The Science Granting Councils Initiative (SGCI) in Africa aims to strengthen the capacities of selected science granting councils (SGCs) in sub-Saharan Africa in order to support research and evidence-based policies that will contribute to Africa’s economic and social development. As part of SGCI, a study was conducted in 2021 to investigate strategies that have been adopted by fifteen SGCs participating in SGCI in promoting ethical practice in research and innovation. Data collection for the study was mainly based on a data abstraction form that was completed for each country by an assigned focal person with a background in research ethics. The focal persons relied on various methods including document and website review and interviews with senior officers at the SGCs. The study specifically sought to describe the strategies and activities being implemented by the 15 SGCs in promoting ethics and integrity in research and innovation. The study revealed various strategies that were being implemented by the 15 SGCs aimed at promoting ethics in research and innovation including requiring proof of research ethics committee approval before releasing research funds and the inclusion of ethics questions in the application form for funding. It was observed that some activities and strategies were generic to most SGCs for example the development of general/standard guidelines for the conduct of research in each respective country. Overall, the different SGCs were involved in a broad spectrum of activities aimed at promoting research ethics and this paper presents an opportunity for cross fertilization of ideas. By providing a summary of the various strategies that SGCs are using in promoting ethical conduct of research, it is hoped that this paper will lead to improvements in the ways SGCs provide support and oversight over the research that they fund.

Introduction: The COVID-19 pandemic has globally impacted health service access, delivery and resources. There are limited data regarding the impact on the prevention of mother to child transmission (PMTCT) service delivery in low-resource settings. Neotree (www.neotree.org) combines data collection, clinical decision support and education to improve care for neonates. Here we evaluate impacts of COVID-19 on care for HIV-exposed neonates. Methods: Data on HIV-exposed neonates admitted to the neonatal unit (NNU) at Sally Mugabe Central Hospital, Zimbabwe, between 01/06/2019 and 31/12/2021 were analysed, with pandemic start defined as 21/03/2020 and periods of industrial action (doctors (September 2019-January 2020) and nurses (June 2020-September 2020)) included, resulting in modelling during six time periods: pre-doctors’ strike (baseline); doctors’ strike; post-doctors’ strike and pre-COVID; COVID and pre-nurses’ strike ; nurses’ strike; post nurses’ strike. Interrupted time series models were used to explore changes in indicators over time. Results: Of 8,333 neonates admitted to the NNU, 904 (11%) were HIV-exposed. Mothers of 706/765 (92%) HIV-exposed neonates reported receipt of antiretroviral therapy (ART) during pregnancy. Compared to the baseline period when average admissions were 78 per week (95% confidence interval (CI) 70-87), significantly fewer neonates were admitted during all subsequent periods until after the nurses’ strike, with the lowest average number during the nurses’ strike (28, 95% CI 23-34, p<0.001). Across all time periods excluding the nurses strike, average mortality was 20% (95% CI 18-21), but rose to 34% (95% CI 25, 46) during the nurses’ strike. There was no evidence for heterogeneity (p>0.22) in numbers of admissions or mortality by HIV exposure status. Fewer HIV-exposed neonates received a PCR test during the pandemic (23%) compared to the pre-pandemic periods (40%) (RR 0.59, 95% CI 0.41-0.84, p<0.001). The proportion of HIV-exposed neonates who received antiretroviral prophylaxis during admission was high throughout, averaging between 84% and 95% in each time-period. Conclusion: While antiretroviral prophylaxis for HIV-exposed neonates remained high throughout, concerning data on low admissions and increased mortality, similar in HIV-exposed and unexposed neonates, and reduced HIV testing, suggest some aspects of care may have been compromised due to indirect effects of the pandemic.