Des enjeux éthiques liés à l’utilisation des données de recherches en collaboration internationale

Étude de cas / Case studyCette étude de cas en santé mondiale met au jour les enjeux éthiques associés à l’utilisation des données de recherche collectées dans le cadre d’une collaboration internationale ayant recours à des assistants de recherche.This global health case study uncovers the ethical issues associated with the use of research data collected in the context of international collaboration involving research assistants

From the Formulation of a National Policy to the Compilation of Social Protection Actions: A Case of ‘Non-design’ in Burkina Faso

To improve the social protection of its population, Burkina Faso adopted a national policy in 2012. This paper analyses the process whereby this policy was formulated, looking at the issue from the standpoint of ‘policy design’ (Howlett and Mukherjee, 2014). Conducted in accordance with an inductive qualitative approach, the collection and analysis of the data show that this process of formulation has led neither to reflecting on the problem to be solved nor to identifying the specific needs of the beneficiaries. Nor has it led to evaluating the potential outcomes of the proposed solutions in order to choose the most appropriate ones. The authors are thus led to an empirical observation of ‘non-design’. This policy boils down to a document whose all-encompassing content brings together every conceivable action of social protection, without any arbitration. Three factors have contributed to this non-formulation: (1) the lack of clear government direction to guide discussions; (2) a weakness of support and of political will, resulting in a low degree of involvement in the process on the part of high-level decision makers; and (3) conceptual and technical misunderstandings on the part of national stakeholders in social protection—so much so that they have simply relied on the advice of international bodies. The government announced its intention of playing a leading role in the process of formulating this policy, but this was a purely rhetorical declaration. The study shows that leadership and political will have been lacking, particularly when it has come to channelling the respective interests of the stakeholders and managing the contradictions that hinder the formulation of a coherent policy adapted to the needs of the population

Le transfert des connaissances scientifiques, « c’est bien, mais c’est pas encore arrivé… »

Éditorial du numéro 1, volume 4 de la Revue Tuc, Revue francophone de recherche sur le transfert et l’utilisation des connaissances

From unintended to undesirable effects of health intervention : the case of user fees abolition in Niger, West Africa; case 16

A case study of an evaluation carried out in Niger describes the situation in which evaluators uncovered effects the client had not anticipated in the evaluation design, but which ultimately helped the client improve the intervention. The intervention consisted of abolishing user fees for deliveries and prenatal consultations in order to increase financial accessibility to health care. The changes provoked unexpected reactions from health care workers and the population, such as users developing strategies for hoarding medicines, and nurses selling (free) healthcare booklets due to an increased workload. Uncovering of these unanticipated, and sometimes illicit effects was not envisioned by the client

Scoping review of the literature on the abolition of user fees in health care services in Africa

Published in association with The London School of Hygiene and Tropical MedicineTwenty studies were selected for analysis of effects of the abolition of user fees in sub-Saharan health care services. Results of the scoping review showed that generally this has had positive effects on the utilization of health services. However, while the literature findings demonstrate positive effects, they also highlight the importance of implementation processes, context, and gaps in information. There is a scarcity of data regarding implementation procedures, and there is a need for further research in this area. Political will should include a commitment to planning implementation processes

Knowledge sharing in global health research : the impact, uptake and cost of open access to scholarly literature

Background: In 1982, the Annals of Virology published a paper showing how Liberia has a highly endemic potential of Ebola warning health authorities of the risk for potential outbreaks; this journal is only available by subscription. Limiting the accessibility of such knowledge may have reduced information propagation toward public health actors who were indeed surprised by and unprepared for the 2014 epidemic. Open access (OA) publication can allow for increased access to global health research (GHR). Our study aims to assess the use, cost and impact of OA diffusion in the context of GHR. Method: A total of 3366 research articles indexed under the Medical Heading Subject Heading “Global Health” published between 2010 and 2014 were retrieved using PubMed to (1) quantify the uptake of various types of OA, (2) estimate the article processing charges (APCs) of OA, and (3) analyse the relationship between different types of OA, their scholarly impact and gross national income per capita of citing countries. Results: Most GHR publications are not available directly on the journal’s website (69%). Further, 60.8% of researchers do not self-archive their work even when it is free and in keeping with journal policy. The total amount paid for APCs was estimated at US$1.7 million for 627 papers, with authors paying on average US$2732 per publication; 94% of APCs were paid to journals owned by the ten most prominent publication houses from high-income countries. Researchers from low- and middle-income countries are generally citing less expensive types of OA, while researchers in high-income countries are citing the most expensive OA. Conclusions: Although OA may help in building global research capacity in GHR, the majority of publications remain subscription only. It is logical and cost-efficient for institutions and researchers to promote OA by selfarchiving publications of restricted access, as it not only allows research to be cited by a broader audience, it also augments citation rates. Although OA does not ensure full knowledge transfer from research to practice, limiting public access can negatively impact implementation and outcomes of health policy and reduce public understanding of health issues

Une politique concernant les données issues d’un programme de recherches interventionnelles en santé mondiale

ArticleLa recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d’argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant la conduite responsable lors des recherches collaboratives. L’un d’eux est la conservation, l’accès, l’utilisation et la publication des données. Malgré l’existence de multiples politiques et documents phares sur l’éthique et la conduite responsable de la recherche, les chercheurs en recherche interventionnelle sont encore peu outillés pour faire face à ce défi. Dans le contexte d’un programme de recherches interventionnelles réalisées au Burkina Faso, les auteurs souhaitent partager leur expérience dans le développement d’une politique interne concernant leurs données. Après avoir évoqué le contexte global et particulier, l’article présente le processus de formulation et d’adoption de cette politique par les chercheurs d’une équipe interdisciplinaire et internationale (Allemagne, Burkina Faso, Canada, France). Les valeurs qui enchâssent cette politique interne sont la transparence, la prévention, le consensus autour du processus de production, le respect des principes internationaux, l’accès libre aux connaissances produites et la préoccupation pour leur diffusion et utilisation. La politique se présente en plusieurs parties : objet, types et statuts des chercheurs impliqués, conservation des données, accès et utilisation des données, production scientifique et paternité. Les principaux défis rencontrés par les chercheurs pour formuler cette politique sont analysés dans un souci de partage pour susciter un débat rarement abordé. La confiance, la transparence et le respect mutuel doivent être au cœur de tout partenariat scientifique en recherche interventionnelle.Interventional global health research is often carried out through international scientific partnerships. However, the conduct of such research, especially in low-income countries where issues of power, money and intercultural relations are exacerbated, raises many ethical challenges particularly related to responsible conduct in collaborative research. One of these challenges is the storage, access, use and publication of data. Despite the existence of multiple influential policies and documents on ethics and the responsible conduct of research, researchers in intervention research are still not equipped to deal with such challenges. In the context of an intervention research program conducted in Burkina Faso, the authors would like to share their experience in the development of an internal policy concerning their data. After presenting the global and the particular context, the paper presents the process of policy formulation and its adoption by the researchers of an interdisciplinary and international team (Burkina Faso, Canada, France, Germany). The values that entrench this internal policy are: transparency, prevention, consensus about the production process, respect for international principles, free access to the knowledge produced and concerns regarding its dissemination and use. The policy is presented in several parts: aim, types and status of the participating researchers, data storage, access and use of data, scientific production and authorship. The main challenges faced by researchers in formulating this policy are analyzed in a shared desire to spark a debate that is rarely addressed. Trust, transparency and mutual respect should be central to any scientific partnership in intervention research