02595nas a2200265   4500000000100000008004100001260004400042653005700086653001800143653001800161653001100179653001600190653001700206653001900223653003000242100001100272700001300283700001400296245011400310856008700424300000900511490000700520520178800527022001402315       2024                            d  bSpringer Science and Business Media LLC10aPublic Health, Environmental and Occupational Health10aHealth Policy10aGlobal health10aRacism10aColonialism10aDecolonizing10aSocial Justice10aInternational development1 aLebu S1 aMusoka L1 aGraham JP00aReflective questioning to guide socially just global health reform: a narrative review and expert elicitation  uhttps://equityhealthj.biomedcentral.com/counter/pdf/10.1186/s12939-023-02083-2.pdf  a1-140 v233 a<p>Recent research has highlighted the impacts of colonialism and racism in global health, yet few studies have presented concrete steps toward addressing the problems. We conducted a narrative review to identify published evidence that documented guiding frameworks for enhancing equity and inclusion in global health research and practice (GHRP). Based on this narrative review, we developed a questionnaire with a series of reflection questions related on commonly reported challenges related to diversity, inclusion, equity, and power imbalances. To reach consensus on a set of priority questions relevant to each theme, the questionnaire was sent to a sample of 18 global health experts virtually and two rounds of iterations were conducted. Results identified eight thematic areas and 19 reflective questions that can assist global health researchers and practitioners striving to implement socially just global health reforms. Key elements identified for improving GHRP include: (1) aiming to understand the historical context and power dynamics within the areas touched by the program; (2) promoting and mobilizing local stakeholders and leadership and ensuring measures for their participation in decision-making; (3) ensuring that knowledge products are co-produced and more equitably accessible; (4) establishing a more holistic feedback and accountability system to understand needed reforms based on local perspectives; and (5) applying systems thinking to addressing challenges and encouraging approaches that can be sustained long-term. GHRP professionals should reflect more deeply on how their goals align with those of their in-country collaborators. The consistent application of reflective processes has the potential to shift GHRP towards increased equity.</p>
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