By Professor Ranjit Roy Chaudhury

WHO-SEA ACHR BANGKOK

12 October 20111

Quality of Research Supported by SEARO in countries of the

Region

PROPOSALS AND REPORTS REVIEWED

BANGLADESH – 15

INDIA - 23

MYANMAR - 22

THAILAND - 06

A total of 66 projects and reports

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CRITERIA FOR EVALUATION

Relevance of project to the national health priorities

Quality of design of proposal

Whether ethical clearance requested

Completion of project

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CRITERIA FOR EVALUATION

Presentation of results at meetings

Publication of results of research

Communication of results to government

Policy change if any caused by research

4

QUALITY OF DESIGN

Objectives of study

Hypothesis

Methodology

Expected outcome

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OVERVIEW OF ASSESSMENT FOR ALL FOUR COUNTRIES

RELEVENCE OF PROPOSAL - High Relevance

DESIGN – Many projects well designed - Always room for improvement ETHICAL CLEARANCE – Poor awareness- Need for improvement in all countries- 14 out of 66 proposals did not need clearance- Only 18 out of 52 proposals mentioned the

need for approval

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OVERVIEW OF ASSESSMENT WITH THIS LIMITED

INFORMATIONCOMPLETION OF PROJECTS – A large

number of projects had not been completed

PRESENTATION OF RESULTS AT MEETINGS – This was low

- Needs improvementPUBLICATIONS FROM RESEARCH –

More emphasis needs to be placed on this - Generally poor

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OVERVIEW OF ASSESSMENT

CHANGE IN POLICY

- Of the 22 completed projects results of 5 sent on to the government

- Change of policy in place from 4 of these- Very encouraging

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WEAKNESSES IN THE STUDY

* In spite of all efforts proposals and reports of projects supported by SEARO could only be obtained from 4 countries

* No proposals received from Indonesia, Nepal and Sri Lanka

* Possible that information sent to SEARO was incomplete or not up to date

* Every effort was made to obtain up to date information

* Appears that improvement needed in information storage and retrieval 9

RESULTS• Presented country wise

• Not meant to be a comparison between countries

• Objective is to learn where strengthening is needed

• Concentrate in future on these areas

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PROPOSALS• 66 project proposals received • 24 project details complete in all

respects• All projects were assessed according to

information provided

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Proposals

66

24

Total

Complete inall respects

BANGLADESH• 15 Proposals received

• All were only at proposal stage

• Assessment was therefore possible only for – - RELEVANCE - DESIGN - ETHICS

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BANGLADESH

RELEVANCE

• All proposals were relevant to needs and prriorities of country

• 5 out of 15 were highly relevant

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EXAMPLE OF HIGHLY RELEVANT PROPOSALS

• Prevalence on injury related disability in manikgunj district of bangladesh

• Study to measure the intensity and incidence of catastrophic health care costs and impact on family budgets

• Therapeutic efficacy of artemether in falciparum malaria

14

BANGLADESHDESIGN OF PROPOSALS

• Quality of design found to be good in 14 proposals

• Improvement in design possible

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BANGLADESHETHICAL CLEARANCE

• 2 out of 15 proposals did not need ethical clearance

• 8 out of 13 proposals needing clearance mentioned this in their proposal

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PROPOSAL WHICH DID NOT NEED ETHICAL CLEARANCE

Fiscal space assessment of Bangladesh health, nutrition and

population sector

17

INDIA

• 23 proposals were received

18

11

8

4

PROJECTSCOMPLETED

PROJECTSONGOING

ONLYPROPOSALS

INDIA

RELEVANCE

• 8 proposals were found very relevant

• 9 proposals were also relevant

• In total 17 out of 23 were relevant to the needs of the country

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INDIA

Examples of high relevance studies

• Validation of haemoglobin colour scale for haemoglobin estimation

• Estimation of malaria disease burden in Jharkhand

• Community based interactions study for cardiovascular risk reduction in Kerala

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INDIADESIGN

• Well designed proposals - 7

• Average but acceptable design - 8

• Design poor and improvement needed - 8

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INDIAETHICAL CLEARANCE

• 17 out of the 23 proposals needed ethical approval

• 4 proposals mentioned ethical clearance in proposal

• Could be that clearance was taken later

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INDIA

Examples of proposals which did not need ethical clearance

• Market study of alternatives of mercury measuring devices in health care in India

