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Canadian Journal of Public Health

, Volume 97, Issue 1, pp 63–68 | Cite as

The BIAS FREE Framework

A New Analytical Tool for Global Health Research
  • Margrit Eichler
  • Mary Anne BurkeEmail author
Practice

Abstract

Objective: To test the applicability of the BIAS FREE Framework in African settings.

Participants: Researchers from the Tanzanian National Institute for Medical Research, university and community-based researchers from Tanzania, the Gambia and South Africa.

Setting: National Institute for Medical Research, Dar es Salaam - Tanzania.

Intervention: An intensive two-day workshop to examine the applicability of the BIAS FREE Framework within an African setting. This involved clarification of the following concepts: construction of knowledge, objectivity, logic of domination, hierarchy, power, sex and gender, disability, and race/ethnicity. The Framework identifies three types of bias problems that derive from social hierarchies based on gender, race and disability: maintaining hierarchy, failing to examine differences, and using double standards. Participants used the 20 diagnostic questions at the heart of the Framework to analyze various research publications, including some authored by participants.

Outcomes: Participants uniformly stated that the Framework is useful for uncovering bias in public health research, policy and programs; that it is immediately applicable in their work settings; and that doing so would improve equity in research and, ultimately, in health. One participant re-analyzed published data using the Framework and submitted a supplementary report with some new recommendations.

Implications: The applicability of the BIAS FREE Framework has been demonstrated in diverse settings. It is now being offered for broader application as a tool for uncovering and eliminating biases in health research that derive from social hierarchies and for addressing the persistence of global health inequities.

MeSH terms

Research design research methodology objectivity logic of domination prejudice social discrimination gender bias sexism ableism racism 

Résumé

Objectif: Tester les possibilités d’application d’un cadre d’impartialité (le BIAS FREE Framework) dans le contexte africain.

Participants: Chercheuses et chercheurs de l’Institut national tanzanien pour la recherche médicale et des milieux universitaires et communautaires de la Tanzanie, de la Gambie et de l’Afrique du Sud.

Lieu: L’Institut national pour la recherche médicale de Dar es-Salaam, en Tanzanie.

Intervention: Un atelier intensif de deux jours pour examiner les possibilités d’application du cadre BIAS FREE dans le contexte africain. Il s’agissait de clarifier les notions de construction des savoirs, d’objectivité, de logique de domination, de hiérarchie, de pouvoir, de sexe et de sexospécificités, d’in/capacité, de race et d’appartenance ethnique. Le Cadre définit trois types de biais découlant des hiérarchies sociales fondées sur les sexospécificités, la race et l’in/capacité, soit: le maintien de la hiérarchie, le non-examen des différences et l’emploi de deux poids deux mesures. Les participantes et les participants ont utilisé les 20 grandes questions diagnostiques du Cadre pour analyser divers articles de recherche (dont ils étaient même parfois les auteurs).

Résultats: Les personnes présentes ont uniformément déclaré que le Cadre était utile pour déceler les biais dans la recherche, les politiques et les programmes en santé publique. Elles ont affirmé également qu’elles pourraient appliquer le Cadre tel quel dans leur milieu de travail, et que son application améliorerait l’équité dans le domaine de la recherche et, en bout de ligne, dans celui de la santé. L’une des personnes présentes a refait, à l’aide du Cadre, l’analyse de données publiées, puis présenté un rapport supplémentaire comportant de nouvelles recommandations.

Conséquences: Les possibilités d’application du cadre BIAS FREE dans divers contextes sont démontrées. On offre maintenant ce cadre sous la forme d’un outil à plus grande échelle pour déceler et supprimer les biais de la recherche en santé découlant des hiérarchies sociales et pour aider à effacer les inégalités sur le plan de la santé mondiale.

