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Front. Pediatr. | doi: 10.3389/fped.2018.00038

Commentary: Challenges and Priorities for Pediatric Critical Care Clinician-Researchers in Low-and Middle-Income Countries

Abigail Beane1, Priyantha L. Athapattu2, Arjen M. Dondorp3, 4 and  Rashan Haniffa1*
  • 1Network for Improving Critical Care Systems and Training (NICST), Sri Lanka
  • 2Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka
  • 3Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol university, Thailand
  • 4Centre for Tropical Medicine, Medical Sciences Division, University of Oxford, United Kingdom

Arnim and colleagues note that LMIC clinicians should be empowered to influence local and global research agendas for critically unwell children1. We too can report that LMIC trained clinicians acknowledge the need for systematic gathering of outcome data in improving services and endorse the role that non-LMIC collaborators can play in contributing to training, surveillance and research2. Interestingly, these perceptions were more strongly held when compared to their non-LMIC trained counterparts who have practiced in LMIC settings. These findings perhaps point to untapped opportunities to upskill LMIC clinicians to build equitable research and training partnerships with their non-LMIC counterparts.
Network for Improving Critical Care Systems and Training (NICST) is an LMIC based organisation working collaboratively with clinical teams to build capacity for research, training and continuous audit to improve patient outcomes. The NICST platform, a clinician-led mobile electronic health information initiative between LMIC and HIC collaborators, is an example of a setting-adapted national registry for critically unwell adults, children and neonates in Sri Lanka and beyond. Output from the registry supports a critical care bed availability system that facilitates access to and utilisation of resources, and provides information on post-hospital outcomes4. Mobile applications linked to the platform improve the availability of information essential for the care of individual patients and enable practical training for nurses and doctors5. NICST is currently exploring patient (and parent) reported outcomes and the critical care registry is being implemented in Pakistan.
Partnered with institutions based in high income countries (UK and the Netherlands), NICST is creating opportunities for shared research and training6,7. Creating sustainable partnerships that harness the power of the existing LMIC based network, enables equitable exchange of expertise and fosters greater understanding of setting-specific research priorities. We anticipate that these successful collaborations coupled with rising awareness of the importance of high-quality surveillance systems in LMICs, will help address the challenges currently experienced by LMIC based researchers approaching traditional funding streams. We believe our model provides a template for promoting setting-relevant research which can enable successful south-to-south (and perhaps south-to north) collaborations.

Keywords: low- and middle-income countries, low resource settings, researchers, pediatric critical care, Support of research, Surveys and questionnaires, Intensive Care Unit

Received: 10 Jan 2018; Accepted: 09 Feb 2018.

Edited by:

Srinivas Murthy, University of British Columbia, Canada

Reviewed by:

Amelie Von Saint Andre-von Arnim, Department of Pediatrics, University of Washington, United States
Ericka L. Fink, Children's Hospital of Pittsburgh, School of Medicine, University of Pittsburgh, United States  

Copyright: © 2018 Beane, Athapattu, Dondorp and Haniffa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Rashan Haniffa, Network for Improving Critical Care Systems and Training (NICST), Colombo, Sri Lanka, rashan@nicslk.com