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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

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

Amy Piatek

Matteo Zignol

Fabio Scano

May 16, 2006


  • What is Operational Research?

  • GFATM analysis of OR in approved grants/proposals

  • Including OR in a GFATM proposal

    • Service Delivery Area

    • Activities

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?)

Guiding principles in setting an OR agenda

  • Define programme objectives

  • Identify constraints to reaching objectives

  • Ask research questions around constraints

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

Approved proposals/grants with OR

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)

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.

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.

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

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).

OR included in past proposals



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)

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

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

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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