{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T15:03:56Z","timestamp":1779807836613,"version":"3.53.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["NWA.1160.18.159"],"award-info":[{"award-number":["NWA.1160.18.159"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001722","name":"Koninklijke Nederlandse Akademie van Wetenschappen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001722","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian Catholic University Limited"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bioethical Inquiry"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>An ethical framework titled \u201cResearch for Health Justice\u201d 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\u2019s guidance by comparing it to the governance and experiences of the \u201cSevere Pre-eclampsia adverse Outcome Triage\u201d (SPOT)-Impact consortium\u2014a transdisciplinary maternal health research consortium. The aim was to identify ways in which the \u201cResearch for Health Justice\u201d framework could learn from the consortium\u2019s 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\u2019s practices strongly aligned with the framework\u2019s guidance, and we describe how that alignment was achieved. We also identified areas of non-alignment, where the consortium\u2019s governance or practices diverged from the framework\u2019s 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.<\/jats:p>","DOI":"10.1007\/s11673-025-10523-7","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:25:02Z","timestamp":1779805502000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Strengthening an Ethical Framework and Research Practice to Better Link Global Health Research to Health Equity"],"prefix":"10.1007","author":[{"given":"Maria","family":"van der Harst","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rieke","family":"van der Graaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Pratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"issue":"4","key":"10523_CR1","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1111\/dewb.12157","volume":"18","author":"D Aarons","year":"2018","unstructured":"Aarons, D. 2018. Research in epidemic and emergency situations: A model for collaboration and expediting ethics review in two Caribbean countries. Developing World Bioethics 18(4): 375\u2013384.","journal-title":"Developing World Bioethics"},{"issue":"4","key":"10523_CR2","doi-asserted-by":"publisher","first-page":"e1003604","DOI":"10.1371\/journal.pmed.1003604","volume":"18","author":"S Abimbola","year":"2021","unstructured":"Abimbola, S., S. Asthana, C. Montenegro, et al. 2021. Addressing power asymmetries in global health: Imperatives in the wake of the COVID\u201019 pandemic. PLoS Medicine 18(4): e1003604.","journal-title":"PLoS Medicine"},{"issue":"1","key":"10523_CR3","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s12978-023-01593-0","volume":"20","author":"K Adu-Bonsaffoh","year":"2023","unstructured":"Adu-Bonsaffoh, K., E. Tamma, A. Nwameme, et al. 2023. Provision and experience of care among women with hypertension in pregnancy: a multi-center qualitative study in Ghana. Reproductive Health 20(1): 49.","journal-title":"Reproductive Health"},{"issue":"6","key":"10523_CR4","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1080\/15265161.2010.482629","volume":"10","author":"AJ Ballantyne","year":"2010","unstructured":"Ballantyne, A.J. 2010. How to do research fairly in an unjust world. American Journal of Bioethics 10(6): 26\u201335.","journal-title":"American Journal of Bioethics"},{"issue":"7454","key":"10523_CR5","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1136\/bmj.328.7454.1494","volume":"328","author":"L Belsky","year":"2004","unstructured":"Belsky, L., and H.S. Richardson. 2004. Medical researchers' ancillary clinical care responsibilities. BMJ 328(7454): 1494\u20131496.","journal-title":"BMJ"},{"issue":"7264","key":"10523_CR6","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1136\/bmj.321.7264.824","volume":"321","author":"SR Benatar","year":"2000","unstructured":"Benatar, S.R., and P.A. Singer. 2000. A new look at international research ethics. BMJ 321(7264): 824\u2013826.","journal-title":"BMJ"},{"issue":"4","key":"10523_CR7","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1136\/jme.2009.032672","volume":"36","author":"SR Benatar","year":"2010","unstructured":"Benatar, S.R., and P.A. Singer. 2010. Responsibilities in international research: A new look revisited. Journal of Medical Ethics 36(4): 194\u2013197.","journal-title":"Journal of Medical Ethics"},{"issue":"10","key":"10523_CR8","doi-asserted-by":"publisher","first-page":"E1465","DOI":"10.1016\/S2214-109X(21)00301-6","volume":"9","author":"H Bhakuni","year":"2021","unstructured":"Bhakuni, H., and S. Abimbola. 