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MRC/DFID/NIHR Call for research to improve adolescent health in LMIC settings

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In 2016 the Medical Research Council (MRC), in partnership with the Department for International Development (DFID), successfully ran a pilot programme focusing on implementation research for improved adolescent health in lower and middle income countries. Five awards were made through this programme all of which have now started. Following the success of the pilot phase the joint funders, now joined by the Department of Health, National Institute for Health Research (NIHR), have launched the next phase of the activity.

Adolescence is a crucial time of life in which access to effective health care and preventive interventions can have a major impact on the health of individuals and their future families. The joint funders invite researchers to apply for funding to address questions of effectiveness and access to health interventions that will result in improved adolescent health in low and middle income countries (LMIC’s). Together the three funders have agreed to commit up to £10 million to this scheme.

Outline Proposals must be submitted via the JeS System.

Please note: applications will be accepted from Principal Investigators based at organisations either in the UK or in Low, Lower-middle and Upper-middle income countries as highlighted on the OECD list.

Aim

This call for proposals seeks to provide the research evidence needed to effect real and practical changes to improve adolescent health in Low and Middle Income Countries.

Proposals should identify clearly the health issues and/or risk factors to be addressed. Applicants should describe the pathway for how the proposed approach can be scalable, as well as highlighting any potential generalizability of findings to improve the health of adolescents in other settings. Proposals should demonstrate how outcomes could be implemented within systems and seek to engage with related social and economic barriers within these systems. We encourage genuine interdisciplinary collaborations across social science, biomedical science and other disciplines.

Earlier phase research relevant to adolescent health, for instance basic, aetiological, and epidemiological research is not eligible for this call for proposals but is welcome for submission to the MRC through our standard Research Boards and Panels.

Background

Adolescence is a unique time in the life-course. There are many opportunities to better tailor existing health improvement strategies to ensure they serve the needs of specific adolescent groups. By improving health at this crucial stage, there is potential to have an effect on adolescents’ future health and that of their future children. For example, a major emerging theme for improving maternal, neonatal and child health is to improve health at the pre-conception phase. By intervening at adolescence, there is potential to improve girls’ health, have a preventative impact for their future health, and to improve maternal and neonatal outcomes.

The aim to improve maternal and child health is an important part of the programme but is not the sole focus. The need to consider a broad range of health issues at this life-stage is increasingly recognised globally. For instance the 2014 the WHO report ‘Health for the world’s adolescents’ highlights some of the key challenges facing the worlds growing adolescent community:

  • The adolescent mortality rate is nine times higher in Africa than the rate in high income countries. Globally the top five causes of mortality in adolescence are: road injuries, HIV/AIDS, self-harm, lower respiratory infections and interpersonal violence.
  • Depression, road injuries, iron-deficiency anaemia, HIV/AIDS and intentional self-harm were the top five global causes of DALYs for adolescents.
  • There are gender and regional differences. For instance, in girls aged 15 to 19 complications in pregnancy are the second highest cause of mortality globally, and the leading cause in this age-group in the Eastern Mediterranean. The highest cause of death of girls in this age group is self-harm and the highest cause of death in boys in this age-group is road injury
  • DALYs do not reflect the start of health-related behaviours that affect future health such as use of tobacco, alcohol, poor diet and lack of exercise.

 

The remit of this programme is therefore broad and funders welcome proposals which address any major health issues that emerge at the adolescent phase of life. 

Target Population

The regional focus for this call is low and middle income countries as defined in the DAC list of ODA recipients. The research proposed should be designed to meet the most vulnerable groups within ODA recipient countries.

For this programme, adolescence is defined as between the ages of 10-19, although for some instances, it may be appropriate to consider issues for a wider age group. For instance, it may be necessary to address continuity of care before and after adolescence, or part of the research question might be to consider whether targeted approaches for adolescents are needed for a particular health issue.

