Setting health research priorities using the CHNRI method: I. Involving funders.

Abstract

In 2007 and 2008, the World Health Organization's Department for Child and Adolescent Health and Development (later renamed as WHO MNCAH – Maternal, Newborn, Child and Adolescent Health) commissioned five large exercises to define research priorities related to the five major causes of child deaths for the period up to the year 2015. The exercises were based on the CHNRI (Child Health and Nutrition Research Initiative) method, which was just being introduced at the time [1,2]. The selected causes were childhood pneumonia, diarrhoea, birth asphyxia, neonatal infections and preterm birth/low birth weight [3–7]. The context for those exercises was clearly defined: to identify research that could help reduce mortality in children under 5 years of age in low and middle income countries by the year 2015. The criteria used in all five exercises were the “standard” CHNRI criteria: (i) answerability of the research question; (ii) likelihood of the effectiveness of the resulting intervention; (iii) deliverability (with affordability and sustainability); (iv) potential to reduce disease burden; and (v) effect on equity [3–7]. The five criteria used by the scorers were intuitive as they followed the path from generating new knowledge to having an impact on the cause of death. They were chosen with a view to identifying research questions that were most likely to contribute to finding effective solutions to the problems. However, after the five exercises – all of which were published in respected international journals [3–7] – the WHO officers were left with an additional question: how “fundable” were the identified priorities, ie, how attractive were they to research funders? More specifically, should another criterion be added to the CHNRI exercises, which would evaluate the likelihood of obtaining funding support for specific research questions? To answer these questions, coordinators of the CHNRI exercises at the WHO agreed that it would be useful to invite a number of representatives from large funding organizations interested in child health research to take part in a consultation process at the WHO. The process aimed to explore funders perspectives in prioritization of health research. The funders would be presented with the leading research priorities identified through the CHNRI exercises and asked to discuss any potential variation in their likelihood of being funded. If all the leading priorities were equally attractive to funders and likely to attract funding support, this would indicate that the “standard” CHNRI criteria were sufficient for the process of prioritization. However, if there were large differences in attractiveness of the identified research priorities to funders, then adding another criterion to the exercise – “likelihood of obtaining funding support”, or simply “fundability” – would be a useful addition to the standard CHNRI framework.