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International Health

Health Systems Program

Date: May 2017

Webinar: "Health Systems Research Ethics: Special Issue Webinar"

When:  05/30/2017   8:30 AM - 9:30 AM

Time Zone:  (GMT-05:00) Eastern Time (US and Canada) 

Host: Professor Adnan Hyder (Johns Hopkins Bloomberg School of Public Health)

To join the webinar:

https://connect.johnshopkins.edu/hsr2017/

Log-in as a guest if unaffiliated with Johns Hopkins. 

 

Please RSVP:

https://goo.gl/forms/Kfwj7NX9vm8myZvz1

Summary: 

Health systems research ethics is a relatively new and emerging field, with numerous normative and descriptive questions that have largely not been considered. It has been argued that the ethical issues arising in health systems research projects may be unique or nuanced relative to biomedical research.

To further build the field of health systems research ethics and promote scholarship in this area, a special issue of Developing World Bioethics was devoted to it in 2016. This webinar brings together the authors (Sassy Molyneux, Bridget Pratt, Hayley MacGregor, Gerry Bloom, and Abbas Rattani) of four papers published in that special issue as well as one of its co-editors (Adnan Hyder) to share their findings and work.

The webinar is one hour and will consist of an introduction, 4 short presentations by the authors discussing their papers, followed by a Q&A with the authors and a broader discussion on the ethics of health systems research moderated by Joe Ali (Berman Institute of Bioethics).

Presenters:

  1. Introduction: Professor Adnan Hyder, Johns Hopkins Berman Institute of Bioethics and Bloomberg School of Public Health; Guest Editor of Special Issue
  2. Health Systems Research Consortia and the Promotion of Health Equity in Low and Middle-Income Countries, Bridget Pratt, University of Melbourne (Australia)
  3. Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale, Hayley MacGregor and Gerry Bloom, Institute of Development Studies (UK)
  4. Research Involving Health Providers and Managers: Ethical Issues Faced by Researchers Conducting Diverse Health Policy and Systems Research in Kenya, Sassy Molyneux, KEMRI-Wellcome Trust Research Programme (Kenya)
  5. What Makes Health Systems Research in Developing Countries Ethical? Application of the Emanuel Framework for Clinical Research to Health Systems Research, Abbas Rattani, Meharry Medical College (USA)

Today, May 23, 2017, marks Johns Hopkins Bloomberg School of Public Health’s Convocation Ceremony, with the school-wide celebration taking place tomorrow. At 3 p.m. today, graduates will take the stage at the Royal Farms Arena in Baltimore, MD, ready to begin their careers in the vast field of public health.

The Health Systems Program is honored to have many graduating students representing the Program in the Department of International Health in today’s ceremony. Thirty-five Health Systems students are officially receiving their degrees: three Master of Health Science (MHS) in Health Economics students, 25 Master of Science in Public Health (MSPH) students, and seven PhD students. The Program is delighted and congratulates all of them!

In March, the Program celebrated three students defending their thesis, and recently celebrated two more in May. Yuen Wai Hung, presented her dissertation, Understanding the Mental Health Consequences and Associated Risk Factors among Adult Injury Survivors in Kenya, and Julia Zhang also presented her dissertation, Rehabilitation of Occupational Injuries: Evaluation of a National Return-to-Work Program in Malaysia.

The Program also had the honor of awarding the 2017 Doctoral Research Award to four outstanding students for their international research. Sudip Bhandari received the award for his qualitative research project, which evaluated the national and local context against which the contracting-out model has been implemented in Nepal. Douglas Glandon’s research examined collaboration between frontline workers from the two Indian government ministries that have joint responsibility for delivering essential health and nutrition services to women and children in villages across the country. Jose Gutierrez received the award for his proposed research on a comparative analysis of Guatemala and El Salvador’s post-conflict health reforms, and Ankita Meghani won for her research on understanding the perspectives of policymakers and key stakeholders in Uganda on the integration of non-communicable disease (NCD) care into existing community health worker (CHW) roles.

The Program works in over 50 countries, and encourages students to seek diverse opportunities for learning and training all over the world. The hallmarks of our academic program are a rigorous focus on scientific methods, a multidisciplinary faculty, and training through real-world examples. It is especially rewarding to see students earn their degrees and contribute the discoveries made through their research.

Health Systems students have gone on to work for renowned global organizations such as the World Bank, the World Health Organization and the Centers for Disease Control. We always seek to train our graduates to design efficient systems and implement equitable strategies for delivering health care, especially in the most vulnerable and disadvantaged parts of the world.

We wish all graduating students a successful career in public health, and are looking forward to seeing great achievements made by Heath Systems students around the globe. Visit us for more information on our Program. 

The Health Systems Program is proud to announce that three students successfully passed their doctoral thesis exams in March. Youngji Jo, Mariana Socal and Veena Sriram presented their research from Bangladesh, Brazil and India.

