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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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    Lessons learnt conducting minimally invasive autopsies in private mortuaries as part of HIV and tuberculosis research in South Africa
    (International Union Against Tuberculosis and Lung Disease, 2019-12-21) Karat, Aaron S.; Omar, T.; Tlali, M.; Charalambous, S.; Chihota, V. N.; Churchyard, G. J.; Fielding, K. L.; Martinson, N. A.; McCarthy, K. M.; Grant, A. D.
    Current estimates of the burden of tuberculosis (TB) disease and cause-specific mortality in human immunodeficiency virus (HIV) positive people rely heavily on indirect methods that are less reliable for ascertaining individual-level causes of death and on mathematical models. Minimally invasive autopsy (MIA) is useful for diagnosing infectious diseases, provides a reasonable proxy for the gold standard in cause of death ascertainment (complete diagnostic autopsy) and, used routinely, could improve cause-specific mortality estimates. From our experience in performing MIAs in HIV-positive adults in private mortuaries in South Africa (during the Lesedi Kamoso Study), we describe the challenges we faced and make recommendations for the conduct of MIA in future studies or surveillance programmes, including strategies for effective communication, approaches to obtaining informed consent, risk management for staff and efficient preparation for the procedure.
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    Qualitative research to enhance the evaluation of results-based financing programmes: The promise and the reality
    (The World Bank, 2016-02) Cataldo, Fabian; Kielmann, Karina
    This Discussion Paper presents the approach, findings, and recommendations from a desk review of the qualitative research conducted within Results-Based Financing programmes (RBF) under the Health Results Innovations Trust Fund (HRITF). The review included 17 studies conducted in Benin, Burundi, Cameroon, DRC, Ethiopia, Haiti, Kenya, Kyrgyzstan, Nigeria, Rwanda, Tajikistan, Tanzania, Zambia, and Zimbabwe. The studies reveal a body of high quality work that is consistent with the conceptual framework of RBF schemes, supported by political will, resources, and research capacity. Strengthening the added value of qualitative inquiry in on-going and future qualitative studies may be enabled by small shifts in thinking and practice, in line with a qualitative research paradigm. First, in order to better ground research in an existing country and system specific context, some interrogation of constructs and posited relationships in the existing conceptual framework for intervention/evaluation may be required. Second, to enable more in-depth and richer data that documents working practices and relations under RBF schemes, training of local researchers should place stronger emphasis on entry to the field, gaining trust, building rapport, and sustaining a dialogue with key informants. Third, smaller, more intensive and focused studies targeting fewer sites and smaller samples - but addressing a wider range of methods and informants within the health system - are likely to yield richer data that can support the understanding of how health workers and managers are responding to schemes, and what impact schemes have on service volumes and outputs.