Request for Proposals - Research into the IMCI community component
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Child Health and Nutrition Research
Global Forum for Health Research
Health research is essential to improve the design of health inter-
ventions, policies and service delivery. Every year more than US$ 70
billion is spent on health research and development by the public and
private sectors. An estimated 10% of this is used for research into
90% of the world's health problems. This is what is called 'the 10/90
gap'.
The Global Forum for Health Research is an independent international
foundation established in 1998 in Geneva, Switzerland. Its central
objective is to help correct the 10/90 gap by focusing research ef-
forts on diseases, determinants and risk factors representing the
heaviest burden on the world's health and by facilitating collabora-
tion between partners in both the public and private sectors.
The Global Forum is supported financially by the Rockefeller Founda-
tion, World Bank, World Health Organization and the governments of
Canada, the Netherlands, Norway, Sweden and Switzerland.
The Global Forum supports networks in health research bringing to-
gether a wide range of partners in a concerted effort to find solu-
tions to priority health problems. One such network is the Child
Health and Nutrition Research Initiative.
Background
The Child Health and Nutrition Research Initiative (CHNRI), supported
by the Global Forum for Health Research, was established to stimulate
and support the expansion of research on priority child health and
nutrition issues on a global basis, especially in the developing
world.
One important area of research identified in collaboration with the
Child and Adolescent Health and Development Department of the World
Health Organization (WHO) concerns household and community Integrated
Management of Childhood Illnesses (IMCI). WHO and UNICEF developed
IMCI in an attempt to more effectively reduce the nearly 11 million
deaths of children aged less than 5 years, which occur each year. The
success of IMCI in reducing childhood mortality depends on improve-
ments at the health facility level, so that health workers have the
necessary skills and drugs to manage illness adequately and can refer
those who require more complex care. It also depends on family and
community practices, such as seeking health care, taking children for
immunizations, exclusively breastfeeding in the first six months of
life. IMCI is now implemented in over 79 countries. In these coun-
tries IMCI is expanding in both health facilities and communities.
Research can be instrumental in identifying effective approaches for
expansion.
Promotion of practices critical for child health, nutrition and de-
velopment is a cornerstone of the IMCI programmes both at the health
facility and in the community. Among all the research questions that
have been identified on this topic, one is of particular importance
to global efforts: "Given the challenge, how to scale up the success
of these interventions?"
The methods of behaviour change communication and social marketing
have been successful in promoting single behavioural objectives (e.g.
ORT use) or clusters of closely related behavioural objectives (e.g.
family planning in specific population groups). Intervention research
needs to examine how to scale up and sustain behaviour change inter-
ventions at the district, state or national level.
The prevalence of exclusive breastfeeding, a major component of IMCI,
rarely exceeds 30% in most regions of the developing world. Reasons
for failure to breastfeed exclusively for the recommended first six
months of life include health systems practices and community beliefs
that delay the initiation of breastfeeding and allow the use of pre-
lacteal feeds, concern for milk quality or quantity, and the lack of
social support for women in resolving difficulties with breastfeed-
ing. Recent studies, however, have shown that it is possible to in-
crease exclusive breastfeeding rates significantly with peer counsel-
ling in the community.
Objectives of this Request for Proposal
The present announcement calls for proposals submitted by teams to
develop and conduct interventions to scale up promotion of exclusive
breastfeeding to six months through IMCI (facility-based counselling
and peer counsellors) to district or national level.
Applicants
Institutions and research groups from Africa, Asia and Latin America
are eligible to apply for this grant. Developing country institutions
and researchers may apply alone or in collaboration with institutions
in the developed world.
Schedule of Work
The deadline for the proposals is 15 March 2002. Review and selection
of groups will take six to eight weeks and results will be announced
by May 2002.
Review Criteria
Proposals will be reviewed by a selection committee comprising repre-
sentatives of the Global Forum, WHO and external technical experts
from the developing world.
1. Demonstrated knowledge of the field.
2. Demonstrated understanding of the scope and intent of the research
topic.
3. Experience (individual or group applicant) in the conduct of
intervention research.
4. Existence or ability to establish a multidisciplinary group with
complimentary skills necessary for research on such subjects.
5. Thoughtful and complete plan for the execution of the required
research and design of a reasonable and practical process to com-
plete that research on a timely basis.
6. Ability to meet deadlines and organize a complex effort.
7. Access to necessary tools and support services.
8. Demonstrated support from associated institutions.
In the proposal it will be important to include a detailed descrip-
tion of how the intervention will be operationalized on a larger
scale. For example, will it be operationalized through the government
health system or through non-governmental organizations (NGOs)? How
will the NGOs be selected, and how will they be approached?
A detailed plan for the delivery of the intervention, including the
specific channels to be used, will be developed.
Finally, it will be very important to define clearly how the inter-
vention will be monitored.
Application Process
Applicants are requested to send in a proposal of no more than 10
pages including an executive summary (excluding appendices which
should also not exceed 10 additional pages) covering the following
sections:
1. Letter of intent (detailing mailing and e-mail address)
2. Executive summary
3. Background
4. Purpose/goal of the project
5. Specific objectives
6. Methods/strategies to be used
7. Expected results
8. Time-lines (we expect this study to last a total of one year)
9. Estimated budget
10.Resume of the principal investigator and core investigators.
Investigators, whose proposals have been selected, will be invited to
develop a full research project.
Proposals should be received by 15 March 2002 at the
Global Forum for Health Research
(attention Andrea Moreira)
c/o WHO
20 Avenue Appia
1211 Geneva 27, Switzerland
Tel: +41-22-791-4497
Fax: +41-22-791-4394
mailto:moreiraa@who.int
Please note: institutions and research organizations are cautioned
that there will be no extension on the above-stated time-frames. Ap-
plicants should carefully consider their capacity to deliver the
products on time.
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