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References

  1. 1.
    VanderPlaat M, Teles N. Mainstreaming social justice: human rights and public health. (Commentary. Can J Public Health 2005;96(1):34–36.PubMedGoogle Scholar
  2. 2.
    Banett I. Health care professionals and their attitudes toward and decisions affecting disabled people. In: Albrecht GL, Seelman KD, Bury M (Eds.). Handbook of Disability Studies. Thousand Oaks, CA: Sage, 2002;450–67.Google Scholar
  3. 3.
    Brett PJ, Graham K, Smythe C. An analysis of specialty journals on alcohol, drugs and addictive behaviors for sex bias in research methods and reporting. J Stud Alcohol 1995;56(1):24–34.PubMedCrossRefGoogle Scholar
  4. 4.
    Groce NE, Chamie M, Me A. Measuring the quality of life: Rethinking the World Bank’s Disability Adjusted Life Years. Int J Educ Res 1999;49:1–2.Google Scholar
  5. 5.
    Gustafson, DL. Understanding women and health. In: Mandell N (Ed.). Feminist Issues: Race, Class and Sexuality. Toronto, ON: Pearson, 2004;266–86.Google Scholar
  6. 6.
    Messing K, Punnett L, Bond M, Alexanderson K, Pyle J, Zahm S, et al. Be the fairest of them all: Challenges and recommendations for the treatment of gender in occupational health research. Am J Ind Med 2003;43:618–29.CrossRefGoogle Scholar
  7. 7.
    Smedley BD, Stith AY, Nelson AR (Eds.). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press, 2003.Google Scholar
  8. 8.
    Smith, LT. Decolonizing Methodologies: Research and Indigenous Peoples. London, UK and New York, NY: Zed Books, 1999.Google Scholar
  9. 9.
    Barnes C. Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People. British Council of Organisations of Disabled People and Ryburn Publ. Ltd., 1992.Google Scholar
  10. 10.
    British Sociological Association. BSA Anti-racist Language: Guidance for Good Practice. British Sociological Association, 1997.Google Scholar
  11. 11.
    Burke, MA. Health Canada’s Gender-based Analysis Policy. Health Canada, 2000.Google Scholar
  12. 12.
    Dei GJS. Towards an anti-racism discursive framework. In: Dei GJS, Calliste A (Eds.). Power, Knowledge and Anti-racism Education: A Critical Reader. Halifax, NS: Fernwood, 2000;23–40.Google Scholar
  13. 13.
    Commonwealth Secretariat. A Quick Guide to Gender Mainstreaming in the Public Service. Commonwealth Secretariat, 1999.Google Scholar
  14. 14.
    Leo-Rhynie E, Institute of Development and Labour Law University of Cape Town. A Quick Guide to Gender Mainstreaming in Education. Commonwealth Secretariat, 1999.CrossRefGoogle Scholar
  15. 15.
    Liverpool School of Tropical Medicine. Guideline for the Analysis of Gender & Health. Department for International Development, 1999.Google Scholar
  16. 16.
    Saskatchewan, Women’s Secretariat. Gender-Inclusive Analysis: A Guide for Policy Analysts, Researchers, Program Managers and Decision-Makers. Regina, SK: Saskatchewan Women’s Secretariat, 1998.Google Scholar
  17. 17.
    Sen G. A Quick Guide to Gender Mainstreaming in Finance. Commonwealth Secretariat, 1999.Google Scholar
  18. 18.
    Bach M, Burke, MA. Toward an Inclusive Approach to Monitoring Investments and Outcomes in Child Development and Learning. North York, ON: The Roeher Institute, 2002.Google Scholar
  19. 19.
    Burke, MA. Child Institutionalisation and Child Protection in Central and Eastern Europe, Innocenti Occasional Paper EPS 52, Florence, Italy: UNICEF Innocenti Research Centre, 1995.Google Scholar
  20. 20.
    Burke, MA. Developing Gender-based Analysis (GBA) tools for the health sector. Health in the Commonwealth Sharing Solutions 1999/2000, Kensington Publications Limited for the Commonwealth Secretariat, 1999.Google Scholar
  21. 21.
    Burke, MA. Health Canada’s achievements to date in mainstreaming gender. Proceedings from the Commonwealth Workshop on Gender Management Systems for the Health Sector, St. Kitts and Nevis. London: Commonwealth Secretariat, 1999.Google Scholar
  22. 22.
    Burke, MA. Gender management system for the health sector in Canada. Proceedings from the Commonwealth Workshop on Gender Management Systems for the Health Sector, St. Kitts and Nevis. London: Commonwealth Secretariat, 1999.Google Scholar
  23. 23.
    Burke MA, Bach M, Coleman R, McKie DC, Stewart G. Dynamic Model of Health. Commonwealth Working Group on Gender Equality and Health Indicators. 2000. Available online at: http://www.cwhn.ca (Accessed on June 5, 2005).Google Scholar
