1. UGANDA NATIONAL HEALTH RESEARCH ORGANISATION HEALTH RESEARCH IN UGANDA: CRITICAL ROLE DR. SAM OKWARE DIRECTOR 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: i) Biomedical research ii) Health systems research – interventions, policies, management, community initiatives etc iii) 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 59 th 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

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.