Transcript HEALTH RESEARCH IN UGANDA FROM RESEARCH TO POLICY

UGANDA NATIONAL HEALTH
RESEARCH ORGANISATION
HEALTH RESEARCH IN
UGANDA: CRITICAL ROLE
DR. SAM OKWARE
DIRECTOR GENERAL
UGANDA NATIONAL HEALTH RESEACH
ORGANIZATION (UNHRO)
UNACOH Annual Scientific Conference 24.09.09
INSTITUTIONAL
MECHANISMS
 Currently low priority, low funding; fragmented, disjointed
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without linkage to HSSP II or research priorities;
Need clear, defined, institutional linkages for contact and
interaction and consensus building at sector national level;
Clear TOR, accountability and channels of communications
between MOH and other Ministries;
Agree on mechanisms for conducting needs assessment,
prioritization, planning, contracting research, M & E,
dissemination.
Encourage ownership from community level to national level
(UNHRO) and to regional level (REACH).
OBJECTIVES OF RESEARCH
 Improve population Health, Equity and
development – part of planning process;
 Support evidence based policies and interventions.
 Identify the gaps for improvement;
 Improve the quantity and quality of interventions;
 Be an effective agent of transformation;
 Identify “make or break” factors that influence the
effectiveness of interventions.
What Research?
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Should be comprehensive: 1) Basic 2)
Intervention/Clinical 3) Applied
 Should improve interventions
 Covers three major disciplines:
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Biomedical research
Health systems research – interventions,
policies, management, community
initiatives etc
Behavioral research – socio-economic,
cultural etc
STRATEGIC APPROACHES
 Basic requirements: Political Commitment (H.E the
President), and EAC Heads of State endorsed EARC with
nodes in Kenya (KEMRI), Tanzania (NIMR) and Uganda (
UNHRO);
WHO resolution: Paris 2008, Algiers 2009, Bamako 2009,
Kigali WHO 59th Session AFRO, Sept 2009 endorsed
setting up by MOH coordinating structures for ENHR;
 Develop draft Essential National Health Research
Strategy - related to HSSP;
 Set up National research policies and agenda;
 Involve a wide and inclusive array of stakeholders –
(Researchers, health managers, civil society).
STRATEGIC APPROACHES cont.
 Place equity at the centre of efforts to improve
ENHR;
 Set National health priorities – get consensus;
 Integrate ENHR into HSSPII and National
Development Plans (PEAP, NDP)
 Monitor the move towards equity in Health.
IMPROVE HEALTH RESEARCH
COMPONENTS
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eg. – Research ethics
 Research
communication, including evidence to
policy and practice
 Community demands for research
 M & E on impact
 Health Systems research needs
 Good research contracting
 Technology transfer arrangements
 Intellectual property rights
 Institution building/motivation.
IMPROVING HEALTH RESEARCH
SYSTEM
 Human resources for Health Improvement –
develop HRH strategy and plan.
 Ensure stable and predicable research
funding – align HSSP; donors, harmonize.
 Strengthen collaborative arrangements and
networking (dip., donors etc).
RESEARCH IMPLEMENTATION
 Identify of resources by priority area.
 Strengthen research protocol development –
(training, incentives, brain drain, solicit TA).
 Establish peer – review process – dynamic and
responsive.
 Develop mechanisms for M & E of research
work.
MEASURING THE PROCESS
 Does the Research Agenda address EQUITY in
Health?
%
no. of projects addressing problems of most vulnerable
(MCH?)
 Diversion
of resources towards equity targeted progress( ? )
 Re-allocation
of Resources for research Agenda/Priorities.
UTILIZATION OF RESEARCH
RESULTS
 Target: from research to policy/advocacy.
 Strengthen dissemination of research findings (w/shops,
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publications, mass media, research rep
Dissemination research results to wider public .
Promote info.sharing, feedback to patients and communities.
Facilitate dialogue between researchers/policy makers.
Translate research results into policy briefs. Build
Knowledge- Translation platforms
Identify indicators on Health status and Health care and
Health Determinants (Resources, utilisation)
INDICATORS TO MONITOR
RESEARCH AGENDA
 Include also indicators on health care financing,
allocation of resources, utilization of services, and
quality.
 Use multiple indicators to explore the way in which
conclusions about equity vary according to
different indicators.
CHALLENGES
 Great potential for research but needs funding, enabling environment,
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increased partnerships;
Alignment and harmonisation of research in health sector inadequate;
Problems: HRH, incentives, training and retention, full time researchers;
Research output low judged by (publications, dissemination)? Info.
Sharing weak;
Lack of capacity and skills to communicate findings by researchers ?
“upgrade communication”. Website and LAN and networks
Low funding level – mainly external – address sustenance;
Weak communication infrastructure, networks, directories, data bases.
Uncoordinated resource mobilisation and advocacy at community,
district and national level;
Weak international collaboration (active Versus passive).
National response: UNHRO
 To evolve and enforce ethical code of conduct for health
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research in Uganda;
Coordinate all health research in the country;
Coordinate, align and harmonise Health Research in
Uganda and Region;
Enforce National Research Policies and Research
Priorities to support HSSP;
Develop a National Research Plan and Agenda;
Strengthen and Supervise health research work (process,
output and quality);
Develop the National Health Research Capacity (i.e HRH
Strategic plan, Infrustructure, documentation)
Specific Objectives contd.
 Promote and improve stakeholder
consultations, information sharing and
consensus building, and up-grade research
communications infrastructure (networking);
 Monitor process and conduct of research and
whether it responds to Equity and Safety of
population (Human Experiments);
 Strengthen International collaboration and
mobilisation of Resources; WHO Algiers, Kigali
declaration, 2009: 5% donor resorces and 2%
national MOH budget be allocated to ENHR
 Promote safety of clients and researchers
(human experiments, and intl. propriety rights
Resource Mobilisation
 Algiers Declaration - 2% of MOH Budget
and 4% of Donor Budget for Health
Research
 Resolution by WHO/AFRO urged to
strengthening health research.
 Health systems reseach: 8Ms- man,
money, materials, machines, methods,
moment, message
CONCLUSION
 Uganda has a favorable health policy environment
but still in transition research to policy.
 Well developed health research system available.
 Reasonable mass researchers addressing health
research priorities set out in the ENHR plan and
HSSP.
 Networking on going (national, international,
regional) but should go further to communities.
 Needed: coordination, Alignment, Harmonization
HEALTH RESEARCH IN UGANDA:
FROM RESEARCH TO POLICY
DR. SAM OKWARE
DIRECTOR GENERAL
UGANDA NATIONAL HEALTH RESEACH
ORGANIZATION (UNHRO)
November 2008
MEASURING THE PROCESS cont.
 Utilization: How much interest has the agenda
generated among stakeholders (donors, GoU, and
researchers).
 Input from multiple stakeholders – who, how many
involved.
 Activity at Forum for sharing of information and
evaluation of process by stakeholders.