“Scaling up of HIV/AIDS Prevention in India; Access, Affordability and Priority Setting”

 

This program of work focuses on the area of economic and health system analysis of HIV prevention interventions.  It will allow the applicant to expand her research in looking at broader access issues and work in North Eastern India among intravenous drug users. India is a developing country, with a growing HIV epidemic situation. Despite many donor and government initiatives, there are insufficient funds to implement all the desired interventions for HIV prevention and treatment. It is important to consider costs and other factors for priority-setting.  On the access side, vulnerable groups such as women, including sex workers, are the most marginalized and are often the intended beneficiaries of such programmes. There is an urgent need to understand the constraints involved in accessing services, including both health system and cultural and social variables such as stigma. 

 

Through this proposed program, the applicant will become proficient in the conduct of research based on health economics principles and contribute to the development of health economics field in her home institution and country.

 

 

“Strengthening Capacities in Research Ethics in Honduras”

 

Increasingly, research cooperation has become internationalized and has crossed geographical borders and cultural boundaries. This globalization of research, especially when carried out in LMICs under the scientific and financial control of developed nations, has revealed the vital need for constant dialogue to address power issues. Ms. Vilma Espinoza has identified issues specifically related to challenges in biotechnology and ensuring responsible and balanced approaches to global governance in research ethics. Her background in microbiology and bioethics has prepared her to address these challenges in research policy and practice.

 

Strengthening research ethics capabilities in Honduras, and in particular at the National Autonomous University of Honduras (UNAH) is the focus of Ms. Espinoza’s research. The existing UNAH Directorate of Scientific Research lacks policies regarding research with human and animal subjects. The current reform process at UNAH seeks to establish a new culture of good governance and high ethic standards. Currently, there is no plan to formulate research ethics policies and a mandatory ethics review process. The present proposal aims to influence policy for the ethical conduct of research activities at UNAH and in Honduras.

 

Ms. Espinoza hopes to strengthen ethics competencies of researchers and research users as well as empower individuals and groups selected as research participants. She will design and implement a program of knowledge transfer and capacity building, implement policy at UNAH and promote its adoption at other organizations, as well as establish an Institutional Review Board.

“Strengthening of Tobacco Control in Georgia through

Multidisciplinary Studies and Advocacy Campaign”

 

The objectives of this program are to 1) Improve knowledge and skills in leadership and fields related to tobacco control; 2) Study mortality and morbidity associated with tobacco consumption in Georgia; 3) Analyse the efficiency of tobacco control legislation and enforcement; 4) Conduct a needs assessment of executive structures for tobacco control implementation; and 5) Develop an advocacy plan for tobacco control interventions in Georgia.

 

The program foresees training, research and advocacy efforts on tobacco control in Georgia. Around each study and advocacy campaign multidisciplinary working groups will be formed. Meta-analysis, based on the existing data, and also observation and qualitative studies on the issues in which primary data does not exists will be carried out. Policy briefs will be prepared following completion of data collection. Summary reports on tobacco control and programs of multisectoral interventions will be developed and discussed with various stakeholders. The integrated advocacy plan includes distribution of reports, policy briefs, organization of meetings, discussions, working with mass-media.

 

“Strengthening Maternal Child Health in Rural Uganda”

 

Consistently high rates of maternal and infant mortality remain a concern in Uganda. Translating national policy in maternal and child health to the most vulnerable groups in rural communities remains a challenge for health professionals. Dr. Jerome Kabakyenga recognizes the need for dynamic leadership in crafting innovative research and creative implementation of evidence-based community interventions. He hopes to provide leadership in maternal and child health issues nationally and regionally in sustainable, cost-effective, replicable, evidence-based research, training, advocacy and service in Uganda.

 

Dr. Kabakyenga is Dean of the Faculty of Medicine at Mbarara University of Science and Technology (MUST). He is also the co-director of child health and HIV / AIDS projects implemented in south western Uganda. His experience has enabled him to operate in a leadership role in health professions such as education, and research and program implementation in maternal child health and HIV / AIDS.

 

The focus of Dr. Kabakyenga’s research is the interface of health policy and its implementation in regards to maternal child health. He is particularly interested in maternal and newborn care and survival. He hopes to use his leadership background to mentor researchers to effectively apply research in both health services and health professional training.

“Towards the Establishment of a National Health Research System in Bolivia”

 

Bolivia, with its high rates of social exclusion, its inequities in the incidence and prevalence of both mortality and morbidity, occupies first place in the indicators of inequality and poverty in Latin America. Health research has had little impact on these problems because researchers are not linked to policymakers and efforts are not coordinated. Compounded by chronic institutional crisis in the health sector, Bolivia is not meeting the national goals for the Millennium Development Goals. Thus, it is important to establish permanent structures and processes to support health research that meets national priorities and informs policy to respond to health needs and improve population health.

