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The BIAS FREE Framework

A New Analytical Tool for Global Health Research

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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.

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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Authors and Affiliations

  1. Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada

    Margrit Eichler PhD

  2. Global Forum for Health Research, 1-5 route des Morillons, PO Box 2100, 1211, Geneva 2, Switzerland

    Mary Anne Burke MA (Health Analyst/Statistician)

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  1. Margrit Eichler PhD
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Correspondence to Mary Anne Burke MA.

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Acknowledgements: The support of the Global Forum for Health Research is gratefully acknowledged. We also thank Jane E. Foy for her editorial commitment and support.

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Eichler, M., Burke, M.A. The BIAS FREE Framework. Can J Public Health 97, 63–68 (2006). https://doi.org/10.1007/BF03405218

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