram P, Musiega A, Ogira D, Okpani I, Ejughemre U, Murthy S, Garimella S, Sanderson M, Ettelt S, Allen P, Nambiar D, Salam A, Kweyu E, Hanson K, Goodman C. When technology precedes regulation: the challenges and opportunities of e-pharmacy in low-income and middle-income countries. BMJ Glob Health 2021; 6:bmjgh-2021-005405. [PMID: 34016578 PMCID: PMC8141442 DOI: 10.1136/bmjgh-2021-005405] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/16/2021] [Accepted: 05/01/2021] [Indexed: 11/15/2022] Open
Abstract
The recent growth of medicine sales online represents a major disruption to pharmacy markets, with COVID-19 encouraging this trend further. While e-pharmacy businesses were initially the preserve of high-income countries, in the past decade they have been growing rapidly in low-income and middle-income countries (LMICs). Public health concerns associated with e-pharmacy include the sale of prescription-only medicines without a prescription and the sale of substandard and falsified medicines. There are also non-health-related risks such as consumer fraud and lack of data privacy. However, e-pharmacy may also have the potential to improve access to medicines. Drawing on existing literature and a set of key informant interviews in Kenya, Nigeria and India, we examine the e-pharmacy regulatory systems in LMICs. None of the study countries had yet enacted a regulatory framework specific to e-pharmacy. Key regulatory challenges included the lack of consensus on regulatory models, lack of regulatory capacity, regulating sales across borders and risks of over-regulation. However, e-pharmacy also presents opportunities to enhance medicine regulation—through consolidation in the sector, and the traceability and transparency that online records offer. The regulatory process needs to be adapted to keep pace with this dynamic landscape and exploit these possibilities. This will require exploration of a range of innovative regulatory options, collaboration with larger, more compliant businesses, and engagement with global regulatory bodies. A key first step must be ensuring that national regulators are equipped with the necessary awareness and technical expertise to actively oversee this e-pharmacy activity.
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Affiliation(s)
- Rosalind Miller
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Francis Wafula
- Institute of Healthcare Management, Strathmore University, Strathmore Business School, Nairobi, Kenya
| | - Chima A Onoka
- Department of Community Medicine, University of Nigeria, Nsukka, Nigeria
| | | | - Anita Musiega
- Institute of Healthcare Management, Strathmore University, Strathmore Business School, Nairobi, Kenya
| | - Dosila Ogira
- Institute of Healthcare Management, Strathmore University, Strathmore Business School, Nairobi, Kenya
| | - Ikedichi Okpani
- National Primary Healthcare Development Agency, Abuja, Nigeria
| | | | - Shrutika Murthy
- The George Institute for Global Health India, New Delhi, India
| | | | - Marie Sanderson
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Stefanie Ettelt
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Pauline Allen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Devaki Nambiar
- The George Institute for Global Health India, New Delhi, India
| | - Abdul Salam
- The George Institute for Global Health India, New Delhi, India
| | | | - Kara Hanson
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine Goodman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Varghese J, Blankenhorn A, Saligram P, Porter J, Sheikh K. Setting the agenda for nurse leadership in India: what is missing. Int J Equity Health 2018; 17:98. [PMID: 29986715 PMCID: PMC6038245 DOI: 10.1186/s12939-018-0814-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 07/03/2018] [Indexed: 11/30/2022] Open
Abstract
Background Current policy priorities to strengthen the nursing sector in India have focused on increasing the number of nurses in the health system. However, the nursing sector is afflicted by other, significant problems including the low status of nurses in the hierarchy of health care professionals, low salaries, and out-dated systems of professional governance, all affecting nurses’ leadership potential and ability to perform. Stronger nurse leadership has the potential to support the achievement of health system goals, especially for strengthening of primary health care, which has been recognised and addressed in several other country contexts. This research study explores the process of policy agenda-setting for nurse leadership in India, and aims to identify the structural and systemic constraints in setting the agenda for policy reforms on the issue. Methods Our methods included policy document review and expert interviews. We identified policy reforms proposed by different government appointed committees on issues concerning nurses’ leadership and its progress. Experts’ accounts were used to understand lack of progress in several nursing reform proposals and analysed using deductive thematic analysis for ‘legitimacy’, ‘feasibility’ and ‘support’, in line with Hall’s agenda setting model. Results The absence of quantifiable evidence on the nurse leadership crisis and treatment of nursing reforms as a ‘second class’ issue were found to negatively influence perceptions of the legitimacy of nurse leadership reform. Feasibility is affected by the lack of representation of nurses in key positions and the absence of a nurse-specific institution, which is seen as essential for creating visibility of the issues facing the profession, their processing and planning for policy solutions. Finally, participants noted the lack of strong support from nurses themselves for these policy reforms, which they attributed to social disempowerment, and lack of professional autonomy. Conclusions The study emphasises that the nursing empowerment needs institutional reforms to facilitate nurse’s distributed leadership across the health system and to enable their collective advocacy that questions the status quo and the structures that uphold it.
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Affiliation(s)
- Joe Varghese
- Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area, Gurgaon, 122002, India.
| | | | - Prasanna Saligram
- Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area, Gurgaon, 122002, India
| | - John Porter
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Kabir Sheikh
- Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area, Gurgaon, 122002, India.,Nossal Institute of Global Health, University of Melbourne, Melbourne, Australia
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Affiliation(s)
- Shehla Zaidi
- Community Health Sciences and Women and Child Health Division, Aga Khan University, Karachi, Pakistan
- Community Health Sciences and Women and Child Health Division, Aga Khan University, Karachi, Pakistan
| | | | | | | | - Kabir Sheikh
- Public Health Foundation of India, New Delhi, India
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Saligram P, Kurpad SS, Narayan T. IJME Fifth National Bioethics Conference: a summary report. Indian J Med Ethics 2015; 12:104-9. [PMID: 25920972 DOI: 10.20529/ijme.2015.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Fifth National Bioethics Conference (NBC) was co-hosted by St John's National Academy of Health Sciences (SJNAHS), Bangalore; Society for Community Health Research Awareness and Action (SOCHARA), Bangalore; and Forum for Medical Ethics Society (FMES), Mumbai, which publishes the Indian Journal of Medical Ethics (IJME). The conference was held at the St John's campus, Bangalore from December 11 to 13, 2014. The theme of the Fifth NBC was "Integrity in medical care, public health, and health research".
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Affiliation(s)
- Prasanna Saligram
- Society for Community Health Research Awareness and Action (SOCHARA)
| | | | - Thelma Narayan
- St John's National Academy of Health Sciences, Sarjapur Road, Bangalore, 560 034, India
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Raman VR, Sheikh K, Saligram P, Verma N, Sharma N. Governance ‘tool kits’ for universal health coverage in India: guidelines for implementing the Expert Group’s recommendations. BMC Proc 2012. [PMCID: PMC3467685 DOI: 10.1186/1753-6561-6-s5-o8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Nambiar D, Saligram P, Sheikh K. Does ‘giving’ influence governance? Application of a framework describing the role of private philanthropy in Indian national health priority setting. BMC Proc 2012. [PMCID: PMC3467666 DOI: 10.1186/1753-6561-6-s5-p5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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