 

The objective of this program is to develop the capacity of one person to assume a leadership role in developing a national health research system. Dr. Ledo will examine and analyze various systems in Latin America and Canada with the goal of identifying institutional structures and management processes most relevant to Bolivia. Via study visits to Canada and three Latin American countries, she will propose structures and policies to an advisory group in Bolivia. This group will meet periodically to orient Dr. Ledo’s professional development, review  results, and make key decisions regarding research priorities, transparent processes for funding, funding management requirements, ethical considerations, strengthening training and retention and a process for communication or research results, will be defined by the end of the second year. Dr. Ledo will be positioned to play the coordinating and leadership role in the management and financing of health research. The funding of this proposal will allow for replacement pay for Dr. Ledo’s teaching and programmatic functions. The plan will be presented to the Ministry of Health in alliance with Departmental Health Services and key NGOs, and universities, in order create the basis for implementing a health research entity that is politically independent but accountable to the government.

“Bridging the Gap Between Evidence and Action: Capacity Building and Advocacy Project to Face the Chronic Disease Epidemic in Colombia”

 

Colombia is progressing through demographic and epidemiological transitions, with chronic diseases (CD) as the leading causes of mortality, causing premature deaths and significant social and economic burdens. The effect that socio-economic causes and environmental and policy interventions have on CD has recently been recognized. Despite this evidence, these diseases are neglected and there is a growing epidemic in the developing world. To deal with this public health problem, it is necessary to use knowledge, appropriate advocacy initiatives and establish coalitions with a multidisciplinary perspective and non-traditional partners.

 

Within a capacity building based framework, specifically from the point of view of the problem solving capability dimension, the core components of the work in this program will be focused on improving access to training, establishing links between researchers, practitioners and policy makers, generating knowledge of socio-economic determining factors, as well as policy and environmental interventions to prevent CD, conducting advocacy initiatives, supporting effective policy development in Colombia and contributing to organizational planning. This project will provide an appropriate context for the development of sustainable skills, structures and resources and increase the effectiveness of national interventions to prevent CD.

 

“Strengthening the Public Health Delivery System in the Turks and Caicos Islands”

 

The population growth in the Turks and Caicos Islands (TCI) has accelerated the pace of environmental, demographic and social change, which if left unmanaged, could have serious ecological and public health consequences. Two economic mainstays (fishing and tourism) depend on TCIs only natural resources, fishing and aesthetic beauty. Seafood is also the only local food source, reportedly consumed at least three times/week. Therefore, public health infrastructure must be strengthened by capacity building of key local personnel within the Ministry of Health to network with national and international partners. This would provide evidence-based research and technical expertise to inform policy to ensure the viability of the fishing industry and maximize health of TCI human capital.

 

The proposal supports a program of training, research and collaboration/networking with partners to acquire the necessary skills and expertise, to address this deficit. Also to conduct epidemiological investigations of significance to public health and fisheries in the areas of emergent and chronic diseases, and nutrition as follows: Investigate knowledge, attitudes and practices regarding risks and benefits of seafood; Develop disease registries and surveillance systems for seafood poisonings; Conduct epidemiological surveys of seafood consumption and seafood poisonings; Contribute to the development of local fishing and natural resource management laws and policies and support international conventions on environmental pollution and fishery management e.g., mercury; amongst others.

 

“Mentorship for Tobacco Control Research in Argentina”

 

Over a third (33%) of adult Argentines smoke, making tobacco control the most significant public health problem in Argentina. A growing number of young investigators are interested in tobacco control research, but developing a cohort of well-trained researchers in this complex field is difficult, as it requires integration of expertise from multiple disciplines.          While the concept of mentoring is new to Latin American researchers, the idea of a “role model” is familiar, so mentoring has the potential to be used in Argentina and in the region to develop research capacity.  Mentoring is an effective way to disseminate the necessary skills and knowledge from an experienced researcher to less experienced investigators, and to facilitate the development of a supportive research environment capable of producing studies that can inform decision makers.

This award will allow the applicant to create and direct a new mentored research program, the Argentine Tobacco Research Program, which will help develop a new generation of researchers and policy leaders in the field. Through this program, the applicant will improve his own capabilities in research leadership and management so as to allow him to become a regional asset in tobacco control research. This training program will focus on research in the local determinants of tobacco consumption and in the effectiveness of anti-tobacco initiatives. This program will also emphasize transfer of knowledge and the graduates will participate in the generation of national health policies with the objective to reduce the absolute smoking prevalence by at least 5% in 2015. The Argentine Tobacco Research Program will also strengthen the ties between local institutions, so that a multidisciplinary perspective can inform the scientific skills of future generations of researchers. Dr. Mejia will collaborate with other senior investigators to ensure effective mentorship and disseminate his skills, in a ‘teach-the-teachers’ model. The combination of direct mentoring by Dr. Mejia and the establishment of the Argentine Tobacco Research Program will increase the number of qualified smoking-related researchers in Argentina and work toward providing a strong evidence-base for the development of sound tobacco control policies.

