Liz Grant

The University of Edinburgh | UoE

Decolonizing Mental Healthcare: An Evaluation of the Clinical Ethics Toolkit

Background Ethiopia has one of the highest maternal mortality ratios in Africa. Few have examined the quality of labour and delivery (L&D) care in the country. This study evaluated the quality of routine L&D care and identified patient-level and hospital-level factors associated with the quality of care in a subset of government hospitals. Materia...

Background Palliative care in low- or middle-income country (LMIC) humanitarian settings is a new area, experiencing a degree of increased momentum over recent years. The review contributes to this growing body of knowledge, in addition to identifying gaps for future research. The overall aim is to systematically explore the evidence on palliative...

Background: Due to their chronicity, prolonged morbidity, and high mortality, chronic respiratory diseases (CRDs) pose a huge burden of disease globally, primarily among low- and middle-income countries. Most of these diseases can be controlled by early diagnosis and treatment, correct practice of medications, regular follow-up, and avoidance of r...

Objectives The COVID-19 pandemic challenged palliative care (PC) services globally. We studied the ways healthcare professionals (HCPs) working in faith-based hospitals (FBHs) experienced and adapted care through the pandemic, and how this impacted patients with PC needs. Methods In-depth interviews were conducted with HCPs from FBHs serving rural...

The climate crisis is a planetary existential threat, disproportionately affecting the poorest populations worldwide. People in low- and middle-income countries (LMICs) experience the most detrimental consequences of climate injustice, endangering their livelihoods, safety, overall wellbeing, and survival. Although the 2022 United Nations Climate C...

The need for palliative care is increasing, especially in low- and middle-income countries (LMICs). Higher education institutions (HEIs) have a role to play in developing a skilled palliative care workforce in LMICs. A workshop was held to discuss this issue, and it was attended by experts from around the world. The workshop highlighted the challen...

Objective To measure and understand mental wellbeing among women prisoners in Chile, as part of a larger study. Result Sixty-eight sentenced prisoners in a women’s prison participated in a survey, giving a response rate of 56.7%. Using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the mean wellbeing score of participants was 53.77 out of...

While scientific research supporting mitigation of further global temperature rise remains a major priority, CoP26 and CoP27 saw increased recognition of the importance of research that informs adaptation to irreversible changes in climate and the increasing threats of extreme weather events. Such work is inevitably and appropriately contextual, bu...

Background Ethiopia has one of the highest maternal mortality ratios in Africa. Few have examined the quality of labour and delivery (L&D) care in the country. This study evaluated the quality of routine L&D care and identified patient-and hospital-level factors associated with the quality of care in a subset of government hospitals.Materials and m...

Background While research has been conducted on the availability, accessibility, and affordability of personal protective equipment for healthcare workers during the COVID-19 pandemic, little information is available on the ways in which health workers, especially those in humanitarian settings see themselves, and engage in self-preparedness for so...

Task shifting (TS) redistributes services from specialised to less-qualified providers. Need for TS was intensified during COVID-19 pandemic. We locate evidences of TS across all health conditions to answer: (A) What role has TS played in services delivery since the onset of the pandemic? (B) How has the pandemic impacted strategies of TS globally?...

Objectives Globally, cancer deaths are rising. In low-and-middle-income countries, there is a gap in access to palliative care (PC). We designed a feasibility trial to study the initiation of early PC in patients with cancer in Addis Ababa, Ethiopia. Methods A randomised controlled trial (RCT) of standard cancer care versus standard cancer care pl...

Background Understanding and improving access to essential services in (post)-conflict settings requires paying particular attention to the actors who occupy the space left ‘empty’ by weak or deficient State institutions. Religious institutions often play a fundamental role among these actors and typically benefit from high trust capital, a rare re...

Most of the new emerging and re-emerging zoonotic virus outbreaks in recent years stem from close interaction with dead or alive infected animals. Since late 2019, the coronavirus disease 2019 (COVID-19) has spread into 221 countries and territories resulting in close to 300 million known infections and 5.4 million deaths in addition to a huge impa...

Purpose To understand challenges faced by faith leaders in the Democratic Republic of Congo (DRC) in engaging with current public health strategies for the COVID-19 pandemic; to explain why long-standing collaborations between government, faith-based health services and leaders of faith communities had little impact; to identify novel approaches to...

