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GLOBVAC-Global helse- og vaksin.forskn

Equity and financial household impact in randomised controlled trials, implementation research and cohort studies in India (EQUIFINANCE)

Alternative title: Rettferdig fordeling av helsegevinster og finansiell risikobeskyttelse i epidemiologiske studier i India (EQUFINANCE)

Awarded: NOK 12.0 mill.

Project Number:

316354

Application Type:

Project Period:

2021 - 2026

Location:

Partner countries:

EQUIFINANCE develops and evaluates new methods to assess impact of health care interventions on equity and financial risk protection, highlighting consequences for vulnerable populations. Equity impact and economic return for households will be assessed in five ongoing high-quality studies of neonatal and child health in India: (1) Community-initiated kangaroo mother care (randomised controlled trial - RCT) (2) Zinc supplementation to antibiotic treatment of severe infections (RCT) (3) Integrated community case management of pneumonia (implementation research design) (4) High-risk infant follow-up (pregnancy cohort study) (5) Action III- Antenatal Corticosteroids for late preterm birth (RCT) Results are expected to be relevant for the sustainable developmental goals on ending poverty and improving health. To improve the equity methodology across clinical and epidemiological methods, EQUIFINANCE aims to bridge standard measures from the ethics and economics literature with standard methods of epidemiology (randomized controlled trials, implementation research and cohort studies). Extended cost-effectiveness analysis (ECEA), concentration index and curves, and CONSORT-Equity 2017 guidance will be applied and developed. Applications of these methods to ongoing high-quality studies of neonatal and child health care interventions in India may serve as reference cases to inform future research on the adoption of consistent equity method approaches. By addressing equity problems in concrete reference cases, EQUIFINANCE can both evaluate and develop quantitative state-of-the-art equity and financial impact methods. This is a collaboration between Bergen Centre for Ethics and Priority Setting (BCEPS), Centre for Intervention Science in Maternal and Child Health (CISMAC) at the University of Bergen, Centre for Health Research and Development, Society for Applied Studies (SAS) in India, and the Translational Health Science and Technology Institute (THSTI), also in India.

The main idea behind the EQUIFINANCE project is to develop and evaluate new methods to assess equity and economic impact (financial risk protection) of health care interventions. Impact on equity and economic return for households of neonatal and child health interventions will be assessed in five ongoing primary high quality studies in India: Three randomised controlled trials (community-initiated kangaroo mother care, zinc supplementation to antibiotic treatment of severe infections, antenatal corticosteroids for late preterm birth), one study with implementation research design (integrated community case management for pneumonia) and one pregnancy cohort study (high-risk infant follow-up). EQUIFINANCE will be an add on study to these Results from the EQUIFINANCE are expected to be relevant for SDG 3.8. Methods of Extended cost-effectiveness analysis (ECEA), Concentration Index and Concentration Curves, financial household impact analysis, and CONSORT-Equity 2017 guidance will be applied and developed to all primary studies. EQUIFINANCE has therefore a high potential for scientific impact, with the establishment of a leading research group on equity and poverty impact methods in randomised controlled trials, implementation research and cohort studies. EQUIFINANCE is a collaboration between Centre for Health Research and Development, Society for Applied Sciences (SAS) in New Delhi (with expertise in conducting large community based trials), Translational Health Science and Technology Institute (THSTI) in New Delhi (with experience in conducting large facility based trials), Centre for Intervention Science in Maternal and Child Health (CISMAC) in Bergen (NRC centre of excellence on maternal and child health randomised controlled trials) and Bergen Centre of Ethics and Priority Setting (BCEPS) (with expertise in equity impact studies and development of national essential health care packages for universal health coverage in low- and middle income countries).

Funding scheme:

GLOBVAC-Global helse- og vaksin.forskn