 

“Experimentation with a Modular Approach for Providing Obstetrics and Gynaecology Training to General Practitioners”

 

To combat maternal mortality, which can be blamed in large part on the shortage of emergency obstetrics care (EOC), Senegal has introduced a strategy for delegating obstetrical surgery responsibilities to general practitioners in remote areas. That strategy faces some constraints, because of the uncertain career prospects for these doctors declared « competent in EOC ». Consequently, there are not enough candidates subscribing to this initiative, and the doctors who receive training lack motivation. In order to breathe new life into this strategy and make it more attractive, the Ministry of Health, in partnership with the University, is planning to offer these physicians training that will qualify them as gynaecologists and obstetricians. The proposed research program will help make this new opportunity operational by experimenting with a modular training and coaching strategy that will provide training of the same quality as that offered through conventional training in the OB/GYN specialty.

The specific objective of this program is to strengthen the capacities of the grant recipient to establish, monitor, and evaluate innovative health policies that will make available qualified human resources for combating maternal and infant mortality.

 

“Building Sustainable Capacities for Knowledge Translation and Transfer Activities for Better Health in Central Africa”

 

In 2004, the World Health Organization (WHO) launched the Evidence Informed Policy Networks (EVIPNet) Initiative, aimed at bridging the gap between research evidence and public health action in developing countries. Following this mandate, Dr. Pierre Ongolo-Zogo seeks to enhance Knowledge Translation and Transfer Activities (KTA), a priority for development actors striving to achieve health-related Millenium Development Goals (MDGs).

 

A Cameroonian M.D., Dr. Ongolo-Zogo has witnessed the insufficient use of health technology assessments resulting in uneven distribution of health technologies to poorer populations. He has extensive experience, including team leader for EVIPNet in Cameroon and Director of Division of Health Operations Research for the Ministry of Public Health. Through these experiences he has engaged in developing health policy, monitoring and evaluation.

 

The project aims to link research evidence to policy and practice in the health system, particularly health organizations. The purpose is to support the health care system in Cameroon to respond appropriately to the growing burden of chronic illness, such as non-communicable diseases (NCDs) and AIDS. Dr. Ongolo-Zogo hopes to create a Knowledge Translation centre thatwill build sustainable capacities for KTA for better health in the Central African sub region.

 

“Social Control, Human Rights and Governance: a Health Promotion Approach to the Reduction of Health Risks Associated with Pesticide use in Carchi, Ecuador”

 

With previous experience as a researcher in agriculture and human health, Dr. Fadya Orozco Terán hopes to continue this path and train to become a social epidemiologist. Through the construction of a health promotion model, she plans to explore determinants that influence an increase in hazardous pesticide use among small-scale Ecuadorian Andean community farmers.

 

Dr. Orozco Terán is interested in social determinants in health and their application to social change. She hopes to become a social epidemiologist that consolidates leadership of trans-disciplinary research teams in partnership with research institutions, universities, public organizations and NGOs.

 

Dr. Orozco Terán’s research is directed at promoting a stronger governance process, and to attain farmers’ rights. Using a health promotion framework, she seeks to increase farmer members’ empowerment as citizens, using social accountability of health and agricultural societal actors. These efforts will help reduce the health impacts associated with highly hazardous pesticide use and inappropriate management in Carchi’s agro-ecosystem. 

 

“Enhancing Capacity for Evidence-Informed Health Policy in Chile and Latin America”

 

A major frustration facing those interested in health in poor countries lies in the gap between what is already known about how to respond to particular health problems and what is actually done in practice. One of the reasons for this gap is the failure of policymaking processes to take into account research evidence about effective technologies and optimal governance, financial and delivery arrangements within health systems. The proposed program of work intends to enhance capacity for the generation and use of HPSR evidence in policymaking about health systems in Chile and other countries in Latin America (particularly Bolivia and Paraguay).

 

This proposal will establish a research program in knowledge translation in policymaking environments focused on the production and packaging of high-priority systematic reviews of HPSR and on the evaluation of evidence-to-policy partnerships; Establish a Regional Centre for Evidence-Informed Policymaking that builds on the current Methodology Centre for Systematic Reviews in HPSR in LMIC and that targets Latin American countries; Supports the establishment of knowledge-translation platforms to improve the use of research evidence in policymaking.

 

“Improving Equity and Efficiency of Health Systems in Latin America: Bridging Research and Policy in Health Resource Allocation by Strengthening Capacity and Application of Health Technology Assessment and Economic Evaluations”