  24. 24.
    Eichler M. And the work never ends: Feminist contributions. Can Rev Sociol Anthropol 1985;22(5):619–44.CrossRefGoogle Scholar
  25. 25.
    Eichler M. Nonsexist Research Methods: A Practical Guide. New York: Routledge, 1991.Google Scholar
  26. 26.
    Eichler M, et al. Zu mehr Gleichberechtigung zwischen den Geschlechtern: Erkennen und Vermeiden von Gender Bias in der Gesundheitsforschung. Deutsche Bearbeitung eines vom kanadischen Gesundheitsministerium herausgegebenen Handbuchs. Berliner Zentrum Public Health, 2002.Google Scholar
  27. 27.
    Eichler M, Reisman AL, Manace Borins E. Gender bias in medical research. Women and Therapy 1992;12(4):61–70.CrossRefGoogle Scholar
  28. 28.
    Lapointe J, Eichler M. Le traitement objectif des sexes dans la recherche. Ottawa, ON: Conseil des recherches en sciences humaines, 1985.Google Scholar
  29. 29.
    Eichler M. Offener und versteckter Sexismus. Methodisch-methodologische Anmerkungen zur Gesundheitsforschung. In: Arbeitskreis Frauen und Gesundheit im Norddeutschen Forschungsverbund (Ed.). Frauen und Gesundheit(en) in Wissenschaft, Praxis und Politik. Public Health. Bern, Switzerland: Verlag Hans Huber,1998;34–49.Google Scholar
  30. 30.
    Bhavnani KK (Ed.). Feminism and ‘Race’. New York: Oxford University Press, 2001.Google Scholar
  31. 31.
    Gaertner SL, Dovidio JF, Banker S, Rust MC, Nier JA, Mottola GR, Ward, CM. Does white racism necessarily mean antiblackness? Aversive racism and prowhiteness. In: Fine M, Weis L, Powell LC, Wong LM (Eds.). Off White: Readings on Race, Power, and Society, New York: Routledge, 1997;167–78.Google Scholar
  32. 32.
    Messing K. One-eyed Science: Occupational Health and Women Workers. Philadelphia, PA: Temple University Press, 1998.Google Scholar
  33. 33.
    Schriner K. A Disability Studies perspective on employment issues and policies for disabled people. In: Albrecht GL, Seelman KD, Bury M (Eds.). Handbook of Disability Studies. Thousand Oaks: Sage, 2001;642–62.CrossRefGoogle Scholar
  34. 34.
    Smedley BD, Stith AY, Nelson AR, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy, and Institute of Medicine of the National Academies. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington: National Academies Press, 2003;160–79.Google Scholar
  35. 35.
    Spivak G. Subaltern studies: Deconstructing historiography. In: Landry D, Maclean G (Eds.). The Spivak Reader. New York: Routledge, 1996;203–35.Google Scholar
  36. 36.
    Thomson, RG. Integrating disability, transforming feminist theory. NWSA Journal 2002;14:1–32.CrossRefGoogle Scholar
  37. 37.
    Wendell S. “Toward a feminist theory of disability.” In: Davis LJ (Ed.). The Disability Studies Reader. New York: Routledge, 1997;260–78.Google Scholar
  38. 38.
    Wolbring G. University of Calgary, Founder and Executive director of the International Center for Bioethics, Culture and Disability. Founder and Coordinator of the International Network on Bioethics and Disability; and Chair: Disabled People’s International Bioethics Taskforce. Personal communication, 2005.Google Scholar
  39. 39.
    Armstrong D, Earnshaw G. A comparison of GPs and nurses in their approach to psychological disturbance in primary care consultations. Health and Social Care in the Community 2005;13(2):108–11.PubMedCrossRefGoogle Scholar
  40. 40.
    Boonsawat W, Charoenphan P, Kiatboosri S, Wongtim S, Viriyachaiyo V, Pothirat D, Thanomsieng N. Survey of asthma control in Thailand. Respirology 2004;9:373–78.PubMedCrossRefGoogle Scholar
  41. 41.
    Cambanis A, Yassin MA, Ramsay A, Bertel Squire S, Arbide I, Cuevas, LE. Rural poverty and delayed presentation to tuberculosis services. Tropical Medicine and International Health 2005; 10(4):330–35.PubMedCrossRefGoogle Scholar
  42. 42.
    Leeder SR, Sominello A. Health, equity and intellectual disability. J Appl Res in Intellectual Disabilities 2005;18:97–100.CrossRefGoogle Scholar
  43. 43.
    Tsai YF, Wong TKS. Strategies for resolving aboriginal adolescent pregnancy in eastern Taiwan. Issues and Innovations in Nursing Practice. 2005;41(4):351–57.Google Scholar
  44. 44.
    Eichler M. Feminist methodology. Current Sociology 1997;45:9–36.CrossRefGoogle Scholar
  45. 45.
    Longino H. Essential tensions, phase two: Feminist, philosophical, and social studies of science. In: Antony LM, Witt C, A Mind of One’s Own: Feminist Essays on Reason and Objectivity. Boulder, CO: Westview Press, 1993:257–72.Google Scholar
