Setting an implementation research agenda for Canadian investments in global maternal, newborn, child and adolescent health: a research prioritization exercise

Abstract

Background: Improving global maternal, newborn, child and adolescent health (MNCAH) is a top development priority in Canada, as shown by the $6.35 billion in pledges toward the Muskoka Initiative since 2010. To guide Canadian research investments, we aimed to systematically identify a set of implementation research priorities for MNCAH in low-and middle-income countries. Methods:We adapted the Child Health and Nutrition Research Initiative method. We scanned the Child Health and Nutrition Research Initiative literature and extracted research questions pertaining to delivery of interventions, inviting Canadian experts on MNCAH to generate additional questions. The experts scored a combined list of 97 questions against 5 criteria: answerability, feasibility, deliverability, impact and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. Results:The overall research priority score ranged from 40.14 to 89.25, with a median of 71.84. The average expert agreement scores ranged from 0.51 to 0.82, with a median of 0.64. Highly-ranked research questions varied across the life course and focused on improving detection and care-seeking for childhood illnesses, overcoming barriers to intervention uptake and delivery, effectively implementing human resources and mobile technology, and increasing coverage among at-risk populations. Children were the most represented target population and most questions pertained to interventions delivered at the household or community level.Interpretation: Investing in implementation research is critical to achieving the Sustainable Development Goal of ensuring health and well-being for all. The proposed research agenda is expected to drive action and Canadian research investments to improve MNCAH. Abstract ResearchResearch CMAJ OPEN CMAJ OPEN, 5(1) E83

Global research priorities for social, behavioural and community engagement interventions for maternal, newborn and child health

“…1 Conceptual framework for SBCE interventions for women, children's and adolescents' health [2] was used, which combined an adapted version of the Child Health and Nutrition Research Initiative (CHNRI) methodology [11] with a qualitative, consensus-building approach with experts. The CHNRI method features a metrics-based approach in which subject experts score a set of research priorities to determine their relative importance and has been used in over 50 health research prioritisation exercises [7][8][9][10][11][12].…”

Social accountability for reproductive, maternal, newborn, child and adolescent health: A review of reviews

“…The reviews were also evaluated for the degree to which they considered equity, using the short checklist shown in Fig 2 [39]. Reviews were rated as high effect (three yes results), medium effect (two yes results), or low effect on equity (one or no yes results) and differences in ratings between reviewers were resolved through discussion.…”

“…Like equity, health and social impact were evaluated according to three questions used elsewhere, slightly adapted for our purposes (Sharma, Buccioni et al 2017 [39]; see Fig 3). Ratings were determined in the same manner as described for assessing the impact on equity.…”

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“…Five of the exercises addressed comprehensive perinatal research priorities [10-14]. One exercise focused exclusively on complex humanitarian emergencies [9], while another exercise focused exclusively on integrating early childhood development with other perinatal research priorities [15].…”