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Operational Research. Stop TB Workshop on TB Proposal Preparation for Round 6 of the GFATM Amy Piatek Matteo Zignol Fabio Scano May 16, 2006. Outline. What is Operational Research? GFATM analysis of OR in approved grants/proposals Including OR in a GFATM proposal Service Delivery Area

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Operational research l.jpg

Operational Research

Stop TB Workshop on TB Proposal Preparation for Round 6 of the GFATM

Amy Piatek

Matteo Zignol

Fabio Scano

May 16, 2006


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Outline

  • What is Operational Research?

  • GFATM analysis of OR in approved grants/proposals

  • Including OR in a GFATM proposal

    • Service Delivery Area

    • Activities


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1. What is Operational Research?

  • Research into strategies, interventions, tools or knowledge which can enhance programme effectiveness.

  • Three themes of OR:

    • Lack of knowledge(What is the prevalence of TB in prisons?)

    • Lack of a suitable tool(Can secondary isoniazid preventive therapy reduce recurrent rates in HIV+ TB patients?

    • Inefficient use of tool(Can TB suspects be screened in a more efficient manner than current 3 smear system?)


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Guiding principles in setting an OR agenda

  • Define programme objectives

  • Identify constraints to reaching objectives

  • Ask research questions around constraints


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2. GFATM analysis of OR in approved grants/proposals

  • Analysis performed by GFATM (E. Korenromp)

  • Approved grants (round 1-4) and proposals (round 5) include OR, proposed OR topics and associated budgets

  • Looked at all components: TB, HIV, malaria, combined, HSS


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Approved proposals/grants with OR


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Approved proposals/grants with OR -- budgets

  • Budget devoted to OR was not separately specified (usually covered under M&E)

  • 17 (of 54) approved grants (all components) provided specific budget for OR

    • Median budget was $500,000 for a median of 5 years (range from $30,000 in DRC for 1 yr to $5 million in Tanzania for 5 yrs)


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Conclusions of analysis

  • Of all reviewed approved proposals/grants, only 11 TB proposals included OR.

  • Few have separate specified budget for OR.

  • Percentage of budget devoted to OR is lower than recommended by Global Forum for Health Research and WHO

    • Median of 2.7% of total budget devoted to OR; close to 5% when combined with M&E budget.


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Conclusions of analysis

  • While most proposals/grants with OR defined a specific research area or topic, not enough detail usually provided about the OR area.

  • Often not clear if ethical review is needed for OR project description. Not all had assurance for human research protections in place

  • Indicators and targets not always included or described fully to measure the extent and success of implementation of OR.


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OR topics in TB approved proposals/grants

  • TB epidemiology including prevalence surveys and repeat-surveys assessing programme impact

  • DOTS expansion, low detection rates among women, defaulter tracing, access to difficult-to-reach groups, costs

  • MDR-TB and second-line treatment

  • KAP among patients including perception of cough

  • Discrimination/stigma studies to inform IEC


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3. Including OR in a GFATM proposal

Why should OR be included in a GFATM proposal?

  • OR is one of the components of the Stop TB Strategy. Programme-based OR should be a component of NTP work.

  • OR is one of the strategic directions of the Global Plan to Stop TB, 2006-2015.

  • Strengthening capacity for OR within NTPs can contribute to strengthened general OR capacity in the country (HSS).


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OR included in past proposals

Gambia


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Rwanda


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How to include OR in the proposal for round 6?

**Include OR as a separate objective and include OR activities of all areas (TB/HIV, MDR-TB, etc) under this objective.**

Objective: To enable and promote programme-based operational research

Service Delivery Area: To develop and implement programme-based operational research

Activities: list activities (next slide)


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Activities corresponding to SDA on OR (planning framework)

  • Preparations to conduct OR

    • Focal person

    • Situational analysis or research capacity

    • Develop plan to build capacity and network

    • Develop OR plans

  • Training

    • In-service training

    • Research training workshop

    • Writing skills workshops


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Activities corresponding to SDA on OR

  • Implementation of OR projects

    • Assess logistics

    • Supervise and monitor implementation

  • Policy change and dissemination

    • Conduct annual review meeting

    • Publish results

  • Evaluation

    • Assess if OR capacity increased, influenced policy, improved performance

    • Papers for publication


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Reference material

  • The Global Plan to Stop TB, 2006-2010. WHO/HTM/STB/2006.35

  • Onyebujoh P, Rodriguez W, Mwaba P. Priorities in tuberculosis research. Lancet 2006; 367: 940-42.

  • TB/HIV Research Priorities in Resource-Limited Settings. WHO/HTM/TB/2005.355

  • Stop TB Working Group on DOTS-Plus for MDR-TB. A prioritised research agenda for DOTS-Plus for multidrug-resistant tuberculosis (MDR-TB). Int J Tuberc Lung Dis 2003;7(5):410-4.


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