Andy Ramsay (ramsaya@who.int) Overview of TDR February 2014 Andy Ramsay (ramsaya@who.int)

PHCPI The Primary Health Care Performance Initiative (PHCPI), proposes to act as a catalyst to mobilize low and middle income countries, as well as the community of donors and international organizations, to focus their health system strengthening efforts on delivering measurable progress in primary health care systems. It aims to explain the gap between aspiration and performance in PHC systems across the world. Then it can identify the causes of that gap and a menu of possible solutions to address these gaps.

The three questions…… What is happening in our public health programme? Is it what we want? Why is it happening like this?

“Our country is data rich but information poor” Minister of Health, Fiji

Public health programmes often not doing simple research that could improve performance and public health Professional researchers linking with public health programmes (and data) but research questions those of researchers

Global Research Capacity Gaps – Researchers per million inhabitants / Country

Structured Operational Research and Training Initiative Aims to help countries to: Conduct operational research (OR) in accordance with their own priorities Develop adequate and sustainable OR capacity in public health programmes; and Make evidence-informed improvements in public health programmes

SORT IT Programmes have 8 phases: 1 SORT IT Programmes have 8 phases: 1. Research prioritization and planning for capacity building 2. OR and training (protocol development to paper writing) 3. Dissemination 4. Research to policy briefs 5. Policy briefs to dialogues 6. Consolidation of gains made 7. Leadership development 8. Assessment

SORT IT Programmes have 8 phases: 1 SORT IT Programmes have 8 phases: 1. Research prioritization and planning for capacity building 2. OR and training (protocol development to paper writing) 3. Dissemination 4. Research to policy briefs 5. Policy briefs to dialogues 6. Consolidation of gains made 7. Leadership development 8. Assessment

SORT IT Programmes have 8 phases: 1 SORT IT Programmes have 8 phases: 1. Research prioritization and planning for capacity building 2. OR and training (protocol development to paper writing) 3. Dissemination 4. Research to policy briefs 5. Policy briefs to dialogues 6. Consolidation of gains made 7. Leadership development 8. Assessment

SORT IT Programmes have 8 phases: 1 SORT IT Programmes have 8 phases: 1. Research prioritization and planning for capacity building 2. OR and training (protocol development to paper writing) 3. Dissemination 4. Research to policy briefs 5. Policy briefs to dialogues 6. Consolidation of gains made 7. Leadership development 8. Assessment

SORT IT Phase 2 Workshop 1: [5 days] Research Protocol Data and analysis milestone 1 milestone 2 milestone 3 Workshop 3: [5 days] The Paper milestone 4

Total SORT IT OR training phases/courses) started: 37 Participants enrolled: 421 Countries: 82 Completed OR training phases/courses: 26 Participants enrolled on completed phases 305 Successful participants: 279 (91%) SORT IT papers submitted: 315 SORT IT papers accepted or published (7/3/16) 248 (91%) Published papers assessed for influence on P&P: 170 Self-reported influence on policy and practice: 110 (65%) Participants 2015 SORT IT 1-day skills training: 181

SORT IT Operational Research Project Sites (2009 – 2016) TOTAL: 421 participants, 82 project countries Europe 2 Moldova 2 Armenia 1 Georgia 1 Azerbaijan 14 Ukraine 1 Denmark 1 Estonia 2 Italy 2 Latvia 1 Switzerland 3 Belarus Asia 1 Singapore 6 China 72 India 3 Vietnam 8 Bangladesh 1 Mongolia 7 Pakistan 4 Cambodia 5 Afghanistan 19 Myanmar 6 Nepal 2 Kazakhstan 8 Bhutan 1 Turkmenistan 5 Sri Lanka 2 Kyrgyzstan 4 Uzbekistan 1 Timor Leste 3 Tajikistan 1 Indonesia 1 Malaysia South Pacific 3 New Caledonia 1 Cook Islands 2 Tonga 3 Marshall Islands 3 Federated States of Micronesia 2 Solomon Islands 2 Vanuata 25 Fiji 1 American Somoa 1 Somoa 1 Guam 4 Kiribati 2 Palau South America 5 Brazil 2 Peru 2 Mexico 1 El Salvador 1 Colombia 1 Dominican Republic 1 Guatemala 1 Honduras 1 Haiti Africa 6 Burundi 3 Botswana 1 Madagascar 1 Lesotho 26 Kenya 7 Swaziland 9 South Africa 4 Democratic Republic of the Congo 8 Ethiopia 4 Sudan 13 Malawi 3 Mozambique 11 Zimbabwe 3 Nigeria 1 Benin 2 Somalia 2 Somaliland 17 Sierra Leone 5 Rwanda 10 Liberia 5 Uganda 3 Guinea 2 Ghana 1 Ivory Coast 2 Tanzania 1 Zambia 3 Namibia 1 Mauritania Multi-Country 1 Africa/ Asia

Outputs from the first 8 trainings 88 papers assessed for policy and practice 65 (74%) made a difference Change in programme implementation N=27 Adaptation of monitoring tools N=24 Change in existing guidelines N=20 Some papers had more than one effect on policy and practice * Data are self-reported through a questionnaire Zachariah et al, TMIH 2014; 19: 1068-1075

Beyond the training…. Participants returning questionnaire 76 Completed research projects after the course 47 (62%) Published papers after the course 38 (50%) Facilitated at further operational research courses 33 (43%) *Data are self-reported through a questionnaire 83 successful participants completed the course: 76 (92%) returned questionnaire

Kenya Leads: Dr Rose J. Kosgei, Dept of Obstetrics and Gynaecology, University of Nairobi. Dr Joseph. K. Sitienei, Head, Division of Disease Control, Ministry of Health, Kenya

19/11/2018

SORT IT Programmes have 8 phases: 1 SORT IT Programmes have 8 phases: 1. Research prioritization and planning for capacity building 2. OR and training (protocol development to paper writing) 3. Dissemination 4. Research to policy briefs 5. Policy briefs to dialogues 6. Consolidation of gains made 7. Leadership development 8. Assessment

Country/sub-region RO Phase 1 Phase 2 Phase 3 Phase 4 Phase 5 Phase 6 Phase 7 E. Europe EURO X   C. Asia Latin America and Caribbean PAHO Southern Africa AFRO  X Myanmar SEARO Peru Pakistan EMRO Ukraine Kenya Sierra Leone Liberia Guinea Colombia Suriname

Thank-you