Dear CHIFA colleagues,
On behalf of CHIFA, I want to thank CHIFA member Trevor Duke for his contributions to this forum, and particularly his annual summary since 2002 of evidence on child and adolescent health derived from randomised controlled trials (RCTs) in low- and middle-income countries (LMICs). Trevor's summary of RCTs in 2023-2024 now rightly enjoys lead article status in the current Archives of Disease in Childhood. Citation, abstract, extracts and a comment from me below.
CITATION: Research on child and adolescent health in low- and middle-income countries in 2023–2024
http://orcid.org/0000-0003-4637-1416 Trevor Duke
Correspondence to Prof Trevor Duke; trevor.duke@rch.org.au
ABSTRACT
Between July 2023 and June 2024, there were 540 publications from randomised controlled trials (RCTs) in child and adolescent health in low- and middle-income countries (LMICs), identified using a standardised process that has been in use for 21 years. This year, trials addressed a wide range of diseases and conditions impacting the health, development and well-being of children, newborns, adolescents and mothers. The RCTs reflected old, new and neglected problems, the rapidly changing epidemiology and the evolving social and economic circumstances in many countries. They also highlighted local and global priorities in LMICs, as well as environmental factors contributing to poor child health and inequities. The trials tested new and refined treatments, diagnostics, vaccines, holistic management and prevention approaches, and explored many outcomes, including mortality, nutrition, psychosocial measures and development. The studies were conducted in hospitals and primary healthcare clinics, schools and communities. Some studies are of the highest quality, while others fall short. The implications are many, including the need for greater capacity for discriminating synthesis and translation of evidence at a national and local level in many LMICs. This involves resourcing and educational components, with implications for healthcare worker training in research translation, quality improvement and learning health systems. Paediatricians and child health nurses everywhere have a role to play.
https://doi.org/10.1136/archdischild-2024-327876
All editions of this publication (2002–2023) are available at: https://pngpaediatricsociety.org/research-2/
SELECTED EXTRACTS
'Each year since 2002, evidence on child and adolescent health derived from randomised controlled trials (RCTs) in low- and middle-income countries (LMICs) have been summarised in a booklet and distributed widely. The aim is to provide information to review treatment policies, clinical guidelines, public health approaches, to teach about evidence-based medicine and to learn about child health in the wider world.'
'Much more support is needed for developing clinical and public health research capacity in the low-income countries, with a focus on children living in the poorest and most volatile conditions. The SDGs urge us to reduce inequities to improve child health, and clinical and public health researchers have a crucial role to play in this effort.'
COMMENT (NPW): Much more support is also needed to bridge the gap between published research and policy and practice. A huge (though largely unquantified) burden of avoidable death and suffering is due to a failure to access and apply reliable healthcare information. By systematically summarising the literature, Trevor Duke helps to bridge this gap, but there are many barriers that remain unaddressed.
CHIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org