Building operational research capacity in low- and middle-income countries
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Transcript of Building operational research capacity in low- and middle-income countries
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Building operational research capacity in low-
and middle-income countries
Anthony D Harries, The Union, Paris, France
London School Hygiene & Tropical medicine
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Previous OR training models
• Class of 15 – 20 people• One – two week course on methods / data• Participants return to countries / stations
But…very few publish
• Why?? – no writing skills, no time, no mentorship
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International TB Course: 2001 - 2007
• 28 participants developed ORP
• 11 started OR when home
• 7 collected and analysed data
• 1 wrote a paper
• 0 published a paperOhkado et al, IJTLD 2010, 14: 371-3
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S RT IT CourseS RT IT CoursePurpose: To teach the practical skills forconducting and publishing operational research
Approach: “combines training with implementation”• Product –oriented [a submitted research paper]• Modular approach [3 modules over 10-12 months]• Milestones must be achieved to stay in course• Targets must be achieved to keep the brand
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Research questions focus on routine data collected within public health systems or by
NGOs
“Our country is data rich but information poor” Minister of Health, Fiji
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Applications invited for 12 places
• Important criteria for being selected:-
– Engaged in programme work
– Supervisors written endorsement –
– Competent in English and computer literate
– Have done MPH or equivalent or come strongly recommended
– Feasible research project based on previously collected data
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Module 1: [6 days]Research Protocol
Module 2: [6 days]Data and analysis
Module 3: [6 days] The Paper
milestone 1
milestone 2
milestone 3
milestone 4
THE COURSE:
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Lectures and discussion
Plenary presentations from participants
Hands-on mentorship from Module 1 to Paper-in-Press
TEACHING FORMAT
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Targets to be achieved: 80-80-80-80
Indicator Target
Aggregate participants score for each module 80%
Participants complete all course milestones 80%
Papers published ≤18 months of submission 80%
Papers assessed for effects on policy and practice ≤18 months of submission
80%
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Are S RT IT courses successful? RT IT courses successful?
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South America
BrazilPeru
South Pacific
New CaledoniaCook IslandsTongaMarshall IslandsFederated States of MicronesiaSolomon IslandsVanuataFiji
All Union – MSF “SORT IT” Operational Research CoursesTOTAL: 18 courses with 212 participants enrolled from 60 countries
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Research Projects undertaken in 18 courses
Research Project Subject Number
Tuberculosis / HIV-TB / Diabetes-TB 135
HIV/AIDS 25
Maternal and Child Health 12
Malaria and NTDs 9
Malnutrition 4
Other [smoking, NCD, Cancer] 35
TOTAL 220
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Outputs from the first 8 courses[80-80-80-80 targets]
Indicators No Outputs No %
Modules assessed 24 Modules scoring ≥ 80% 24 100%
Participants enrolled 93 Participants completing course 83 89%
Papers submitted 96 Papers published ≤ 18 months 89 93%
Papers published 89 Assessed for policy & practice 88 99%
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Outputs from the first 8 courses
88 papers assessed for policy and practice 65 (73%) made a difference
Change in programme implementation N=27Adaptation of monitoring tools N=24Change in existing guidelines N=20
Some papers had more than one effect on policy and practice
Data are self-reported through a questionnaire
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Costs per published paper[total cost of 8 courses including open access publication = 603,000 Euro]
89 published papers at 6,800 Euro per paper
EU-funded papers [PubMed]: cost per paper = 224,769 EuroSource: Galsworthy et al, Academic output of 9 years of EU investment into health research. Lancet 2012; 380: 971-2
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Why does SORT IT work?
• Active selection of participants• Protocols adhere to “STROBE” guidance• Straightforward ethics approvals• Structured course with clear milestones• Active “hands-on” mentorship by facilitators• Rigorous and transparent monitoring /
reporting of outputs
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Beyond the course….
Participants returning questionnaire 76
Completed research projects after the course 47 (62%)
Published papers after the course 38 (50%)
Facilitated at further operational research courses 33 (43%)
83 successful participants completed the course: 76 (92%) returned questionnaire
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“Training and implementation” of operational research
with excellent outputs and value for money
S RT ITS RT ITImproving health systems through research