Всемирная организация здравоохранения (ВОЗ / WHO) · Meeting reports

Report on the workshop on research management, Islamabad, 4-14 April, 1981

31 декабря 1981 г. Всемирная организация здравоохранения

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May 1 9 8 1

WORKSHOP ON RESEARCH MANAGEMENT Islamabad, 4 - 1 4 A p r i l 1 9 8 1

The views expressed in this report do not necessarily reflect the official policy of the World Health Organization.

EM/RSR/16 EM/MG/3 EM/wKP.RCH.MGT/~ page i TABLE OF CONTENTS

page I INAUGURAL SESSION 1

I1 WORKING SESSIONS Session 1 Session 2 - Status of Medical Research in Member Countries Session 3 Session 4 2

- Need

and Importance of Medical Research and Planning

2 3 5 7 9

- Management

Session 5 - Organization of Research Sessions 6, 15, 18 and 23

Assessment of Scientific Activities

Session 7 - Network Diagrams Sessions 8 and 9 - Research planning Exercise Sessions 10 and 11

L3 14 15 19 20 21

Decisionaaking and Uncertainty

Session 12 - Staff Planning and Development Sessions 13 and 14 - System Comparisons - Quantitative and Subjective Session 16

Network Planning with Uncertainty

Sessions 19 and 20 - Formulation and Evaluation of Research Proposals Ethical Review Procedures Session 21 - Project Monitoring and Gantt Charts S e s s i u n 22

25 26

D e h a v i o u r a l Aspects of R e s e a r c h Managcmcnt and thc

Role of Communication in Management Session 24

Research Information

Sessions 25 and 26 - Development of Programme for Training in Research Management in Participants' Countries 111 UTILIZATION OF THE RESULTS OF RESEARCH IV

EVALUATION OF THE WORKSHOP CONCLUDING SESSION LIST OF PARTICIPANTS - MESSAGE OF DR A.H. TABA. DIRECTOR. WHO EASTERN MEDITERRANEAN REGION -

ANNEX I ANNEX T T

EM/RSR/16 EM/MG/~ EM/WKP.RCH.MGT/~ page ii

page ANNEX I11

ANNEX IV

PROGRAMME OF THE WORKSHOP SUMMARIES OF THE PAPERS PRESENTED BY THE PARTICIPANTS ON THE ESTABLISHMENT AND MANAGEMENT OF MEDICAL RESEARCH IN T H E I R COUNTRIES

ANNEX V

PLANS DEVELOPED BY THE TWO GROUPS OF PARTICIPANTS FOR ASSESSING THE SCIENTIFIC ACTIVITIES OF THE PUBLIC HEALTH AND NUTRITION DIVISIONS OF THE N.I.H. EVALUATION FORM

ANNEX VI

A Regional Workshop on Research Management was h e l d a t t h e N a t i o n a l I n s t i t u t e of H e a l t h , Islamabad, 4-14 A p r i l 1981. It was a t t e n d e d by p a r t i c i -

p a n t s from Egypt, I r a n , P a k i s t a n and Sudan (Annex I . )

INAUGURAL SESSION The Workshop was i n a u g u r a t e d by D r K a z i , Adviser on S c i e n c e and Technology

t o t h e P r e s i d e n t of P a k i s t a n .

D r Kazi i n h i s a d d r e s s p o i n t e d o u t t h e l i m i t e d

c a p a c i t y of t h e developing c o u n t r i e s t o o r g a n i z e t h e i r r e s e a r c h e f f o r t s e f f e c t i v e l y , due t o l a c k of r e s o u r c e s and e x p e r t i s e i n management. S e s s i o n t h e p a r t i c i p a n t s were welcomed by Maj. Gen. M.A.Z. t h e P a k i s t a n Medical Research Council (PMRC). A t the Inaugural

Mohydin, Chairman of

D r M. Abdussalam, Chairman of

t h e E14/Advisory Committee on Medical Research, b r i e f l y recounted t h e development of t h e r e s e a r c h p r o g r a m e w i t h i n WHO, and pointed o u t t h e importance of h e a l t h s e r v i c e s r e s e a r c h i n t h e s o l u t i o n of t h e h e a l t h problems f a c i n g t h e Member C o u n t r i e s of WHO.

D r A.H.