Youngji’s dissertation, Cost-Effectiveness and Scalability of an mHealth Intervention to Improve Pregnancy Surveillance and Care Seeking in Rural Bangladesh, focused on how digital health can be used to improve maternal and newborn health. Proven health interventions could save millions of lives, but coverage of these interventions in low- and middle-income countries (LMICs) is low. Mobile health (mHealth) has shown a potential impact for improving knowledge, service delivery and intended health outcomes, but little evidence exists on its value for money or affordability in developing countries. Youngji examined the mCARE program in rural Bangladesh, which was designed to increase service utilization during pregnancy using SMS and home visit reminders to pregnant women from an established group of community workers. Her research found that the program, implemented from 2011 – 2015, was highly cost-effective and had a marginal budget impact in the country, based on her forecasting model scenarios. With her research, Youngji hopes to guide policy and program decision-making in Bangladesh and provide evidence for globally investing in healthcare innovations.

Mariana's dissertation, Polypharmacy in Older Adults: A Multi-Level Analysis of Trends and Determinants in Sao Paulo, Brazil, examined the occurrence of polypharmacy, an emerging public health problem where individuals utilize too many prescription drugs. Mariana found that a large proportion of older adults in Sao Paulo are exposed to polypharmacy, and that most of them are at an increased risk of adverse effects from the drugs they are taking. Through an examination of the health systems factors associated with polypharmacy, Mariana found that lower availability of doctors in the public health system and higher presence of private pharmacies and hospitals in a geographic area were associated with a higher likelihood of polypharmacy among persons living in that area, regardless of health conditions and socio-demographic characteristics. With her findings, Mariana hopes to bring to light that polypharmacy among older adults should be a public health concern in Sao Paulo, and that increasing the number of doctors in the public health system and focusing on integrating healthcare could potentially be policy options used to mitigate polypharmacy in the Sao Paulo context.  

Veena’s dissertation, The Evolution of Emergency Medicine as a Medical Specialty in India: A Policy Analysis, examined the power dynamics in play in the specialization of medical services in LMICs, using emergency medicine in India as a case study. Her research centered on the dual concepts of equitable access to health care and how medical specialties are regulated in India. Developed in response to a lack of emphasis in health systems research on governance and regulation, her study examined how new medical specialties emerge in India and how regulatory institutions within a country decide whether to include a specialty or not. Veena aimed to interrogate the idea of ‘specialization’ as a solution to service delivery problems, such as weak emergency care, and understand how stakeholders perceive the impact of specialization on health systems and equitable access to care. The role of power is not well understood in health systems research, and with her work, Veena hopes to contribute to the knowledge gap around this topic.

Congratulations to all three students for championing their research in Health Systems as they embark on the next step in their journey as public health leaders.

The Journal of Medical Internet Research (JMIR) has published a special issue of scientific papers on the use of mobile technologies for national-scale population surveys. The special theme issue features the Johns Hopkins Bloomberg School of Public Health (JHSPH)’s work for Bloomberg Philanthropies Data for Health Initiative (D4H).

Researchers at JHSPH are working to assess, harness and roll out the use of mobile phone technology in low- and middle-income countries (LMICs) as a cost-effective method for the rapid collection of quality non-communicable disease (NCD) risk factor data, such as tobacco and alcohol use, physical inactivity and unhealthy diets. The special issue features JHPSH’s work in closing critical gaps in understanding the ways by which mobile phone surveys (MPS) could be used as a digital health tool in the collection of NCD data in LMICs. The issue addresses current knowledge gaps through an examination of relevant extant literature, provides an analysis of several ethical issues surrounding the use of mobile phones to collect personal data in LMICs, and examines the challenges of turning data into international- and national-level policies. The issue also offers a comparison of each primary MPS method and examines the current landscape of MPS technology currently being used for population-level data collection in LMICs.

Researchers from the Health Systems Program in the Department of International Health at JHSPH were key contributors to the issue, including Drs. Adnan Hyder, Alain Labrique, Dustin Gibson and George Pariyo. They hope that this research will help to provide guidance on using MPS to understand and curb the rise of NCDs in LMICs and respond to challenges surrounding the employment of mobile phone technology in LMICs.

Next steps include continuing to document empirical experiences of MPS used to collect NCD risk factor data, engaging with global bodies toward the development of a research agenda, establishing a global working group of experts to address the ethical issues surrounding MPS use in LMICs, and working with international and national level policy-makers to create a comparative framework for turning results into policy and practice.

D4H seeks to help government officials and public health leaders make informed decisions on health care priorities by collecting public health data. The Initiative seeks to improve civil registration and vital statistics (CRVS) systems, explore ways to expand current non-communicable disease (NCD) surveillance efforts, and provide training on data analysis and use to governments in low- and middle-income countries (LMICs). JHSPH is a partner organization that is leading the research and development (R&D) component of the NCD arm of the Initiative.

The Health Systems Program is focused on achieving accessible, cost-effective health care and healthy outcomes across the lifespan for families, communities and nations. In the past decade, the Program has conducted projects in over 50 countries, with particular expertise in South Asia and sub-Saharan Africa, where the greatest number of people continue to struggle with deep poverty and unmet health needs.

For more information, please contact Melissa Reed, Communications and Program Specialist, at melissar@jhu.edu