• Feasibility study to develop healthy work place in the industrial settings in Chandigarh

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INDIA• Presentation of results at meetings 2/11 studies presented

• Publication of results No publications mentioned

• Communication of results to government Results of 3 out of 11 completed projects Sent to government

• Policy change Policy change expected in two

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MYANMARProposals and requests

• 22 proposals received

• 9 were completed proposals

• Assessment carried out on all aspects of 9 proposals

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RELEVANCE

• Proposals with high relevance - 9

• Proposals with average relevance -12

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EXAMPLES OF HIGH RELEVANCE PROGRAMMES

• Therapeutic efficacy of Myanmar traditional anti malarial drug (MTM-61-a) for treatment of uncomplicated p. Falciparum malaria

• Antibiotic sensitivity monitoring of bacterial diarrhoeal diseases in central Myanmar

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DESIGN

• Proposals with good design - 4

• Proposals with average design - 2

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EXAMPLES OF PROPOSALS WITH GOOD DESIGN

• Identification of different causal organisms of oral and respiratory diseases by saliva and sputum cytology

• Research on utilization pattern of traditional medicine in a rural community of Pymoo and Naungeho

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ETHICAL APPROVAL

• Total proposals – 22

• Proposals needing clearance – 20

• Proposals which contained component

of ethical clearance - 11

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ETHICAL CLEARANCE NOT NEEDED

Determination of in vitro anti TB activity of traditional medicine

formulations and plants

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RESULTS

Presentation at scientific meeting - 1

The problem of MDR-TB in HIV patients

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RESULTS

Publications - Nil

Findings sent to government - 1

• Study on assessment of physical and mental health of adolescents in various disorders

• Change in policy - not yet but expected

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THAILAND

• Proposals received- 6

• Completed projects- 2

• Ongoing projects - 3

• Proposal stage - 1

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RELEVANCE

High relevance – 2

• Role of health technology assessment evidence in decision making - human papilloma vaccine

• Continuing T B treatment upon being released from prison

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DESIGN

• Two proposals -very good

• Four proposals - adequate

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VERY GOOD DESIGN

• Role of health technology assessment in decision making

• An assessment of the thai national health research system

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THAILANDEthical Clearance

• 4 out of 6 proposals needed ethical clearance

• Only 1 proposal mentioned ethical clearance

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PROPOSAL FOR WHICH ETHICAL CLEARANCE OBTAINED

Continuing T B treatment after

release from prison

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ASSESSMENT

• Completion of projects – 2

Presentation at meetings

Results of both completed projects presented at meetings

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ASSESSMENT* Publications

no evidence of any publication

Results communicated to government - results of both projects sent to government

Policy change

policy change under consideration due to results sent to government

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OVERALL ASSESSMENT

Relevance – good

Design - could be better

Ethical clearance - very poor

Completion - large number of projects not completed

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OVERALL ASSESSMENT

Presentation at scientific meetings – low

Publications – low. More emphasis needed

Presentation of results to government- not adequate

Policy change - good reactions when results sent to government

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RECOMMENDATIONS

• Research methodology training courses

• Create awareness of need of ethical clearance in research proposals

• Presentation at meetings essential

• Publications should be made part of the project

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RECOMMENDATIONS• Summary reports to government to be

always sent

• Help needed to researchers for doing all this should be provided

• Documentation and data storage to be improved

• Regional Office and WR Offices could help in all three activities

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