Proposals should consider the impact of gender on the adolescent health trajectory. Although some individual proposals may have a reason to focus on one gender our intention is to have a mixed portfolio of projects across the programme. If proposals focus on one gender, the reason for this should be justified in the proposal.

Please justify clearly in your proposal why you have chosen the selected populations and how the project will provide evidence for improvement of adolescent health.

Scope

We will accept proposals from Principal Investigators based in UK research organisations and Lower and Middle Income Country (LMIC) research organisations. If the Principal Investigator (PI) is based in the UK, there must be clear partnership with, and scientific leadership from, co-investigators (Co-Is) based in the LMIC countries where the project will take place.

Areas of particular research interest include:

  • Life course approaches to mental health including issues such as substance misuse, violence prevention and suicide
  • Life course approaches to NCD risk factors including tobacco, alcohol and diet/nutrition
  • Addressing maternal, neonatal and child health challenges by improving health at the preconception phase including early pregnancy and parenthood, accessing contraception, and safe abortion
  • Injuries (for example road traffic accidents), violence and disability
  • Migrant populations/Adolescents affected by war
  • Sexual and reproductive health including prevention and management of HIV and other sexually transmitted infections
  • Other communicable diseases in adolescent populations

 

Applicants are strongly encouraged to explore opportunities to consider:

  • Interventions with a preventative focus
  • Inter-sectoral applications e.g. education and health
  • Inter-disciplinary collaborations across social science, biomedical science, and other disciplines including health economics and political sciences
  • The social determinants of health and how these affect health as well as access and uptake of healthcare by Adolescent populations
  • Using a range of quantitative and qualitative methods
  • Inclusion of innovative technologies and devices
  • Engaging adolescents and policy stakeholders in the development of research questions and plans

Eligible research activities

The research approach taken should be clearly justified in the proposal indicating why it is the most appropriate and robust methodology to address the proposed research questions. The following research activities are eligible for submission this scheme:

  • Developing complex health interventions that explicitly address health needs of adolescent populations
  • Using randomized controlled trial or other methodologies to assess the effectiveness of interventions specifically for adolescents, including adaptation of interventions of known effectiveness in other populations
  • Implementation research questions that address issues faced in making interventions of known effectiveness accessible to adolescent populations within the health system
  • Research that explores health system barriers to effective healthcare for adolescents, including user and provider perspectives, social and economic barriers, as well as policy and governance challenges

 

All funders are committed to supporting capacity building in research. Capacity-building elements should be set out in relation to the core intellectual agenda of the research proposal and not treated separately; the focus should be on the quality and impact of the research, and how increasing research capacity contributes to this. Proposals should demonstrate how capacity building for junior UK and developing county staff will lead to developing future scientific leadership. 

Timeline

Applications will be accepted through the research council’s Joint Electronic Submission System (Je-S). The timeline for applications will be as follows:

  1. Outline Grant application deadline: 16:00 BST 15 June 2017
  2. Panel meeting of academic experts July 2017
  3. Successful applications will be notified and given Panel feedback in July 2017 to be incorporated into full applications with a deadline for September
  4. Applications will be sent out for external peer review and the applicants will be given the opportunity to respond to those comments before a final Panel meeting in early December 2017
  5. Decisions to be relayed in mid-December 2017 and successful projects will be required to start in April 2018.

 

Please note that submission of the same proposal to more than one MRC scheme will not be permitted

How to apply

Proposals must be submitted to Je-S by the call deadline: 4pm BST Thursday 15th June 2017.

For further information on how to apply to this call for proposals please consult the scheme specific outline application guidance document and the MRC Guidance for applicants.

Proposals can only be accepted by electronic submission through the Je-S system.

If you have any technical issues with the Je-S system please contact Je-S help desk at JeSHelp@rcuk.ac.uk

Guidance on this system can be found in the Je-S Handbook.

Applicants are welcome to contact MRC Head Office for further information:

Contact details:

Aaron Holliday, MRC Strategy Support Officer,

aaron.holliday@headoffice.mrc.ac.uk +44 (0) 207 395 2370