Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Abstract

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.

Post-COVID-19 Assessment of Physical, Psychological, and Socio-Economic Impact on a General Population of Patients From Odisha, India

“…Thus a mix of limited published literature has quantified substantial OOPE borne by the COVID-19 infected patients for accessing healthcare services in India. Populations LMICs have been disproportionately affected by the pandemic, which brought about an additional burden on their already weak health systems [26]. To address the socioeconomic impact of the COVID-19 pandemic and its after-effects on the vulnerable population, the health expenditures done as OOPE should be monitored by healthcare providers, health policymakers, and the governments in LMICs.…”

Using dashboards to verify coronavirus (COVID-19) vaccinations can reduce fatality rates in countries/regions: Development and usability study

“…[18] Both Pfizer and Moderna vaccines are messenger ribonucleic acid vaccines and are more than 94% effective against COVID-19. [10,11]…”

“…[10] The top 10 research priorities included health care system access barriers to equitable uptake of COVID-19 vaccination, determinants of vaccine hesitancy, development and evaluation of effective interventions to decrease vaccine hesitancy, and vaccination impacts on vulnerable population/s. [10] In addition, the safety and efficacy of the COVID-19 vaccine have become issues of much concern due to the urgent need after the development of numerous vaccine research projects. [11][12][13] 1.…”

Prognostic accuracy of triage tools for adults with suspected COVID-19 in a middle-income setting: an observational cohort study

“…However, uneven vaccination in low- and middle-income settings coupled with international relaxation of COVID restrictions and less resilient health care provision mean that emergency health care systems in low- and middle-income countries (LMICs) may still be at risk of being overwhelmed during periods of increased infection. 1, 2 Although, for now, the acute surge and demands of COVID on health care facilities has relaxed, there is a pressing need for tools to assist clinician decision making, as well as the ability to adapt such tools rapidly to future COVID19 variants or other new epidemics.…”