Taba,

Regional

D i r e c t o r WHO/EMRO,

i n h i s message of welcome

(Annex 11) thanked t h e P M R C and t h e Government of P a k i s t a n f o r h o s t i n g t h i s Workshop. D r Taba hoped t h a t t h e Workshop would go a long way towards improving

t h e q u a l i t y of r e s e a r c h planning i n t h e Member C o u n t r i e s and i t s e f f e c t i v e l i n k up w i t h n a t i o n a l development p l a n s . He p o i n t e d o u t t h a t W H O would be prepared

t o c o l l a b o r a t e , should i t be r e q u i r e d , i n t h e planning and implementation of n a t i o n a l t r a i n i n g programmes i n r e s e a r c h management.

WORKING SESSIONS Session 1

I n t h i s i n t r o d u c t o r y S e s s i o n t h e p a r t i c i p a n t s i n t r o d u c e d themselves and t h e o v e r a l l o b j e c t i v e s of t h e Workshop were o u t l i n e d . These were :

t o a p p r e c i a t e t h e s c i e n t i f i c a p p r o a c h t o t h e management o f m e d i c a l r e s e a r c h and be committed t o promote and implement t h i s i n t h e i r own c o u n t r i e s ;

t o a c q u i r e r e l e v a n t up-to-date

knowledge of t h e e l e m e n t s o f

r e s e a r c h management and be a b l e t o a p p l y and d i s s e m i n a t e t h i s knowledge i n t h e i r own work;

t o develop a p p r o p r i a t e c r i t e r i a f o r t h e assessment of r e s e a r c h management p r a c t i c e s i n t h e n own i n s r i t u ~ i o n so r c u u l ~ t r i e s ;

t o a c q u i r e t h e a b i l i t y t o o r g a n i z e and c o n d u c t n a t i o n a l workshops on r e s e a r c h management.

The d e t a i l e d programme of t h e

Workshop w a s p r e s e n t e d (Annex 111) and

adopted. Session 2

S t a t u s o f M e d i c a l R e s e a r c h is Member C o u n t r i e s

A p a r t i c i p a n t from e a c h of t h e c o u n t r i e s r e p r e s e n t e d a t t h e Workshop

gave a resume of t h e e s t a b l i s h m e n t and management of m e d i c a l r e s e a r c h i n h i s r e s p e c t i v e country. g i v e n i n Annex I V . The summaries o f t h e s e c o u n t r y s t a t e m e n t s a r e

The following factors appeared to be c o m o n to all the four countries:

Lists of various health problems or health-related issues, requiring research, have been compiled. Howevcr,

little

effort has been made to prioritize them ;

Mechanisms for formulating pertinent researchable questions are lacking;

The impact of whatever research has been undertaken on health services has not been evaluated; Dissemination of research findings is inadequate; There is a lack of manpower fully committed to research; Research is very often individual-oriented and linked to personal advancement, rather than being related to national needs. Effective c o - o r d i ~ ~ a L i u u n f research ar: the national level is lacking.

Session 3

Need and Importance of Medical Research

In the introduction to this Session, the need for formulating a medical research policy, as an integral component of health services development, was emphasized. To ensure this, a continuing dialogue, both formal and

informal, between the researchers and the health services managers was necessary. Where feasible, research workers should be integrated with the

health delivery system.

The f o l l o w i n g s t e p s were s u g g e s t e d i n t h e f o r m u l a t i o n o f a n a t i o n a l policy f o r medical r e s e a r c h :

i d e n t i f i c a t i o n of n a t i o n a l development p o l i c i e s

i d e n t i f i c a t i o n o f n a t i o n a l h e a l t h problems p r i o r i t i z a t i o n of h e a l t h problems

- s e t t i n g o b j e c t i v e s f o r medical r e s e a r c h , e.g.

H e a l t h f o r A l l by t h e Year 2000 e r a d i c a t i o n of s c h i s t o s o m i a s i s by t h e Year 2000 p r o d u c t i o n o f food f o r c r i t i c a l p o p u l a t i o n g r o u p s

communicating r e s e a r c h needs t o d e c i s i o n - m a k e r s a t t h e n a t i o n a l level i n order t o gain p o l i t i c a l support.

