Background The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. Results Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

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Aims To examine the strengths and weaknesses of multi‐context (international) qualitative evidence syntheses in comparison with single‐context (typically single‐country) reviews. We compare a multi‐country synthesis with single‐context syntheses on facility‐based delivery in Nigeria and Kenya. Design Discussion paper. Background Qualitative evidence increasingly contributes to decision‐making. International organizations commission multi‐context reviews of qualitative evidence to gain a comprehensive picture of similarities and differences across comparable (e.g., low‐ and middle‐income) countries. Such syntheses privilege breadth over contextual detail, risking inappropriate interpretation and application of review findings. Decision‐makers value single‐context syntheses that account for the contexts of their populations and health services. We explore how findings from multi‐ and single‐context syntheses contribute against a conceptual framework (adequacy, coherence, methodological limitations and relevance) that underpins the GRADE Confidence in Evidence of Reviews of Qualitative Evidence approach. Data sources Included studies and findings from a multi‐context qualitative evidence synthesis (2001–2013) and two single‐context syntheses (Nigeria, 2006–2017; and Kenya, 2002–2016; subsequently updated and revised). Findings Single‐context reviews contribute cultural, ethnic and religious nuances and specific health system factors (e.g., use of a voucher system). Multi‐context reviews contribute to universal health concerns and to generic health system concerns (e.g., access and availability). Implications for nursing Nurse decision‐makers require relevant, timely and context‐sensitive evidence to inform clinical and managerial decision‐making. This discussion paper informs future commissioning and use of multi‐ and single‐context qualitative evidence syntheses. Conclusion Multi‐ and single‐context syntheses fulfil complementary functions. Single‐context syntheses add nuances not identifiable in the remit and timescales of a multi‐context review. This study offers a unique comparison between multi‐context and single country (Nigeria and Kenya) qualitative syntheses exploring facility‐based birth. Clear strengths and weaknesses were identified to inform commissioning and application of future syntheses. Characteristics can inform the commissioning of single‐ and multi‐context nursing‐oriented reviews across the world.

Introduction High-quality facility-based birth reduces maternal and perinatal morbidity and mortality. Previous multi-country systematic reviews have analysed qualitative research studies to understand the barriers and facilitators of delivery in a health facility. However, questions remain as to the extent to which generic multi-context reviews capture nuanced insights from a specific country context. Nigeria contributes significantly to the global burden of maternal mortality and hence the need to explore the country’s contextual factors affecting maternal mortality viz-a-viz a previous international review. Methods To synthesise published and unpublished qualitative research on factors that influence decision-making and use of facility-based delivery services in Nigeria using a qualitative evidence synthesis methodology. Multiple electronic databases, citation chaining and checking of reference lists were searched. Studies were screened by title, abstract and full text. The quality of the included studies was evaluated using the Critical Appraisal Skills Programme (CASP) checklist for appraising a qualitative study. Synthesis of extracted data followed the ‘best-fit’ framework method which combines deductive and then inductive approaches to analysis. Results 27 eligible studies were identified. Data were organised around four principal themes, further divided into subthemes: perceptions of pregnancy and childbirth, the influence of the sociocultural context and care experiences; resource availability and access and perceptions of quality of care. Conclusions Beyond the structural gaps that exist which affect quality care provided at health facilities, wider social determinants like sociocultural beliefs, care experience and resource availability impact upon the utilisation of facility-based delivery services. Future research should prioritise interventions and programmes to address prevalent gaps involving distance and access. In this way, progress can be made against longstanding deficits in the quality of maternal and infant care.

Back Background ground The World Health Organization's Global Polio Eradication Initiative (GPEI) has succeeded in reducing the cases of Polio by 99%. The persistence of the remaining 1% in Pakistan, Afghanistan and Nigeria has continued to pose threats to polio-free neighbouring countries. This systematic review aims to contribute to ongoing efforts to eradicate polio by exploring factors that influence the successful implementation of the GPEI in low-and middle-income countries. Methods Methods We reviewed qualitative research or mixed methods study reports published between 2012-2018 from studies conducted in low-and middle-income countries. We extracted qualitative research data using a standardised data extraction form and assessed study quality using the Critical Appraisal Skills Programme (CASP) qualitative checklist. We then conducted best-fit framework synthesis to organise, and explore patterns in, the data relating to new and existing themes. We report data on factors influencing the implementation of polio eradication efforts organised by theme.