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 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?

Should be comprehensive: 1) Basic 2) Intervention/Clinical 3) Applied

Should improve interventions Covers three major disciplines:

i) Biomedical research ii) Health systems research – interventions,

policies, management, community initiatives etc

iii) 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

eg. – Research ethicsResearch communication, including evidence to

policy and practiceCommunity demands for researchM & E on impactHealth Systems research needsGood research contractingTechnology transfer arrangementsIntellectual property rightsInstitution 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,

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, 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 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 NATI ONAL 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.