Background Worldwide, cancer pain management follows the WHO three step analgesic ladder. Using weak opioids (e.g. codeine) at step two is debatable with low dose strong opioids potentially better, particularly in low and middle-income countries where weak opioids are expensive. We wanted to assess the efficiency, safety and cost of omitting step t...

Background Ethiopia has low skilled birth attendance rates coupled with low quality of care within health facilities contributing to one of the highest maternal mortality rates in Sub-Saharan Africa, at 412 deaths per 100,000 live births. There is lack of evidence on the readiness of health facilities to deliver quality labor and delivery (L&D) car...

Background Health behaviour can change outcomes in both healthy and unhealthy populations and are particularly useful in promoting compliance to treatment and maintaining fidelity to care seeking and follow-up options in chronic diseases. Interventions to change health behaviour based on psychological theory are more often successful than those wit...

Resumen A partir de datos etnográficos de los proyectos SyrianFoodFutures (2019) y From the FIELD (2020), se proporciona evidencia sobre los primeros efectos de la pandemia de COVID‐19 en el trabajo agrícola de refugiadas y refugiados en Iraq, Jordania, el Líbano, Siria y Turquía. En la primavera de 2020, las restricciones de movimientos y las inte...

Background A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping pol...

Résumé Les auteurs utilisent des données ethnographiques issues de deux enquêtes auprès de réfugiés syriens employés dans l'agriculture au Moyen‐Orient (SyrianFoodFutures et From the FIELD) pour décrire les premiers effets de la pandémie sur cette population particulière. Ils montrent que les restrictions de déplacement et la perturbation des chaîn...

Background A One Health approach has been increasingly mainstreamed by the international community, as it provides the holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. The dearth of real-world evidence has hampered application of a One Health approach in shaping policies and...

La investigación intercultural plantea desafíos éticos complejos. Por ello, en el año 2019 se desarrolló un modelo de análisis de conflictos éticos en colaboración con más de 200 investigadores de más de 30 países. Este modelo parece pertinente para América Latina. El modelo propone que los desafíos éticos (y sus soluciones) dependen de cuatro fact...

Background: understanding and improving access to essential services in (post)-conflict settings requires paying particular attention to the actors who occupy the space left ‘empty’ by weak or deficient State institutions. Religious institutions often play a fundamental role among these actors and typically benefit from high trust capital, a rare r...

Background Deaths due to non-communicable diseases are rising worldwide, with low-income and middle- income countries (LMICs) particularly affected. Palliative care can reduce pain and suffering for patients with incurable disease. A gap in access to palliative care and research to support its implementation exists in LMICs, and cancer care is a pa...

Aims/Background Emergency care is being provided to, and utilised by, Ugandan patients despite there being no formal system capable of producing optimal outcomes. For the country’s emergency care system to be appropriate and contextualised, there must first be an understanding of the actual utilisation of emergency care services. Current coding sys...

Introduction Emergency conditions constitute a large proportion of the total global burden of disease and annual global deaths. All 10 leading causes of death in LMICs are conditions which are amenable to emergency care. Much of the research performed in the sub-Saharan African region focuses on single disease processes or particular causations, gi...

Drawing on ethnographic data from the 2019 SyrianFoodFutures and 2020 From the FIELD projects, this article provides insights into the early effects of the COVID-19 pandemic on refugee labour in agriculture in Jordan, Turkey, Lebanon, Iraq, and Syria. In spring 2020, movement restrictions and supply chain disruptions caused displaced Syrian farmwor...

Background Mutually respectful and long-term global partnerships are critical to increasing hospice and palliative care access as a key component of universal health coverage. The importance of sustained, transnational palliative care collaboration has become more urgent since the COVID-19 pandemic. Aim To provide an overview of characteristics fo...

Background Paediatric palliative care services in LMIC countries compete for resources with many other priorities. Their provision is desirable and includes advocacy, training health and community care workers, policy development and mentorship. Objectives The THET J&J start-up grants provided an ideal opportunity to establish a partnership with t...

