Shifting research priorities in maternal and child health in the COVID-19 pandemic era in India: A renewed focus on systems strengthening

  1. Kayur Mehta
  2. Sanjay Zodpey
  3. Preetika Banerjee
  4. Stephanie L. Pocius
  5. Baldeep K. Dhaliwal
  6. Andrea DeLuca
  7. Sangeeta Das Bhattacharya
  8. Shailendra Hegde
  9. Paramita Sengupta
  10. Madhu Gupta
  11. Anita Shet

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Abstract

The remarkable progress seen in maternal and child health (MCH) in India over the past two decades has been impacted by the COVID-19 pandemic. We aimed to undertake a rapid assessment to identify key priorities for public health research in MCH in India within the context and aftermath of the COVID-19 pandemic.

Methods

A web-based survey was developed to identify top research priorities in MCH. It consisted of 26 questions on six broad domains: vaccine preventable diseases, outbreak preparedness, primary healthcare integration, maternal health, neonatal health, and infectious diseases. Key stakeholders were invited to participate between September and November 2020. Participants assigned importance on a 5-point Likert scale, and assigned overall ranks to each sub-domain research priority. Descriptive statistics were used to examine Likert scale responses, and a ranking analysis was done to obtain an “average ranking score” and identify the top research priority under each domain.

Results

Amongst the 84 respondents from across 15 Indian states, 37% were public-health researchers, 25% healthcare providers, 20% academic faculty and 13% were policy makers. Most respondents considered conducting systems strengthening research as extremely important. The highest ranked research priorities were strengthening the public sector workforce (vaccine preventable diseases), enhancing public-health surveillance networks (outbreak preparedness), nutrition support through community workers (primary care integration), encouraging at least 4–8 antenatal visits (maternal health), neonatal resuscitation to reduce birth asphyxia (neonatal health) and screening and treatment of tuberculosis (infectious diseases). Common themes identified through open-ended questions primarily included systems strengthening priorities across domains.

Conclusions

The overall focus for research priorities in MCH in India during the COVID-19 pandemic is on strengthening existing services and service delivery, rather than novel research. Our results highlight pivotal steps within the roadmap for advancing and sustaining maternal and child health gains during the ongoing COVID-19 pandemic and beyond.

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  1. Version published to 10.1371/journal.pone.0256099
  2. ScreenIT

    SciScore for 10.1101/2021.02.28.21252648: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was reviewed by the JHSPH Institutional Review Board (IRB) and determined to be exempt from human subjects research oversight.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    While there are useful lessons learned from these findings, the study limitations are worth noting. The survey was distributed within a short timeline between September - November 2020, and the results are limited by the small sample size and possible selection bias. Since this was a rapid assessment, we did not use qualitative methods to capture perspectives, and priorities were identified solely based on overall ranking and Likert scales. Further, the survey did not explore priorities for chronic and non-communicable diseases which have also witnessed an escalating burden in India in recent years. Diagnosis and treatment for such diseases have likely been affected by COVID-19 as well and warrant further research. Despite these limitations, our study has been able to perceive a shift in research priorities for MCH towards systems strengthening during this unprecedented pandemic, and can serve as a valuable resource for donors, researchers and other stakeholders engaged in maternal and child health in India. The COVID-19 pandemic and its response has significantly challenged health systems globally. It has exposed glaring loopholes in health systems, and has demonstrated that countries’ response to pandemics is ultimately dependent on the resilience of their health systems (17). Countries such as New Zealand, Sri Lanka, Taiwan and South Korea have been praised for their handling of the COVID-19 crisis; they were able to do so efficiently by investing heavily in their public h...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.02.28.21252648v1 on medRxiv