In this study, researchers investigated the alignment of health research capacity at Makerere College of Health Sciences (MakCHS) with the health needs and priorities of Uganda, as outlined in the country’s Health Sector Strategic Plan (HSSP). They assessed MakCHS’s research grants and publication portfolio, as well as all the university’s publications, between January 2005 and December 2009. A total of 58 active grants were identified, of which 18 had been initiated prior to 2005 and there were an average of about eight new grants per year. Most grants funded basic and applied research, with major focus areas being HIV and AIDS (44%), malaria (19%), maternal and child health (14%) and tuberculosis (11%). A total of 837 publications were identified, with an average of 167 publications per year, 66% of which addressed the country’s priority health areas, and 58% had MakCHS faculty members or students as first authors. Findings indicate that the research grants and publications at MakCHS are generally well-aligned with Ugandan Health Ministry priorities. Greater efforts to establish centralised and efficient grants management procedures are needed, the researchers argue. In addition, efforts are needed to expand capacity for MakCHS faculty leadership of grants, as well as to continue to expand the contribution of MakCHS faculty to lead research publications.
Monitoring equity and research policy
In this study, reproductive-age women were recruited from the Butajira Demographic Surveillance System (DSS) database to analyse the determinants of fertility in rural Ethiopia. A district health survey maternity history questionnaire was administered to 9,996 participants. Results showed that delayed marriage, a higher level of education, a smaller family, absence of child death experience and living in food-secured households were associated with a smaller number of children. Fertility was significantly higher among women with no child-sex preference. However, migration status of women was not statistically significant. The researchers argue that policy makers should focus on increasing women’s secondary school enrollment and age at first marriage. The community should also be made aware on the negative impact of fertility on household economy, the environment and the country's socio-economic development at large.
The World Intellectual Property Organisation (WIPO), in conjunction with the World Health Organisation, private sector and foundation partners, is preparing to launch a new voluntary database for the sharing of intellectual property for research and development (R&D) on medicines, vaccines and diagnostics for neglected diseases. The project will target least-developed countries and is likely to include a database and a space for creating partnerships. But budget, oversight and the role of member states are still unclear. The aim of the initiative is to boost discovery and development of medicines, vaccines and diagnostics for neglected tropical diseases plus malaria and tuberculosis through greater availability of intellectual property to researchers.
The World Intellectual Property Organisation (WIPO) has joined the Research4Life partnership, which enables free or low-cost online access in the developing world to vital scientific research. With a particular focus on applied science and technology, Access to Research for Development and Innovation (ARDI) seeks to reinforce the capacity of developing countries to participate in the global knowledge economy and to support researchers in developing countries in the innovation process to create and develop new solutions to technical challenges faced on local and global levels. ARDI includes a growing network of Technology and Innovation Support Centres (TISCs) based in universities and research centres around the world, whose trained staff support local users in effectively accessing and exploiting technological knowledge.
Mahmood Mamdani, director of Makerere University's Institute of Social Research in Uganda, has accused universities in Sub-Saharan Africa of not creating researchers but churning out native informers for national and international non-governmental organisations. Addressing academics and students at Makerere, Mamdani said academic research and higher education in most African universities is controlled and dominated by a corrosive culture of consultancy. The little research capacity that exists in Africa, especially in universities, is driven by culture of consultancy and global market trends, with African researchers being used to provide raw material - in form of data - to foreign academics who process it and then re-export it back to Africa. He told his audience that research proposals from African universities are increasingly simply descriptive accounts of data collection and the methods used to collate data. According to the United Nations Educational Scientific and Cultural Organisation (UNESCO), Africa is home to only 2.3% of the world's researchers.
There remains considerable disconnect between globalisation scholars about how to conceptualise its meaning and how we understand how its processes operate and transform our lives. The authors of this article argue that to better understand what globalisation is and how it affects issues such as global health, we can explore how the multiple processes of globalisation are encountered and informed by different social groups within particular contexts. The article reviews how qualitative field research assist in doing this. Three recent case studies conducted on globalisation and HIV and AIDS are reviewed for their use of qualitative methods in understanding the contexts and processes of globalisation and their impact on health.
In this paper, the author considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. He identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them, before outlining some analytical tools of operational research and management science and illustrating how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.
According to this report by UNESCO, in sub-Saharan Africa, social science themes have over the years evolved from topics such as structural adjustment, poverty, gender, the spread of armed confl icts, and HIV and AIDS to more recent concerns such as citizenship and rights in an era of crisis, and the response to neoliberalism. The big challenge, however, is to reconstruct autonomous social science research in Africa. But as the Council for the Development of Social Science Research in Africa (CODESRIA) points out, the lack of a research infrastructure prevents social scientists from contributing as much as they could to these social endeavours. In low-income countries, the increasing role of consultancy firms and NGOs in social science research follows the relative or absolute shrinking of public funds allocated to universities, for research in general and for the social sciences in particular. In such conditions, academics rarely have the chance of working on long-term projects involving strong theoretical considerations. The report also points to the corrosive effect of the ‘brain drain’ on research in low-income countries and acknowledges many of these countries have instituted measures to help retain professionals, but the efficiency of these measures remains limited as long as working conditions do not improve significantly.
In 2008, Makerere University began a radical institutional change to bring together four schools under one College of Health Sciences. This paper’s objective is to demonstrate how the University’s leadership in training, research and services has impacted health in Uganda. Data were collected through analysis of key documents; systematic review of MakCHS publications and grants; surveys of patients, students and faculty; and key informant interviews of the College’s major stakeholders. The researchers found that the University inputs to the health sector include more than 600 health professionals graduating per year, many of whom assume leadership positions. University contributions to processes include strengthened approaches to engaging communities, standardised clinical care procedures and evidence-informed policy development. Outputs include the largest number of out-patients and in-patient admissions in Uganda. Outcomes include an expanded knowledge pool, and contributions to coverage of health services and healthy behaviours. Pilot projects have applied innovative demand and supply incentives to create a rapid increase in safe deliveries (three-fold increase after three months), and increased quality and use of HIV services with positive collateral improvements on non-HIV health services at community clinics.
The Ghanaian government’s strategy on orphans and vulnerable children (OVCs) recommends they should be encouraged to live in their home communities rather than in institutions. The paper presents lessons here on efforts to use research to build a response across different agencies to address the problems that communities and families face in caring for these children in their communities. This approach to building consensus on research priorities points to the value of collaboration and dialogue with multiple stakeholders as a means of fostering ownership of a research process and supporting the relevance of research to different groups. The authors argue that if the context within which researchers, policy makers and stakeholders work were better understood, the links between them were improved and research were communicated more effectively, then better policy making which links across different sectors may follow. At the same time, collaboration among these different stakeholders to ensure that research meets social needs, must also satisfy the requirements of scientific rigour.