2021. Epistemic injustice in academic global health. The Lancet Global Health 9(10): E1465\u2013E1470.","journal-title":"The Lancet Global Health"},{"issue":"1","key":"10523_CR9","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s12910-023-00888-y","volume":"24","author":"T Burgess","year":"2023","unstructured":"Burgess, T., S. Rennie, and K. Moodley. 2023. Key ethical issues encountered during COVID-19 research: a thematic analysis of perspectives from South African research ethics committees. BMC Medical Ethics 24(1): 11.","journal-title":"BMC Medical Ethics"},{"issue":"1","key":"10523_CR10","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s12910-015-0010-3","volume":"16","author":"R Davies","year":"2015","unstructured":"Davies, R., J. Ives, and M. Dunn. 2015. A systematic review of empirical bioethics methodologies. BMC Medical Ethics 16(1): 15.","journal-title":"BMC Medical Ethics"},{"issue":"9","key":"10523_CR11","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1111\/j.1467-8519.2009.01721.x","volume":"24","author":"M De Vries","year":"2010","unstructured":"De Vries, M., and E. Van Leeuwen. 2010. Reflective equilibrium and empirical data: third person moral experiences in empirical medical ethics. Bioethics 24(9): 490\u2013498.","journal-title":"Bioethics"},{"issue":"1","key":"10523_CR12","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","volume":"62","author":"S Elo","year":"2008","unstructured":"Elo, S., and H. Kyng\u00e4s. 2008. The qualitative content analysis process. Journal of Advanced Nursing 62(1): 107\u2013115.","journal-title":"Journal of Advanced Nursing"},{"key":"10523_CR13","first-page":"181","volume-title":"Global justice and bioethics","author":"EJ Emanuel","year":"2012","unstructured":"Emanuel, E.J. 2012. Global justice and the \u201cstandard of care\u201d debates. In Global justice and bioethics, edited by J. Millum and E.J. Emanuel, 181\u2013212. New York: Oxford University Press."},{"issue":"3","key":"10523_CR14","doi-asserted-by":"publisher","first-page":"17","DOI":"10.2307\/3528416","volume":"34","author":"M El Setouhy","year":"2004","unstructured":"El Setouhy, M., T. Agbenyega, F. Anto, et al. 2004. Moral standards for research in developing countries: From \u201creasonable availability\u201d to \u201cfair benefits\u201d. The Hastings Center Report 34(3): 17\u201327.","journal-title":"The Hastings Center Report"},{"issue":"9","key":"10523_CR15","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","volume":"15","author":"H Hsieh","year":"2005","unstructured":"Hsieh, H., and S.E. Shannon. 2005. Three approaches to qualitative content analysis. Qualitative Health Research 15(9): 1277\u20131288.","journal-title":"Qualitative Health Research"},{"issue":"2","key":"10523_CR16","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/ACM.0b013e318160b0a7","volume":"83","author":"JP Koplan","year":"2008","unstructured":"Koplan, J.P., and R.L. Baggett. 2008. The Emory Global Health Institute: Developing partnerships to improve health through research, training, and service. Academic Medicine 83(2): 128\u2013133.","journal-title":"Academic Medicine"},{"issue":"4","key":"10523_CR17","doi-asserted-by":"publisher","first-page":"e008950","DOI":"10.1136\/bmjgh-2022-008950","volume":"7","author":"ES Koum Besson","year":"2022","unstructured":"Koum Besson, E.S. 2022. How to identify epistemic injustice in global health research funding practices: A decolonial guide. BMJ Global Health 7(4): e008950.","journal-title":"BMJ Global Health"},{"issue":"1","key":"10523_CR18","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1186\/1471-2458-10-384","volume":"10","author":"JV Lavery","year":"2010","unstructured":"Lavery, J.V., S.V.S. Bandewar, J. Kimani, R.E.G. Upshur, F.A. Plummer, and P.A. Singer. 2010. \u2018Relief of oppression\u2019: An organizing principle for researchers\u2019 obligations to participants in observational studies in the developing world. BMC Public Health 10(1): 384.","journal-title":"BMC Public Health"},{"key":"10523_CR19","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780197534830.001.0001","volume-title":"For the common good: Philosophical foundations of research ethics","author":"AJ London","year":"2022","unstructured":"London, A.J. 2022. For the common good: Philosophical foundations of research ethics. New York: Oxford University Press."