Networking among young global health researchers through an intensive training approach: a mixed methods exploratory study.

BACKGROUND: Networks are increasingly regarded as essential in health research aimed at influencing practice and policies. Less research has focused on the role networking can play in researchers' careers and its broader impacts on capacity strengthening in health research. We used the Canadian Coalition for Global Health Research (CCGHR) annual Summer Institute for New Global Health Researchers (SIs) as an opportunity to explore networking among new global health researchers. METHODS: A mixed-methods exploratory study was conducted among SI alumni and facilitators who had participated in at least one SI between 2004 and 2010. Alumni and facilitators completed an online short questionnaire, and a subset participated in an in-depth interview. Thematic analysis of the qualitative data was triangulated with quantitative results and CCGHR reports on SIs. Synthesis occurred through the development of a process model relevant to networking through the SIs. RESULTS: Through networking at the SIs, participants experienced decreased isolation and strengthened working relationships. Participants accessed new knowledge, opportunities, and resources through networking during the SI. Post-SI, participants reported ongoing contact and collaboration, although most participants desired more opportunities for interaction. They made suggestions for structural supports to networking among new global health researchers. CONCLUSIONS: Networking at the SI contributed positively to opportunities for individuals, and contributed to the formation of a network of global health researchers. Intentional inclusion of networking in health research capacity strengthening initiatives, with supportive resources and infrastructure could create dynamic, sustainable networks accessible to global health researchers around the world.

Systematic review of strategies to increase use of oral rehydration solution at the household level.

BACKGROUND: Diarrhea is one of the major causes of death in children under five years of age, disproportionately affecting children in low- and middle-income countries. Treatment of diarrhea with oral rehydration solution addresses dehydration and reduces diarrhea related deaths. The World Health Organization Programme for the Control of Diarrhoeal Disease began in 1978 and while global ORS access rates have improved substantially over the past forty years, rates of ORS use have stagnated. Investigation is required to understand which interventions are effective in promoting the use of ORS, and where there are gaps in the literature. METHODS: We conducted a systematic search of peer-reviewed and grey literature and included interventions to promote the use of ORS for the treatment of acute diarrhea in children under 6 years. We used a standardized grading format based on the Child Health Epidemiology Research Group guidelines and performed meta-analysis for all categories with more than one data point. RESULTS: We identified 19 studies for abstraction. For co-promotion of zinc and ORS, mothers in the intervention group were 1.82 (95% CI 1.17, 2.85) times more likely to use ORS to treat their child's diarrhea episode than mothers in the comparison group. Meta-analysis of ORS social marketing and mass media strategies indicates that mothers exposed to messages were 2.05 (95% CI, 0.78, 5.42) times more likely to use ORS to treat their child's diarrhea episode than unexposed mothers. However, this is not statistically significant. Both meta-analysis had significant heterogeneity and were graded as moderate/low and low quality, respectively. CONCLUSIONS: We found few studies of interventions to promote the use of ORS; many categories of interventions had only one study. While there are some promising results, this analysis reinforces the need for further investigation into approaches to increasing ORS use.

Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process.

BACKGROUND: Globally, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) affect approximately 52 million children under five. This systematic review evaluates the effectiveness of interventions for SAM including the World Health Organization (WHO) protocol for inpatient management and community-based management with ready-to-use-therapeutic food (RUTF), as well as interventions for MAM in children under five years in low- and middle-income countries. METHODS: We systematically searched the literature and included 14 studies in the meta-analysis. Study quality was assessed using CHERG adaptation of GRADE criteria. A Delphi process was undertaken to complement the systematic review in estimating case fatality and recovery rates that were necessary for modelling in the Lives Saved Tool (LiST). RESULTS: Case fatality rates for inpatient treatment of SAM using the WHO protocol ranged from 3.4% to 35%. For community-based treatment of SAM, children given RUTF were 51% more likely to achieve nutritional recovery than the standard care group. For the treatment of MAM, children in the RUSF group were significantly more likely to recover and less likely to be non-responders than in the CSB group. In both meta-analyses, weight gain in the intervention group was higher, and although statistically significant, these differences were small. Overall limitations in our analysis include considerable heterogeneity in many outcomes and an inability to evaluate intervention effects separate from commodity effect. The Delphi process indicated that adherence to standardized protocols for the treatment of SAM and MAM should have a marked positive impact on mortality and recovery rates; yet, true consensus was not achieved. CONCLUSIONS: Gaps in our ability to estimate effectiveness of overall treatment approaches for SAM and MAM persist. In addition to further impact studies conducted in a wider range of settings, more high quality program evaluations need to be conducted and the results disseminated.