背景:卫生政策和系统研究(HPSR)可以加强卫生系统并改善人群健康结果。在东地中海地区(EMR),人们对HPSR的重要性认识有限,资金仍然是主要挑战。本研究旨在:(1)评估2010年至2022年在EMR上发表的HPSR论文中的资金报告,(2)检查EMR中已发表的HPSR论文中的资金来源;(3)探索影响资金来源的变量,包括2019年冠状病毒病(COVID-19)相关文章的资金来源的任何差异。
方法:我们对EMR中2010年至2022年(包括在内)发表的HPSR论文进行了快速范围审查,解决以下领域:HPSR论文中的资金报告,已发表的HPSR论文中的资金来源,作者的从属关系和关注的国家。我们遵循JoannaBriggsInstitute(JBI)的指导原则进行范围审查。我们还对0.05显著性水平的所有变量进行了单变量和双变量分析。
结果:筛选的10797篇文章中,包括3408人(其中9.3%与COVID-19相关)。超过一半的文章来自三个EMR国家:伊朗(n=1018,29.9%),沙特阿拉伯王国(n=595,17.5%)和巴基斯坦(n=360,10.6%)。大约30%的文章没有报告研究经费的任何细节。在报告资金的文章中(n=1346,39.5%),对所有国家收入群体的资金来源分析显示,最突出的来源是国家(55.4%),其次是国际来源(41.7%),最后是区域来源(3%)。在国家资金来源中,大学占76.8%,而政府占14.9%。按国家收入群体对资金来源的进一步分析表明,在低收入和中低收入国家,全部或大部分资金来自国际来源,而在高收入和中高收入国家,国家资金来源,主要是大学,是主要的资金来源。大多数获得资助的文章的第一作者都隶属于学术界/大学,虽然少数人隶属于政府,医疗机构或政府间组织。我们确定了以下与资金来源显著相关的特征:国家收入水平,HPSR文章的焦点(仅在EMR内,或作为国际研究联盟的一部分延伸到EMR之外),和第一作者的从属关系。与COVID-19相关的HPSR文章也观察到了类似的资助模式,国家资金来源(78.95%),主要是大学,构成主要资金来源。相比之下,国际资金来源降至15.8%。
结论:这是第一项在EMR发表的HPSR文章中讨论资金和资金来源报告的研究。大约30%的HPSR文章没有报告资金来源。研究结果表明,严重依赖大学和国际资金来源,而国家政府和区域实体在为EMR中的HPSR文章提供资金方面的作用微乎其微。我们为政策和实践提供了影响,以增强HPSR在该地区的形象。
BACKGROUND: Health policy and systems research (HPSR) can strengthen health systems and improve population health outcomes. In the Eastern Mediterranean Region (EMR), there is limited recognition of the importance of HPSR and funding remains the main challenge. This study seeks to: (1) assess the reporting of funding in HPSR papers published between 2010 and 2022 in the EMR, (2) examine the source of funding in the published HPSR papers in the EMR and (3) explore variables influencing funding sources, including any difference in funding sources for coronavirus disease 2019 (COVID-19)-related articles.
METHODS: We conducted a rapid scoping review of HPSR papers published between 2010 and 2022 (inclusively) in the EMR, addressing the following areas: reporting of funding in HPSR papers, source of funding in the published HPSR papers, authors\' affiliations and country of focus. We followed the Joanna Briggs Institute (JBI) guidelines for conducting scoping reviews. We also conducted univariate and bivariate analyses for all variables at 0.05 significance level.
RESULTS: Of 10,797 articles screened, 3408 were included (of which 9.3% were COVID-19-related). More than half of the included articles originated from three EMR countries: Iran (n = 1018, 29.9%), the Kingdom of Saudi Arabia (n = 595, 17.5%) and Pakistan (n = 360, 10.6%). Approximately 30% of the included articles did not report any details on study funding. Among articles that reported funding (n = 1346, 39.5%), analysis of funding sources across all country income groups revealed that the most prominent source was national (55.4%), followed by international (41.7%) and lastly regional sources (3%). Among the national funding sources, universities accounted for 76.8%, while governments accounted for 14.9%. Further analysis of funding sources by country income group showed that, in low-income and lower-middle-income countries, all or the majority of funding came from international sources, while in high-income and upper-middle-income countries, national funding sources, mainly universities, were the primary sources of funding. The majority of funded articles\' first authors were affiliated with academia/university, while a minority were affiliated with government, healthcare organizations or intergovernmental organizations. We identified the following characteristics to be significantly associated with the funding source: country income level, the focus of HPSR articles (within the EMR only, or extending beyond the EMR as part of international research consortia), and the first author\'s affiliation. Similar funding patterns were observed for COVID-19-related HPSR articles, with national funding sources (78.95%), mainly universities, comprising the main source of funding. In contrast, international funding sources decreased to 15.8%.
CONCLUSIONS: This is the first study to address the reporting of funding and funding sources in published HPSR articles in the EMR. Approximately 30% of HPSR articles did not report on the funding source. Study findings revealed heavy reliance on universities and international funding sources with minimal role of national governments and regional entities in funding HPSR articles in the EMR. We provide implications for policy and practice to enhance the profile of HPSR in the region.