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      Promoting equitable global health research: a policy analysis of the Canadian funding landscape

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          Abstract

          Background

          Recognising radical shifts in the global health research (GHR) environment, participants in a 2013 deliberative dialogue called for careful consideration of equity-centred principles that should inform Canadian funding polices. This study examined the existing funding structures and policies of Canadian and international funders to inform the future design of a responsive GHR funding landscape.

          Methods

          We used a three-pronged analytical framework to review the ideas, interests and institutions implicated in publically accessible documents relevant to GHR funding. These data included published literature and organisational documents (e.g. strategic plans, progress reports, granting policies) from Canadian and other comparator funders. We then used a deliberative approach to develop recommendations with the research team, advisors, industry informants and low- and middle-income country (LMIC) partners.

          Results

          In Canada, major GHR funders invest an estimated CA$90 M per annum; however, the post-2008 re-organization of funding structures and policies resulted in an uncoordinated and inefficient Canadian strategy. Australia, Denmark, the European Union, Norway, Sweden, the United Kingdom and the United States of America invest proportionately more in GHR than Canada. Each of these countries has a national strategic plan for global health, some of which have dedicated benchmarks for GHR funding and policy to allow funds to be held by partners outside of Canada. Key constraints to equitable GHR funding included (1) funding policies that restrict financial and cost burden aspects of partnering for GHR in LMICs; and (2) challenges associated with the development of effective governance mechanisms. There were, however, some Canadian innovations in funding research that demonstrated both unconventional and equitable approaches to supporting GHR in Canada and abroad. Among the most promising were found in the International Development Research Centre and the (no longer active) Global Health Research Initiative.

          Conclusion

          Promoting equitable GHR funding policies and practices in Canada requires cooperation and actions by multiple stakeholders, including government, funding agencies, academic institutions and researchers. Greater cooperation and collaboration among these stakeholders in the context of recent political shifts present important opportunities for advancing funding policies that enable and encourage more equitable investments in GHR.

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          Most cited references58

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          Towards a common definition of global health

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            Deliberative dialogues as a mechanism for knowledge translation and exchange in health systems decision-making.

            Models that describe the key features and intended effects of specific knowledge translation and exchange (KTE) interventions are much less prominent than models that provide a more general understanding of KTE. Our aim was to develop a model in order to describe the key features and intended effects of deliberative dialogues used as a KTE strategy and to understand how deliberative dialogues can support evidence-informed policymaking. By using critical interpretive synthesis, we identified 17 papers representing four fields of enquiry and integrated our findings into a model. The key features described in the model are: 1) an appropriate (i.e., conducive to the particular dialogue) meeting environment; 2) an appropriate mix of participants; and, 3) an appropriate use of research evidence. These features combine to create three types of intended effects: 1) short-term individual-level; 3) medium-term community/organizational-level; and, 3) long-term system-level. The concept of capacity building helps to explain the relationship between features and effects. The model is a useful contribution to the KTE field because it is a practical tool that could be used to guide the development and evaluation of deliberative dialogues in order to understand more about achieving particular outcomes in relation to specific issues or contexts. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              Using reflexivity to optimize teamwork in qualitative research.

              Reflexivity is often described as an individual activity. The authors propose that reflexivity employed as a team activity, through the sharing of reflexive writing (accounts of personal agendas, hidden assumptions, and theoretical definitions) and group discussions about arising issues, can improve the productivity and functioning of qualitative teams and the rigor and quality of the research. The authors review the literature on teamwork, highlighting benefits and pitfalls, and define and discuss the role for reflexivity. They describe their own team and detail how they work together on a project investigating doctor-patient communication about prescribing. The authors present two reflexive tools they have used and show through examples how they have influenced the effectiveness of their team in terms of process, quality, and outcome.
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                Author and article information

                Contributors
                katrina.plamondon@ubc.ca
                dylan.walters@mail.utoronto.ca
                sandy.campbell@gmail.com
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                29 August 2017
                29 August 2017
                2017
                : 15
                : 72
                Affiliations
                [1 ]Research Department, Interior Health, Kelowna, BC Canada
                [2 ]ISNI 0000 0001 2288 9830, GRID grid.17091.3e, School of Nursing, , University of British Columbia, ; 3333 University Drive, Kelowna, BC V1V 1V7 Canada
                [3 ]ISNI 0000 0001 2157 2938, GRID grid.17063.33, Canadian Centre for Health Economics, Institute of Health Policy, Management and Evaluation, , University of Toronto, ; 155 College Street, 4th Floor, Toronto, ON M5T 3M6 Canada
                [4 ]Independent consultant, Taos, New Mexico USA
                [5 ]ISNI 0000 0004 1936 7697, GRID grid.22072.35, Global Health & International Partnerships Office, Cumming School of Medicine, , University of Calgary, ; Dean’s Office, 7th Floor, Teaching Research & Wellness Building, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
                Author information
                http://orcid.org/0000-0002-2817-0621
                Article
                236
                10.1186/s12961-017-0236-2
                5576339
                28851388
                61efc9e8-e52b-4598-90df-b948c1873d90
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 October 2016
                : 28 July 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000193, International Development Research Centre;
                Award ID: 107680-001
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: 314705
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                global health research,funding,research policy,canada
                Health & Social care
                global health research, funding, research policy, canada

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