Call for proposals: Health equity in decentralized democracy 

Open call for proposals for research on the nexus between local democracy and equitable health provision.

Background 

Democracy is essential for achieving good health globally.¹ A recent comprehensive study by Bollyky et al. (2019) asserts that “democracies are more likely than autocracies to lead to health gains for causes of mortality”.² Democracy explained variance in mortality for cardiovascular diseases, transport injuries, cancers, cirrhosis, and other non-communicable diseases. It was found that this effect is driven by the higher degree of health care investment in experienced democracies. 

At the local level, democracy is widely assumed to have a positive effect on health because it empowers communities to actively participate in decision-making processes. As communities are included, it ensures that healthcare policies and practices are tailored to their specific needs, values, and priorities, which fosters a more inclusive and responsive healthcare system.  

However, while social scientists have long debated the relationship between democracy and health, it is a debate that has intensified in recent years along with global trends of autocratization. More research is needed to draw more definitive conclusions about the effects that democratic governance may have on population health. 

Scope 

This research initiative aims to explore the democracy-health nexus, with a focus on the local level. The research is meant to support and provide recommendations for local governments striving to promote health equity within the framework of decentralized democracy. The research team shall provide knowledge support to local governments in ICLD’s programmes, with special attention to ICLD’s Network of Municipal Partnerships for Equitable Health.    

Potential research questions may include: 

• How does improved citizen participation benefit health (care) decision-making?  
• How can we integrate and understand local knowledge from local communities to find more equitable and sustainable solutions to problems of healthcare provision? 
• What are communities’ perspectives of health equity in resource-constrained areas? And what are the key drivers building equity through sensible (local) government policy? 
• How can local governments in resource-constrained areas work to strengthen health system financing? Departing from lessons from WHO guiding principles for health financing.  

ICLD encourages the use of participatory methodologies such as Participatory Action Research and Community-Based Participatory Research. 

Deliverables 

The research project shall produce: 

• A detailed Research Report according to ICLD guidelines that articulates the findings and provides actionable recommendations for policymakers and stakeholders. 
• A concise Policy Brief according to ICLD guidelines aimed at translating complex research findings into practical guidance for local governments. 
• At least one dissemination/learning activity related to ICLD’s Network of Municipal Partnerships for Equitable Health. 

Please see ICLD’s previous publications for examples of research reports and policy briefs. Additionally, the project team must commit to organise a dissemination activity online, and be proactive in identifying and leveraging opportunities for knowledge dissemination in meetings of the ICLD network and other relevant fora.   

Budget  

This grant is the equivalent of up to 500.000 SEK including personnel, operational cost of fieldwork and dissemination activity, and overhead costs (maximum 20%).  

Timeline 

8 months from the signing of contract until deliverable submission. Applicants should provide a clear timeline with milestones.  

Who can apply? 

Applicants must be affiliated with an accredited research institution, which is to channel and administer the funds. The principal investigator must hold a PhD degree in a relevant field and be proficient in English.  

Applicants can be from anywhere in the world, but the proposed study must show clear relevance to the Eastern African context.

How to apply? 

The researcher or research team should submit a proposal using ICLD’s system SBS Manager. The portal requires an account to be made by the main applicant. The account and portal will also be used for contract writing, reporting and other administration around the grant. Make sure to start the application procedure well in advance of the deadline, to leave room for any unclarities and need for support. ICLD encourages collaboration with researchers from its scholarly network and ICLD partner universities.  

In the application you must attach:  

• Proposal using the following template: Research proposal template.docx 
• CVs of the main project members 
• It is highly encouraged to upload a letter of support from the local government(s) and/or active organisations where fieldwork will take place. Please utilize existing contacts or ask us for contact persons for selected municipalities.  
• Letter of intent from the research institution confirming they can administer the grant. 

Deadline for application: 18 August 2024, 23:59 CEST. 

Footnotes:

1. V-Dem. 2019. “Does Democracy Increase Global Health?”. The Case for Democracy. https://v-dem.net/media/publications/pb_29.pdf  
2. Bollyky et al. (2019). The relationships between democratic experience, adult health, and cause-specific mortality in 170 coutries between 1980 and 2016: an observational analysis. The Lancet, 393(10181), 1628-1640.