{"id":453100,"date":"2011-07-04T11:07:39","date_gmt":"2011-07-04T11:07:39","guid":{"rendered":"http:\/\/www.ghanamma.net\/2011\/07\/04\/challenges-from-research-to-practice-in-health-system-part-2\/"},"modified":"2011-07-04T11:07:39","modified_gmt":"2011-07-04T11:07:39","slug":"challenges-from-research-to-practice-in-health-system-part-2","status":"publish","type":"post","link":"https:\/\/www.ghanamma.com\/2011\/07\/04\/challenges-from-research-to-practice-in-health-system-part-2\/","title":{"rendered":"Challenges From Research to Practice in Health System (part 2)"},"content":{"rendered":"
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\"Daily<\/a><\/p>\n

DR Aminu Magashi<\/p>\n

30 June 2011<\/p>\n

\n

opinion<\/p>\n

Last week I commenced a discussion on how useful a research should be in improving health practice with respect to health system. I outlined the definition of a ‘health system’ and the 6 dimensions of ‘quality of care’, which are effectiveness, efficiency, accessibility, acceptability, equity and safety.<\/p>\n

A senior colleague based on the article called me on phone expressing dismay that, he and his academic colleagues are doing lots of research and being published all over the places and I didn’t seems to acknowledge that. I actually appreciated his intervention and will continue to commend such effort. I drew his attention that my concern was not that there are ‘no researches’ but to what extend such research findings are being properly disseminated to programnmers and policy makers and to what extend such findings improve decision making to improve quality of care. At the end our lengthy phone conversation he saw my line of thinking that majority of researches are kept within the confine of academic institutions and peer reviewed journals and in the context of using such findings to influence decision making in the health sector, a huge gap exist.<\/p>\n

I am referring to Operations research or whatever name one gives it ‘Implementation or action research.’ A little background will be useful here.Any research producing practically-usable knowledge (evidence, findings, information, etc) which can improve program implementation (e.g., effectiveness, efficiency, quality, access, scale-up, sustainability) regardless of the type of research (design, methodology, approach) falls within the boundaries of operations research<\/p>\n

The goal of OR is to increase the efficiency, effectiveness, and quality of services delivered by<\/p>\n

Providers, and the availability, accessibility, and acceptability of services desired by users. The scope of OR are;<\/p>\n

Identify common implementation problems and their main determinants which prevent effective access to interventions and determine which of these problems are susceptible to research.<\/p>\n

Develop practical solutions to these problems and test whether new implementation strategies based on these solutions can significantly improve access under conditions of routine disease control.<\/p>\n

Determine – in collaboration with partners – the best way to introduce these new implementation strategies into the health system and facilitate their full scale implementation, evaluation and modification, as required’<\/p>\n

Operations research (OR) addresses specific problems within specific programs, not general health issues. It also addresses those problems that are under control of managers, such as program systems, training, pricing and provision of information and requires collaboration between managers and researchers in identification of the research problem, development of the study design, implementation of the study and analysis and interpretation of results. It succeeds only if the study results are used to make program decisions; publication alone is not a valid indicator of successful OR.” Published papers are not valid indicators of OR success<\/p>\n

It is divided into 4 different kinds of studies. Diagnostic studies: used to assess the nature and extent of a health or service delivery problem. These studies seek to determine the parameters of a problem situation before programming begins. In an effort to respond as quickly as possibly to a devastating epidemic such as HIV\/AIDS, programs sometimes were hastily planned and rapidly implemented without a clear understanding of the underlying nature of the problem the program was designed to address. Exploratory\/diagnostic studies examine the basic factors influencing a problem situation that need to be addressed later through planned programs.<\/p>\n

Another one is Evaluative studies: used to evaluate ongoing innovative health interventions. Evaluative studies can be a valuable operations research approach for examining retrospectively or cross-sectionally the effect of program activities. Evaluation is an ongoing process that should occur continually over the life of a program.<\/p>\n

Another is the Intervention studies: used to test, the effectiveness of service delivery interventions explicitly designed to address a specific service delivery problem. These studies test, on an experimental basis, new approaches or solutions to overcoming a program problem. They can be thought of as “proof of concept” studies. In many situations, an earlier exploratory\/diagnostic study has identified the factors responsible for a problem, but the most effective and efficient solution for alleviating the problem is not known.<\/p>\n

Cost-effectiveness studies: Cost of Effectiveness not known in many places. In many cases, the overall impact of a program in terms of increasing knowledge or changing an approach, cost effectiveness studies can be a valuable management tool, and cost-effectiveness analyses are frequently part of intervention and evaluation studies.<\/p>\n

Some of the challenges to ensure use of research findings to improve practice are;<\/p>\n

Limited research capacities and no strategic plan for capacity strengthening<\/p>\n

Most of the researches conducted are donor driven and carried out by individuals, not institution-based.<\/p>\n

Student thesis remain on shelves and not used.<\/p>\n

Documentation of the volume of research conducted and topics covered not completed.<\/p>\n

Insufficient use of research evidence for decision-making.<\/p>\n

No information about resources available for health research.<\/p>\n

No research unit or centre and Internet access limited.<\/p>\n

Another challenge is communicating the research findings to various stakeholders and to use it for decision making. A communication strategy needs to be developed for research and to start by asking four essential questions. These questions address the essential elements of an effective communication strategy.<\/p>\n

1. What are the objectives of the communication strategy?<\/p>\n

2. Who are the target audiences?<\/p>\n

3. What are appropriate channels of communication?<\/p>\n

4. How will you assess information use?<\/p>\n

While these challenges appear many, it requires bringing the researchers closer to those who will use the findings to improve health system and overall improve quality of care.<\/p>\n

All comments to Dr A Magashi at<\/p>\n

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Read more here:
\nChallenges From Research to Practice in Health System (part 2)<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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