Background Paediatric palliative care services in LMIC countries compete for resources with many other priorities. Their provision is desirable and includes advocacy, training health and community care workers, policy development and mentorship. Objectives The THET J&J start-up grants provided an ideal opportunity to establish a partnership with t...

Background Ethiopia has low skilled birth attendance rates coupled with low quality of care within health facilities contributing to one of the highest maternal mortality rates in Sub-Saharan Africa, at 412 deaths per 100,000 live births. There is lack of evidence on the readiness of health facilities to deliver quality labour and delivery (L&D) ca...

Healthcare costs are escalating due to public demand for, and the increasing availability of, treatment. National frameworks that use economic evaluation as a basis for health technology assessment have been successful at constraining expenditure on low-value treatments primarily by explicitly considering the opportunity cost of new technology adop...

Background Chronic respiratory diseases (CRDs) are major causes of mortality and morbidity worldwide with a substantial burden of the disease being borne by the low and middle income countries (LMICs). Interventions to change health behaviour which aim to improve the quality of life and reduce disease burden due to CRD require knowledge of the prob...

Background Health behaviour can change outcomes in both healthy and diseased populations and are particularly useful in promoting compliance to treatment and maintain fidelity to care seeking and follow-up options in chronic diseases. Interventions to change health behaviour based on psychological theory more often successful than those without any...

Objectives Faith-based organisations (FBOs) in India provide health services particularly to marginalised communities. We studied their preparedness and delivery of palliative care during COVID-19 as part of a mixed-method study. We present the results of an online questionnaire. Methods All FBOs providing palliative care in India were invited to...

The public role of Christianity in Africa has gained increased attention from scholars. This article gives four snapshots of the responses of churches to COVID-19 in Africa in the early weeks of disease spread on the continent. In many countries, churches are at the forefront of formal and informal health delivery and disease control, through medic...

Background 80% of the 60 million individuals experiencing preventable severe health-related suffering live in Low-and Middle-Income Countries (LMICs) where there are limited resources, and few hospice and palliative care services to alleviate the suffering of patients. In many countries, especially with poorer public facing health services, and cos...

Global challenge-led research seeks to contribute to solution-generation for complex problems. Multicultural, multidisciplinary, and multisectoral teams must be capable of operating in highly demanding contexts. This brings with it a swathe of ethical conflicts that require quick and effective solutions that respect both international conventions a...

COVID-19 is compromising all aspects of society, with devastating impacts on health, political, social, economic and educational spheres. A premium is being placed on scientific research as the source of possible solutions, with a situational imperative to carry out investigations at an accelerated rate. There is a major challenge not to neglect et...

Digital Health Information Systems (HIS) have potential to improve the finances of healthcare organisations in lower income countries through better tracking of patients and procedures, more timely billing, greater professional accountability and more informed decisions. However, little is known about how HIS influence these processes in such setti...

Patient-reported outcomes and economic aspects of Palliative Care (PC) provision in low-income countries (LIC) are under-studied. Demonstrating the economic value of PC is key to sustainability and guiding health care policy. Our preliminary data in Ethiopia demonstrated a widespread need for PC, poor access to it, and high out of pocket payments (...

Background Despite recognition that palliative care is an essential component of any humanitarian response, serious illness-related suffering continues to be pervasive in these settings. There is very limited evidence about the need for palliative care and symptom relief to guide the implementation of programs to alleviate the burden of serious ill...

This project exists to strengthen how we lead, support and enable ethical action in global research. The project promotes a values-driven, solution-focussed and iterative approach to ethics. It seeks to illuminate and address existing and emerging issues in a rapidly changing landscape of expectations about ethical research conduct. In collaboratio...

Introduction The dissemination of research, and evaluation of its impact is an increasing priority for the scientific community and funders. We take the topic of golf and health and aim to outline processes that may contribute to improved research uptake, use and impact proposing a research impact (RI) tool. We then evaluate our published research...

This article describes the key health system strengthening approaches employed by the Malawian government and international agencies working with them, as articulated in the nation' s Health Sector Strategic Plan (HSSP, 2011-2016), and seeks to understand its implementation through examining open-access reports, publications and articles. It also s...