During t h e g r o u p e x e r c i s e i n t h i s S e s s i o n , t h e p a r t i c i p a n t s f e l t t h a t t h e f o l l o w i n g f a c t o r s s h o u l d be t a k e n i n t o a c c o u n t when a s s e s s i n g n a t i o n a l needs f o r r e s e a r c h :

Requirements of N a t i o n a l Development, e s p e c i a l l y t h o s e r e l a t e d t o the health sector.

I d e n t i f i c a t i o n of h e a l t h problems which need r e s e a r c h .

Priority

s h o u l d be g i v e n t o h e a l t h problems a c c o r d i n g t o t h e i r magnitude a s measured by m o r t a l i t y , m o r b i d i t y and economic l o s s .

D e c i d i n g upon r e s e a r c h a b l e q u e s t i o n s aimed a t s o l v i n g t h e i d e n t i f i e d h e a l t h problems.

~ossibilit~/feasibilit~ of generating new knowledge to fill gaps. Availability of human and financial resources and facilities for undertaking research. Expected utilization of the results of research findings in the solution of health problems,

- Availability of relevant information for research workers and decision-makers.

- Socio-medical problems which require research, e.g. family planning, social behaviour and practices detrimental to health.

Action in emergencies, such as national disasters and epidemics.

Session 4

Management and Planning

It was pointed out that although management includes executive action and administration, this Session would concentrate on the decision-making and planning aspects of the management task. of management will be covered in Session 22.) Although the theme of the Workshop is scientific management, it was stressed that intuition and experience also play an important part in managerial problems. This was supported by the participants who gave (Part of the executive role

several examples of Buch situations. The view of decision-making as a continuous chain of activities, from policy-setting to the implementation of change, was discussed. Some

problems w e r e e n c o u n t e r e d o v e r s e m a n t i c p o i n t s c o n c e r n i n g " p o l i c y - s e t t i n g 1 ' , " g o a l s " and ' l o b j e c t i v e s " , b u t t h e s e were l a r g e l y r e s o l v e d i n d i s c u s s i o n . The main a r e a s i n which p a r t i c i p a n t s e n c o u n t e r e d d i f f i c u l t i e s a c t i n g a s r e s e a r c h managers w e r e found t o be :

a g r e e i n g t o p o l i c i e s a n d objertives

i m p l e m e n t a t i o n of p l a n s

l i m i t a t i o n of resources b e h a v i o u r a l problems ( t h e s e u s u a l l y a r i s e n o t w i t h r e s e a r c h s t a f f b u t w i t h p e o p l e i n v o l v e d i n f i e l d work s t u d i e s ) .

I n f u r t h e r d i s c u s s i o n i t was a g r e e d t h a t r e s o u r c e l i m i t a t i o n s s h o u l d o f t e n n o t p r o p e r l y be r e g a r d e d a s a problem o f management, b u t a s o n e of t h e c o n s t r a i n t s which t h e manager s h o u l d t a k e i n t o a c c o u n t i n p l a n n i n g activities. It was o b s e r v e d t h a t i n a d d i t i o n t o d e t a i l e d logistic points, a good

plan should a l s o cover :

s e c u r i n g a p p r o v a l and r e s o u r c e s

implementation monitoring

evaluation

F i n a l l y i n c o n s i d e r i n g d e s i r a b l e a s p e c t s of p l a n n i n g , i t was agreed t h a t p l a n s should:

be l i n k e d t o o v e r a l l o b j e c t i v e s compare a l t e r n a t i v e s

assign priorities

preserve f l e x i b i l i t y

Session 5

O r g a n i z a t i o n of r e s e a r c h S e s s i o n i t was p o i n t e d o u t t h a t some I n o r d e r t o be

I n the introduction to t h i s

p o t e n t i a l f o r medical r e s e a r c h e x i s t s i n a l l c o u n t r i e s .

able to expLoit and harnees this potcntial it is necessary to have an

o r g a n i z a t i o n f o r planning and implementing r e s e a r c h which i s commensurate w i t h t h e country's r e s o u r c e s and f a c l l l t l e s . Research workers would l i k e t o have t h e freedom t o s e l e c t t h e i r problems f o r r e s e a r c h and t o o r g a n i z e t h e i r r e s e a r c h p r o j e c t s on an i n d i v i d u a l b a s i s . However, due t o g e n e r a l l y l i m i t e d r e s o u r c e s a v a i l a b l e f o r medical r e s e a r c h , i t i s of paramount importance t o o r g a n i z e r e s e a r c h i n a s y s t e m a t i c manner.