},{"issue":"2","key":"10523_CR20","doi-asserted-by":"publisher","first-page":"211","DOI":"10.2105\/AJPH.2009.168393","volume":"100","author":"MW Merritt","year":"2010","unstructured":"Merritt, M.W., H.A. Taylor, and L.C. Mullany. 2010. Ancillary care in community\u2010based public health intervention research. American Journal of Public Health 100(2): 211\u2013216.","journal-title":"American Journal of Public Health"},{"key":"10523_CR21","unstructured":"Nuffield Council on Bioethics. 2020. Research in global health emergencies: Ethical issues. London: Nuffield Council on Bioethics. https:\/\/cdn.nuffieldbioethics.org\/wp-content\/uploads\/Research-in-global-health-emergencies-NCOB-report-FINAL.pdf."},{"key":"10523_CR22","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511841286","volume-title":"Women and human development: The capabilities approach","author":"MC Nussbaum","year":"2000","unstructured":"Nussbaum, M.C. 2000. Women and human development: The capabilities approach. New York: Cambridge University Press."},{"issue":"10","key":"10523_CR23","doi-asserted-by":"publisher","first-page":"e0163579","DOI":"10.1371\/journal.pone.0163579","volume":"11","author":"M Parker","year":"2016","unstructured":"Parker, M., and P. Kingori. 2016. Good and bad research collaborations: Researchers' views on science and ethics in global health research. PLoS ONE 11(10): e0163579.","journal-title":"PLoS ONE"},{"issue":"October","key":"10523_CR24","doi-asserted-by":"publisher","first-page":"112530","DOI":"10.1016\/j.socscimed.2019.112530","volume":"239","author":"KM Plamondon","year":"2019","unstructured":"Plamondon, K.M., and E. Bisung. 2019. The CCGHR Principles for Global Health Research: Centering equity in research, knowledge translation, and practice. Social Science & Medicine 239(October): 112530.","journal-title":"Social Science & Medicine"},{"issue":"2","key":"10523_CR25","doi-asserted-by":"publisher","first-page":"e002921","DOI":"10.1136\/bmjgh-2020-002921","volume":"6","author":"B Pratt","year":"2021","unstructured":"Pratt, B. 2021. Research for health justice: An ethical framework linking global health research to health equity. BMJ Global Health 6(2): e002921.","journal-title":"BMJ Global Health"},{"issue":"1","key":"10523_CR26","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/jlme.12202","volume":"43","author":"B Pratt","year":"2015","unstructured":"Pratt, B., and A.A. Hyder. 2015. Global justice and health systems research in low and middle-income countries, Journal of Law, Medicine & Ethics 43(1): 143\u2013161.","journal-title":"Journal of Law, Medicine & Ethics"},{"issue":"10","key":"10523_CR27","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1080\/15265161.2016.1214304","volume":"16","author":"B Pratt","year":"2016","unstructured":"\u2014\u2014\u2014. 2016. Governance of transnational global health research consortia and health equity. American Journal of Bioethics 16(10): 29\u201345.","journal-title":"American Journal of Bioethics"},{"issue":"1","key":"10523_CR28","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1177\/1556264617741022","volume":"13","author":"B Pratt","year":"2017","unstructured":"\u2014\u2014\u2014. 2017. Linking participatory action research on health systems to justice in global health: A case study of the maternal and neonatal implementation for equitable health systems project in rural Uganda. Journal of Empirical Research on Human Research Ethics 13(1):74\u201387.","journal-title":"Journal of Empirical Research on Human Research Ethics"},{"issue":"1","key":"10523_CR29","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1080\/17441692.2018.1471148","volume":"14","author":"B Pratt","year":"2018","unstructured":"\u2014\u2014\u2014. 2018. Ethical responsibilities of research funders to advance global health justice. Global Public Health 14(1): 80\u201390.","journal-title":"Global Public Health"},{"issue":"8","key":"10523_CR30","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1111\/bioe.12009","volume":"28","author":"B Pratt","year":"2014","unstructured":"Pratt, B., and B. Loff. 2014. A framework to link international clinical research to the promotion of justice in global health. Bioethics 28(8): 387\u201396.","journal-title":"Bioethics"},{"issue":"7","key":"10523_CR31","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/bioe.12465","volume":"32","author":"B Pratt","year":"2018","unstructured":"Pratt, B., and de Vries, J. 2018. Community engagement in global health research that advances health equity. Bioethics 32(7): 454\u2013463.","journal-title":"Bioethics"},{"issue":"7","key":"10523_CR32","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1093\/heapol\/czac012","volume":"37","author":"B Pratt","year":"2022","unstructured":"Pratt, B., P.N. Srinivas, and T. Seshadri. 