Objectives: To investigate the period prevalence and risk factors for clinically important prescription and monitoring errors among adults managed in community care in Saudi Arabia (SA). Methods: This retrospective cohort study used electronic health record (HER) data. A random sample comprising of 2,000 adults (≥18 years old) visiting Family Medi...

Background Previous research of spectators at professional golf tournaments has highlighted that obtaining exercise/physical activity (PA) can be a motivator to attend, and that spectators can engage in health-enhancing PA while at the event. We assessed whether attending a golf event and receiving an intervention improve knowledge and change attit...

Background: Rates of cervical and oral cancer in India are unacceptably high. Survival from these cancers is poor, largely due to late presentation and a lack of early diagnosis and screening programmes. Mobile Health ('mHealth') shows promise as a means of supporting screening activity, particularly in rural and remote communities where the requi...

Palliative care is recognised as a fundamental component of Universal Health Coverage (UHC), which individual countries, led by the United Nations and the WHO, are committed to achieving worldwide by 2030—Sustainable Development Goal (SDG) 3.8. As the incidence of non-communicable diseases (NCD) in low-income and middle-income countries (LMICs) inc...

Background: Rwanda Ministry of Health in collaboration with partners has initiated an innovative initiative named Home Based Care Practitioners (HBCPs) to respond to the burden of long-term hospitalization for end of life patients. Aim: The program aims at providing home-based care to accompany patients and their families in their home, reduce unne...

Background: Rwanda is among the first African countries with a palliative care (PC) policy and implementation plan. A partnership with the Ministry of Health (MoH) through the Rwanda Biomedical Centre (RBC) and the University of Edinburgh has supported an integrated approach including expanding the evidence base. Aim: To assessing the need for (PC)...

Introduction Of the 40 million people globally in need of palliative care (PC), just 14% receive it, predominantly in high-income countries. Within fragile health systems that lack PC, incurable illness is often marked by pain and suffering, as well as burdensome costs. In high-income settings, PC decreases healthcare utilisation, thus enhancing va...

Scientific and public interest relating to golf and health has increased recently. Players, potential players, the golf industry and facilities, and decision makers will benefit from a better understanding of how to realise potential health benefits and minimise health issues related to golf. We outline an International Consensus on Golf and Health...

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres,...

To date, most empirical research on religion/spirituality and health, like most other health research, has been conducted in the United States or other western countries. Earlier sections of this volume have explicated the public health releva nce of religion and spirituality with a corresponding western emphasis. But religion and spirituality are...

Introduction Makerere and Mulago Palliative Care Unit (MPCU) provides quality, evidence-based palliative care (PC) for patients and families through a centre of excellence delivering: an integrated clinical service within the national referral hospitals site; carrying out research, training and capacity-building in collaboration with partners; and...

Background Access to palliative care (PC) in Uganda has been hampered by the lack of prescribers. Thus PC care trained nurses have been able to prescribe since 2004, however, no full scale evaluation had been undertaken, despite the fact that PC stakeholders are advocating for nurse prescribing in other countries. Thus an evaluation was undertaken...

Background Heart failure is an emerging challenge for Sub Saharan Africa. However, research on patients’ needs and experiences of care is scarce with little evidence available to support and develop services. We aimed to explore the experiences of patients living and dying with heart failure in Kenya. Methods We purposively recruited 18 patients ad...

Background Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients’ understanding of their illness and their beliefs influence their health related...

Timing of face-to-face and telephone interviews and patient deaths. (ODT)

In 2011, Rwanda's Ministry of Health set a goal of universal access to palliative care by 2020. Toward this audacious egalitarian and humanitarian goal, the Ministry of Health worked with partners to develop palliative care policies and a strategic plan, secure adequate supplies of opioid for the country, initiate palliative care training programs,...

Background Spectators at several hundred golf tournaments on six continents worldwide may gain health-enhancing physical activity (HEPA) during their time at the event. This study aims to investigate spectators’ reasons for attending and assess spectator physical activity (PA) (measured by step count). Methods Spectators at the Paul Lawrie Matchpl...

Background The WHO is calling for the integration of palliative care in all health care settings globally. Methods A 3.5–year program was implemented in 12 government hospitals, three each in Kenya, Rwanda, Uganda and Zambia. A four–pillared approach of advocacy, staff training, service delivery strengthening and international and regional partner...