Strengthening an Ethical Framework and Research Practice to Better Link Global Health Research to Health Equity : A...

An ethical framework titled "Research for Health Justice" has been developed that provides global health researchers with guidance on how to design their research to promote health equity and global justice. This study sought to test the framework's guidance by comparing it to the governance and experiences of the "Severe Pre-eclampsia adverse Outcome Triage" (SPOT)-Impact consortium-a transdisciplinary maternal health research consortium. The aim was to identify ways in which the "Research for Health Justice" framework could learn from the consortium's insights and practices and to identify how the SPOT-Impact consortium could more systematically link its governance and research to health equity. We conducted in-depth interviews with investigators, held a validation/reflection session with the consortium, and read core consortium documents. Our analysis identified areas of alignment, where the consortium's practices strongly aligned with the framework's guidance, and we describe how that alignment was achieved. We also identified areas of non-alignment, where the consortium's governance or practices diverged from the framework's guidance or where interviewees defined ethical concepts such that they differed from those of the framework. Based on our findings, we suggest several directions for the revision and expansion of the framework as well as lessons for the SPOT-Impact consortium regarding inclusive priority-setting, sharing resources, and research capacity strengthening.