Epidemiological Researches in Egypt Dr.Abdelnasser Mohammed Ahmed Epidemiology & Surveillance unit director

Background  Egypt is passing through epidemiological and demographic transition phase  Extensive health care system  Research capacities(academic and service level)  Researches addressed both community and system problems  Increase awareness of need and use of research use  Increase efforts made by capacity building  Reform health system to meet population needs

Current Status A. Advocacy & Promotion  Increased awareness among scientific/academic community and service officials and professionals through: – Create a post for a vice-dean at each medical school for environmental affair responsible for linking university to its surrounding community. – Conduct workshops for orientation of senior service officials at MOHP

Current Status B. Priority setting  Develop a system for health promotion and provision of quality services.  Develop of human resources for health through equal distribution, continuing equation and economics of their employment.  Empower the concept of district health system approach.  Prevent and manage endemic parasitic diseases, particularly shistosmiasis  Prevent and manage chronic diseases especially heart diseases, hypertension, diabetes mellitus and renal diseases

Current Status C. Capacity Development  Assessment of the health needs at all levels of the health care system  Assessment of the most common health problems in Egypt and prioritization process.  Monitoring and evaluation of health research projects.  Satellite units for field applied research at almost each governorate 2 Programs adopted at personnel capacity level:  2 Year course in field epidemiology for field practice to identify problems and carry out a research project.  Annual 2 week course on health system research with intervening periods for homework and ending with 3-4 research proposals.

Current Status D. Networking  Organization of national and local conferences and seminars.  Preparation in regional and international conferences and seminars.  Creating links with internet/Medline at almost all research institutions  Strengthening the local network established at the academy of science and technology.  Acknowledgment of the role of non governmental organization in the research.  Establishment of health information system network at governorate level to collect,process and analyze health data related to all health services and programs

Current Status E. Financing and Evaluation  Most bilateral health projects allocate an appreciable proportions of their funds for research.  The government funds allocated to the Ministry of higher education and scientific research have been almost doubled during the current financial year.  Evaluation of developmental research projects for relevance, methodology, interpretation of results and timeliness of providing needed information.  Evaluation of the extent to which results of research are utilized.

Current Status F. Research Activities  Nation wide research on maternal mortality  Household survey of management of children with diarrhea and acute respiratory infections in Egypt  Nation wide community based research on Hepatitis C and B incidence and risk factors  Nation wide community based study to measure prevalence, incidence and mortality rates of shidtosomiasis  National survey of tuberculosis.

Current Status F. Research Activities, cont  Health system research  Maintainace of hospital equipment  Control of infection in dental clinics  Evolution of training output of medical team  Control of smoking in children.  Research on heart diseases using different levels of screening tests.  National survey of maternal and child health related morbidity and mortality.  Family planning researches

Current Status G. Research utilization  Using situational analysis survey in formulation of national master plan for health sector reform  Integration of PHC/reproductive health services based on findings of community based research conducted by MOHP researcher team  Development of new projects to reformulate / strengthen district health management system.

National institutes deals with health researches in Egypt A.Ministry of health and population  Center for field and applied research  Started as a training center then engaged in operational research related to health delivery  Its activities related to priority health problems and environmental impacts.  In 1997, a health system was created within the center to support decision- making mechanism and planning of cost effective studies and development of health management indicators  Advocacy of NGOs and community mobilization  National specialized councils:  Established 20 years ago to provide venue for high expertise to work together in areas of common interest  Study how to improve health policy and utilization of health services.  Dissemination of information to better serve decision-making

National institutes deals with health researches in Egypt A.Ministry of health and population  National institute for nutrition Promote research in the area of nutrition  Field Epidemiology Training Unit:  2 year training program for physicians and public health officials  Training in Epidemiology, biostatistics, computer use in public health together with extensive fieldwork  Designing and implementing field studies of different nature  Nasser Institute Hospital for treatment and research: Harbor medical specialists and centers for excellence  National Institute of Diabetes mellitus and endocrinology: Includes hospital for research  Poliomyelitis institute

National institutes deals with health researches in Egypt B. Ministry of Higher and Scientific Research  Medical Research Institutes:  Institute of Theodore bilharz  Institute of ophthalmology  National center of research  High institute of public health and medical research  Local universities: Serve as a good medium for research activities  Medical Research Council of the National academy of science, research and technology:  National needs assessment  Pritorization process  Research capacity  Budget for contract research  Monitoring and evaluation mechanisms  Academy of scientific research and technology:

National institutes deals with health researches in Egypt C. Population Research Institutions  National Population council:  Carry out researches related to population  Help the Egyptian government to achieve national population policy  Study important issues affect efficiency and effectiveness of population programs  Cairo demographic center  Population Council

National institutes deals with health researches in Egypt D. Professional non-governmental organizations – Egyptian community medicine association – Egyptian medical women association – Egyptian breast milk friends association – Egyptian fertility society – Society for health research for development

Implementation plan for situational analysis of health research activities  Formulation of executive committee:  Coordinate activities of situational analysis  Assign tasks to implement the plan  Arrange meeting/workshop  Prepare questionnaires/interview items  Surveying health research centers and institutes:  Collect basic information about researches capacity  Analyze data  Develop a manual identify organizations in research  Studying status of health researcher:  Investigate challenges facing researches, documentation, training, information accessibility and financing sources  Analyze data collected on status of health  Report findings to policy makers

Implementation plan for situational analysis of health research activities, cont  Exploring health research key stakeholders opinion for research pritorization:  Interview key stakeholders for policy makers  Identify problems of research needs utilization  Assess involvement of civil society  Exploring research opportunities

Action plan  Conduct seminars, meetings to build consensus for research:  Invite all stakeholders involved in research  Discuss findings of situational analysis  Consensus building on national health policies  Develop agreed national health policies into operational strategies  Recommend a mechanism to pritorize and coordinate research  Establish national health research data bank:  Invite all stakeholders in researches  Use findings of survey of institutes  Develop software for data storage contain basic information for research  Develop electronic copies of software to be available for health researchers  Recommend a mechanism to guarantee sustainable updates of these data and software

Action plan, Cont  Create the culture of research among health professionals:  Advocate to incorporate training on research methodology  Develop training curriculum about health research  Train health professionals on health research

Future Plan  Strengthen health research priority setting at sub national and district level  Involve non governmental organizations and private sector in policy making  Dialogue and partnerships between research procedures and potential consumers need to be strengthened  Better description, analysis and assessment of different coordination mechanisms

Future Plan, Cont  Maintain a balance between basic, clinical and health system research  Maintain available systematic information and strong health management information system  Networking model to support and organize regular consultative meetings and assist powerful databases that would benefit in many researches.