INSTITUTIONAL MECHANISMS

1. UGANDA NATIONAL HEALTH RESEARCH ORGANISATIONHEALTH RESEARCH IN UGANDA: CRITICAL ROLEDR. SAM OKWAREDIRECTOR GENERAL UGANDA NATIONAL HEALTH RESEACH ORGANIZATION (UNHRO)UNACOH Annual Scientific Conference 24.09.09

2. INSTITUTIONAL MECHANISMS • Currently low priority, low funding; fragmented, disjointed without linkage to HSSP II or research priorities; • Need clear, defined, institutional linkages for contact and interaction and consensus building at sector national level; • Clear TOR, accountability and channels of communications between MOH and other Ministries; • Agree on mechanisms for conducting needs assessment, prioritization, planning, contracting research, M & E, dissemination. • Encourage ownership from community level to national level (UNHRO) and to regional level (REACH).

3. OBJECTIVES OF RESEARCH • Improve population Health, Equity and development – part of planning process; • Support evidence based policies and interventions. • Identify the gaps for improvement; • Improve the quantity and quality of interventions; • Be an effective agent of transformation; • Identify “make or break” factors that influence the effectiveness of interventions.

4. What Research? • Should be comprehensive: 1) Basic 2) Intervention/Clinical 3) Applied • Should improve interventions • Covers three major disciplines: • Biomedical research • Health systems research – interventions, policies, management, community initiatives etc • Behavioral research – socio-economic, cultural etc

5. STRATEGIC APPROACHES • Basic requirements: Political Commitment (H.E the President), and EAC Heads of State endorsed EARC with nodes in Kenya (KEMRI), Tanzania (NIMR) and Uganda ( UNHRO); WHO resolution: Paris 2008, Algiers 2009, Bamako 2009, Kigali WHO 59th Session AFRO, Sept 2009 endorsed setting up by MOH coordinating structures for ENHR; • Develop draft Essential National Health Research Strategy - related to HSSP; • Set up National research policies and agenda; • Involve a wide and inclusive array of stakeholders – (Researchers, health managers, civil society).

6. STRATEGIC APPROACHES cont. • Place equity at the centre of efforts to improve ENHR; • Set National health priorities – get consensus; • Integrate ENHR into HSSPII and National Development Plans (PEAP, NDP) • Monitor the move towards equity in Health.

7. IMPROVE HEALTH RESEARCH COMPONENTS • eg. – Research ethics • Research communication, including evidence to policy and practice • Community demands for research • M & E on impact • Health Systems research needs • Good research contracting • Technology transfer arrangements • Intellectual property rights • Institution building/motivation.

8. IMPROVING HEALTH RESEARCH SYSTEM • Human resources for Health Improvement – develop HRH strategy and plan. • Ensure stable and predicable research funding – align HSSP; donors, harmonize. • Strengthen collaborative arrangements and networking (dip., donors etc).

9. RESEARCH IMPLEMENTATION • Identify of resources by priority area. • Strengthen research protocol development – (training, incentives, brain drain, solicit TA). • Establish peer – review process – dynamic and responsive. • Develop mechanisms for M & E of research work.

10. MEASURING THE PROCESS • Does the Research Agenda address EQUITY in Health? • % no. of projects addressing problems of most vulnerable (MCH?) • Diversion of resources towards equity targeted progress( ? ) • Re-allocation of Resources for research Agenda/Priorities.

11. UTILIZATION OF RESEARCH RESULTS • Target: from research to policy/advocacy. • Strengthen dissemination of research findings (w/shops, publications, mass media, research rep • Dissemination research results to wider public . • Promote info.sharing, feedback to patients and communities. • Facilitate dialogue between researchers/policy makers. • Translate research results into policy briefs. Build Knowledge- Translation platforms • Identify indicators on Health status and Health care and Health Determinants (Resources, utilisation)

12. INDICATORS TO MONITOR RESEARCH AGENDA • Include also indicators on health care financing, allocation of resources, utilization of services, and quality. • Use multiple indicators to explore the way in which conclusions about equity vary according to different indicators.

13. CHALLENGES • Great potential for research but needs funding, enabling environment, increased partnerships; • Alignment and harmonisation of research in health sector inadequate; • Problems: HRH, incentives, training and retention, full time researchers; • Research output low judged by (publications, dissemination)? Info. Sharing weak; • Lack of capacity and skills to communicate findings by researchers ? “upgrade communication”. Website and LAN and networks • Low funding level – mainly external – address sustenance; • Weak communication infrastructure, networks, directories, data bases. • Uncoordinated resource mobilisation and advocacy at community, district and national level; • Weak international collaboration (active Versus passive).

14. National response:UNHRO • To evolve and enforce ethical code of conduct for health research in Uganda; • Coordinate all health research in the country; • Coordinate, align and harmonise Health Research in Uganda and Region; • Enforce National Research Policies and Research Priorities to support HSSP; • Develop a National Research Plan and Agenda; • Strengthen and Supervise health research work (process, output and quality); • Develop the National Health Research Capacity (i.e HRH Strategic plan, Infrustructure, documentation)

15. Specific Objectives contd. • Promote and improve stakeholder consultations, information sharing and consensus building, and up-grade research communications infrastructure (networking); • Monitor process and conduct of research and whether it responds to Equity and Safety of population (Human Experiments); • Strengthen International collaboration and mobilisation of Resources; WHO Algiers, Kigali declaration, 2009: 5% donor resorces and 2% national MOH budget be allocated to ENHR • Promote safety of clients and researchers (human experiments, and intl. propriety rights

16. Resource Mobilisation • Algiers Declaration - 2% of MOH Budget and 4% of Donor Budget for Health Research • Resolution by WHO/AFRO urged to strengthening health research. • Health systems reseach: 8Ms- man, money, materials, machines, methods, moment, message

17. CONCLUSION • Uganda has a favorable health policy environment but still in transition research to policy. • Well developed health research system available. • Reasonable mass researchers addressing health research priorities set out in the ENHR plan and HSSP. • Networking on going (national, international, regional) but should go further to communities. • Needed: coordination, Alignment, Harmonization

18. THANK YOU

25. MEASURING THE PROCESS cont. • Utilization: How much interest has the agenda generated among stakeholders (donors, GoU, and researchers). • Input from multiple stakeholders – who, how many involved. • Activity at Forum for sharing of information and evaluation of process by stakeholders.