  46. 46.
    Warren, KJ. The power and promise of ecological feminism. In: Zimmerman ME, Callicott JB, Sessions G, Warren KJ, Clark J. Environmental Philosophy: From Animal Rights to Radical Ecology. Englewood Cliffs, NJ: Prentice Hall, 1993;320–41.Google Scholar
  47. 47.
    Burke MA (Ed.). The Construction of Disability and Risk in Genetic Counselling Discourse. North York: The Roeher Institute, 2002.Google Scholar
  48. 48.
    Eichler M, Burke, MA. Towards BIAS FREE Research for Health. The Global Forum for Health Research, forthcoming.Google Scholar
  49. 49.
    Levin, RI. The puzzle of aspirin and sex. N Engl J Med 2005;352:1366–68. Available online at: www.nejm.org (Accessed on March 8, 2005. (10.1056/NEJMe058051).PubMedCrossRefGoogle Scholar
  50. 50.
    Ridker PM, Cook NR, Lee IM, Gordon D, Gaziano JM, Manson JE, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 2005;352:1293–304. Available online at: www.nejm.org (Accessed on March 7, 2005. (10.1056/NEJMoa050613).PubMedCrossRefGoogle Scholar
  51. 51.
    Peck P, Web, MD. Aspirin won’t prevent 1st heart attack in women. Medical News, March 07, 2005. Available online at: http://www.medicinenet.com (Accessed on June 11, 2005).Google Scholar
  52. 52.
    Barnes C. Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People. Halifax, British Council of Organisations of Disabled People and Ryburn Publ. Ltd., 1992.Google Scholar
  53. 53.
    Canadian Down Syndrome Society. Redefining Down Syndrome: Position Statement on Redefining Down Syndrome. 2003.Google Scholar
  54. 54.
    Shiva V. Biopiracy: The Plunder of Nature and Knowledge. Toronto: Between the Lines, 1997.Google Scholar
  55. 55.
    Shiva V. Stolen Harvest: The Hijacking of the Global Food Supply. Cambridge, MA: South End Press, 2000.Google Scholar
  56. 56.
    Tsing, AL. Environmentalisms: Transitions as translations. In: Scott J, Caplan C, Keates D (Eds.). Transitions, Translations, Environments: International Feminism in Contemporary Politics. New York: Routledge, 1997.Google Scholar
  57. 57.
    Brillhart, BS. Attitudes toward people with disabilities. Rehabilitation Nursing 1990;15(2):80–82,85.PubMedCrossRefGoogle Scholar
  58. 58.
    Hurtado A, Stewart, AJ. Through the looking glass: Implications of studying whiteness for feminist methods. In: Fine M, Weis L, Powell LC, Wong LM (Eds.). Off White: Readings on Race, Power, and Society. New York: Routledge,1997;297–311.Google Scholar
  59. 59.
    Health Canada. Health Canada’s Women’s Health Strategy. Minister of Public Works and Government Services, 1999.Google Scholar
  60. 60.
    Essed P. Understanding Everyday Racism. An Interdisciplinary Theory. Newbury Park, CA: Sage, 1991.CrossRefGoogle Scholar
  61. 61.
    Gaskell J, Eichler MJ, Pan J, Xu J, Zhang X. The participation of women faculty in Chinese universities: Paradoxes of globalization. Gender and Education 2004;16(4):511–29.CrossRefGoogle Scholar
  62. 62.
    Henry F, Tator C, Mattis W, Rees T (Eds.). The ideology of racism. The Colour of Democracy: Racism in Canadian Society. Toronto: Harcourt and Brace Canada, 2000;15-34.Google Scholar
  63. 63.
    MacFarlane A. Disability and ageing. In: Swain J, French S, Barnes C, Thomas C (Eds.). Disabling Barriers—Enabling Environments. London: Sage, 2004;189–94.Google Scholar
  64. 64.
    Burke MA, Eichler M. Summary of Evaluations Received. BIAS FREE Workshop, Dar es Salaam, Tanzania, 17–18 May 2005, The Global Forum for Health Research, unpublished.Google Scholar
  65. 65.
    Manzi F, Mbuyita S, Urassa H. Development of a Standardized Exemption Mechanism for Kilombero District, Tanzania, 2003.Google Scholar
  66. 66.
    Mbuyita S. The importance of routine inclusion of gender analysis in all stages of the research process: A case study of an analysis of a final report on the development of a Standardized Exemption Mechanism for Kilombero District, Tanzania. Forthcoming CD-ROM. Poverty, Equity and Health Research: Final documents from Forum 9, Mumbai, India, 12–16 September 2005, Global Forum for Health Research, 2005.Google Scholar

Copyright information

© The Canadian Public Health Association 2006

Authors and Affiliations

  1. 1.Ontario Institute for Studies in EducationUniversity of TorontoTorontoCanada
  2. 2.Global Forum for Health ResearchGeneva 2Switzerland

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