By Professor Ranjit Roy Chaudhury WHO-SEA ACHR BANGKOK 12 October Quality of Research Supported by SEARO in countries of the Region

PROPOSALS AND REPORTS REVIEWED  BANGLADESH – 15  INDIA - 23  MYANMAR - 22  THAILAND - 06 A total of 66 projects and reports 2

CRITERIA FOR EVALUATION  Relevance of project to the national health priorities  Quality of design of proposal  Whether ethical clearance requested  Completion of project 3

CRITERIA FOR EVALUATION  Presentation of results at meetings  Publication of results of research  Communication of results to government  Policy change if any caused by research 4

QUALITY OF DESIGN  Objectives of study  Hypothesis  Methodology  Expected outcome 5

OVERVIEW OF ASSESSMENT FOR ALL FOUR COUNTRIES  RELEVENCE OF PROPOSAL - High Relevance  DESIGN – Many projects well designed - Always room for improvement  ETHICAL CLEARANCE – Poor awareness - Need for improvement in all countries - 14 out of 66 proposals did not need clearance - Only 18 out of 52 proposals mentioned the need for approval 6

OVERVIEW OF ASSESSMENT WITH THIS LIMITED INFORMATION  COMPLETION OF PROJECTS – A large number of projects had not been completed  PRESENTATION OF RESULTS AT MEETINGS – This was low - Needs improvement  PUBLICATIONS FROM RESEARCH – More emphasis needs to be placed on this - Generally poor 7

OVERVIEW OF ASSESSMENT  CHANGE IN POLICY - Of the 22 completed projects results of 5 sent on to the government - Change of policy in place from 4 of these - Very encouraging 8

WEAKNESSES IN THE STUDY * In spite of all efforts proposals and reports of projects supported by SEARO could only be obtained from 4 countries * No proposals received from Indonesia, Nepal and Sri Lanka * Possible that information sent to SEARO was incomplete or not up to date * Every effort was made to obtain up to date information * Appears that improvement needed in information storage and retrieval 9

RESULTS Presented country wise Not meant to be a comparison between countries Objective is to learn where strengthening is needed Concentrate in future on these areas 10

PROPOSALS 66 project proposals received 24 project details complete in all respects All projects were assessed according to information provided 11

BANGLADESH 15 Proposals received All were only at proposal stage Assessment was therefore possible only for –  - RELEVANCE  - DESIGN  - ETHICS 12

BANGLADESH  RELEVANCE All proposals were relevant to needs and prriorities of country 5 out of 15 were highly relevant 13

EXAMPLE OF HIGHLY RELEVANT PROPOSALS Prevalence on injury related disability in manikgunj district of bangladesh Study to measure the intensity and incidence of catastrophic health care costs and impact on family budgets Therapeutic efficacy of artemether in falciparum malaria 14

BANGLADESH  DESIGN OF PROPOSALS Quality of design found to be good in 14 proposals Improvement in design possible 15

BANGLADESH  ETHICAL CLEARANCE 2 out of 15 proposals did not need ethical clearance 8 out of 13 proposals needing clearance mentioned this in their proposal 16

PROPOSAL WHICH DID NOT NEED ETHICAL CLEARANCE Fiscal space assessment of Bangladesh health, nutrition and population sector 17

INDIA 23 proposals were received 18

INDIA  RELEVANCE 8 proposals were found very relevant 9 proposals were also relevant In total 17 out of 23 were relevant to the needs of the country 19

INDIA  Examples of high relevance studies Validation of haemoglobin colour scale for haemoglobin estimation Estimation of malaria disease burden in Jharkhand Community based interactions study for cardiovascular risk reduction in Kerala 20

INDIA  DESIGN Well designed proposals - 7 Average but acceptable design - 8 Design poor and improvement needed

INDIA  ETHICAL CLEARANCE 17 out of the 23 proposals needed ethical approval 4 proposals mentioned ethical clearance in proposal Could be that clearance was taken later 22

INDIA  Examples of proposals which did not need ethical clearance Market study of alternatives of mercury measuring devices in health care in India Feasibility study to develop healthy work place in the industrial settings in Chandigarh 23

INDIA Presentation of results at meetings 2/11 studies presented Publication of results No publications mentioned Communication of results to government Results of 3 out of 11 completed projects Sent to government Policy change Policy change expected in two 24

MYANMAR  Proposals and requests 22 proposals received 9 were completed proposals Assessment carried out on all aspects of 9 proposals 25

RELEVANCE Proposals with high relevance - 9 Proposals with average relevance

EXAMPLES OF HIGH RELEVANCE PROGRAMMES Therapeutic efficacy of Myanmar traditional anti malarial drug (MTM-61-a) for treatment of uncomplicated p. Falciparum malaria Antibiotic sensitivity monitoring of bacterial diarrhoeal diseases in central Myanmar 27

DESIGN Proposals with good design - 4 Proposals with average design

EXAMPLES OF PROPOSALS WITH GOOD DESIGN Identification of different causal organisms of oral and respiratory diseases by saliva and sputum cytology Research on utilization pattern of traditional medicine in a rural community of Pymoo and Naungeho 29

ETHICAL APPROVAL Total proposals – 22 Proposals needing clearance – 20 Proposals which contained component of ethical clearance

ETHICAL CLEARANCE NOT NEEDED Determination of in vitro anti TB activity of traditional medicine formulations and plants 31

RESULTS Presentation at scientific meeting - 1  The problem of MDR-TB in HIV patients 32

RESULTS Publications - Nil Findings sent to government - 1 Study on assessment of physical and mental health of adolescents in various disorders Change in policy - not yet but expected 33

THAILAND Proposals received- 6 Completed projects- 2 Ongoing projects - 3 Proposal stage

RELEVANCE  High relevance – 2 Role of health technology assessment evidence in decision making - human papilloma vaccine Continuing T B treatment upon being released from prison 35

DESIGN Two proposals -very good Four proposals - adequate 36

VERY GOOD DESIGN Role of health technology assessment in decision making An assessment of the thai national health research system 37

THAILAND  Ethical Clearance 4 out of 6 proposals needed ethical clearance Only 1 proposal mentioned ethical clearance 38

PROPOSAL FOR WHICH ETHICAL CLEARANCE OBTAINED  Continuing T B treatment after release from prison 39

ASSESSMENT Completion of projects – 2  Presentation at meetings Results of both completed projects presented at meetings 40

ASSESSMENT *Publications no evidence of any publication  Results communicated to government - results of both projects sent to government  Policy change policy change under consideration due to results sent to government 41

OVERALL ASSESSMENT  Relevance – good  Design - could be better  Ethical clearance - very poor  Completion - large number of projects not completed 42

OVERALL ASSESSMENT  Presentation at scientific meetings – low  Publications – low. More emphasis needed  Presentation of results to government- not adequate  Policy change - good reactions when results sent to government 43

RECOMMENDATIONS Research methodology training courses Create awareness of need of ethical clearance in research proposals Presentation at meetings essential Publications should be made part of the project 44

RECOMMENDATIONS Summary reports to government to be always sent Help needed to researchers for doing all this should be provided Documentation and data storage to be improved Regional Office and WR Offices could help in all three activities 45