2022. How is inclusiveness in health systems research priority-setting affected when community organizations lead the process?. Health Policy and Planning 37(7): 811\u2013821.","journal-title":"Health Policy and Planning"},{"key":"10523_CR33","volume-title":"Development as freedom","author":"A Sen","year":"1999","unstructured":"Sen, A. 1999. Development as freedom. Oxford: Oxford University Press."},{"issue":"1","key":"10523_CR34","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1136\/jme.2004.008102","volume":"31","author":"K Shapiro","year":"2005","unstructured":"Shapiro, K., and S.R. Benatar. 2005. HIV prevention research and global inequality: Steps towards improved standards of care. Journal of Medical Ethics 31(1): 39\u201347.","journal-title":"Journal of Medical Ethics"},{"issue":"9","key":"10523_CR35","doi-asserted-by":"publisher","first-page":"e273","DOI":"10.1371\/journal.pmed.0040273","volume":"4","author":"PO Tindana","year":"2007","unstructured":"Tindana, P.O., J.A. Singh, C.S. Tracy, et al. 2007. Grand challenges in global health: Community engagement in research in developing countries. PLoS Medicine 4(9): e273.","journal-title":"PLoS Medicine"},{"issue":"November","key":"10523_CR36","doi-asserted-by":"publisher","first-page":"114402","DOI":"10.1016\/j.socscimed.2021.114402","volume":"289","author":"A Vestering","year":"2021","unstructured":"Vestering, A., B.C. de Kok, J.L. Browne, and K. Adu-Bonsafoh. 2021. Navigating with logics: Care for women with hypertensive disorders of pregnancy in a tertiary hospital in Ghana. Social Science & Medicine 289(November): 114402.","journal-title":"Social Science & Medicine"},{"issue":"1","key":"10523_CR37","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1186\/s12939-016-0488-4","volume":"15","author":"A Walsh","year":"2016","unstructured":"Walsh, A., R. Brugha, and E. Byrne. 2016. \u201cThe way the country has been carved up by researchers\u201d: Ethics and power in north\u2010south public health research. International Journal for Equity in Health 15(1): 204.","journal-title":"International Journal for Equity in Health"},{"key":"10523_CR38","unstructured":"World Health Organization Task Force on Health Systems Research. 2005. The Millennium Development Goals will not be attained without new research addressing health system constraints to delivering effective interventions: Report of the Task Force on Health Systems Research. Geneva: WHO Task Force on Health Systems Research. https:\/\/researchonline.lshtm.ac.uk\/id\/eprint\/4647860\/"},{"issue":"6","key":"10523_CR39","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1093\/inthealth\/ihaa053","volume":"12","author":"KS Wright","year":"2020","unstructured":"Wright, K.S. 2020. Ethical research in global health emergencies: making the case for a broader understanding of \u2018research ethics\u2019. International Health 12(6): 515\u2013517.","journal-title":"International Health"}],"container-title":["Journal of Bioethical Inquiry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11673-025-10523-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11673-025-10523-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11673-025-10523-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:25:07Z","timestamp":1779805507000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11673-025-10523-7"}},"subtitle":["A Case Study of the SPOT-Impact Consortium"],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":39,"alternative-id":["10523"],"URL":"https:\/\/doi.org\/10.1007\/s11673-025-10523-7","relation":{},"ISSN":["1176-7529","1872-4353"],"issn-type":[{"value":"1176-7529","type":"print"},{"value":"1872-4353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"22 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study does not fall under the scope of the Dutch Medical Research Involving Human Subjects Act (WMO). It therefore did not require approval from an accredited medical ethics committee in the Netherlands. However, an independent quality check has been carried out by the sponsoring institution UMC Utrecht to ensure compliance with legislation and regulations (regarding informed consent, data management, privacy aspects and legal aspects). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"The authors declare the following financial interests\/personal relationships which may be considered as potential competing interests:","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent"}},{"order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Appendix<!--InternalRef removed-->1: Interview Question Examples"}}]}}