I n t h i s c o n n e c t i o n t h e e s t a b l i s h m e n t of Medical Research Councils (MRCS: o r analogous bodies was s e e n a s a p o s s i b l e mechanism f o r planning and o r g a n i z i n g r e s e a r c h on a n a t i o n a l b a s i s . Such a body should be autonomous I t s members '

and have f u l l c o n t r o l over t h e disbursement of i t s budget.

should include senior representatives from the academic world, hcalth scrviccs,

t h e M i n i s t r i e s of Higher

Education H e a l t h , S c i e n c e and Technology and Finance.

As it is not possible to have all the biomedical disciplines represented in such a body, specialist sub-committees can be constituted to provide technical advice and also to plan and commission goal-oriented research, as and when required. The Council, in addition to receiving and financing

invited research projects, should play an active role in planning and commissioning research on important health problems. The Council should

also be charged with collecting and disseminating information on ongoing research activities within the country, even those not financed by it. This inf~rmation~which should be available centrally, would help to obviate unnecessary duplication. It was felt that, as financial and human resources for medical research are generally limited in most of the countries of the Region, Lhe Research Council should preferably sponsor and commission research in existing health institutions, rather than establish and run its own institution. In this connection the work "Research Institute" was felt In order that international contribution to national

to be a misnomer.

research does not alter or distort national priorities, all internationally sponsored programmes should be examined by the MRC. The Research Council should also assist in the development of institutions which provide supporting services for medical research, e.g. experimental animals, data processing, libraries and other information services. In a group exercise, in this Session, the participants dealt with steps which could be taken for developing the ~ e s e a ~ capaLiliLy cl~ ill

Medical

School.

The objective of building up such a research capability

should be t o i n s t i l a s p i r i t of s c i e n t i f i c e n q u i r y i n t h e s t u d e n t s d u r i n g t h e i r undergraduate y e a r s and t o i n t e g r a t e medical e d u c a t i o n and h e a l t h c a r e d e l i v e r y through a community-oriented t e a c h i n g process. The s t u d e n t s

should be informed about n a t i o n a l p r i o r i t i e s f o r r e s e a r c h and be encouraged t o c a r r y o u t a s m a l l p r o j e c t themselves o r t o p a r t i c i p a t e i n t h e p r o j e c t s being conducted by t h e s t a f f . Obtaining funds f o r r e s e a r c h was a major problem i n most c o u n t r i e s . I n o r d e r t o o b t a i n n e c e s s a r y funds it i s n o t merely enough t o come up w i t h a s c i e n t i f i c a l l y v a l i d and w e l l - w r i t t e n p r o j e c t b u t a l s o t o be a b l e t o

p r e s e n t i t i n a manner which can be understood by t h e decision-makers who a r e responsible f o r a l l o c a t i n g resources. The r o l e of i n t e r n a t i o n a l c o o p e r a t i o n i n biomedical r e s e a r c h programmes, i n c l u d i n g Lhe p r o v i s i v n uL L r a i u i n g , w a s also d i s c u s s e d . Mention was made

of t h e v a r i o u s b i l a t e r a l , m u l t i l a t e r a l and i n t e r n a t i o n a l a g e n c i e s , i n c l u d i n g WHO,

s u p p o r t i n g biomedical r e s e a r c h i n d i f f e r e n t p a r t s of t h e world.

The r o l e

TCDC was emphasized.

I n o r d e r t o e n s u r e t h e b e s t u s e of r e s o u r c e s o b t a i n e d t i i l -

i n t e r n a t i o n a l c o o p e r a t i o n , e f f o r t s should be made t o f i t t h e m t o n a t i o n a l p r i o r i t ; , S e s s i o n s 6 , 1 5 , 18 and 23

Assessment of S c i e n t i f i c A c t i v i t i e s

T h i s t o p i c was t r e a t e d a s a Case Study, and d e a l t w i t h t h e assessment of s c i e n t i f i c a c t i v i t i e s of two D i v i s i o n s of t h e N a t i o n a l I n s t i t u t e of Health (NIH)

, Islamabad. The o b j e c t i v e of t h e Case Study was t o p r o v i d e t h e p a r t i c i p a n t s w i t h

a learl~il~g experience i n p l a n n i n g and u n d e r t a k i n g an assessment of s c i e n t i f i c

a c t i v i t i e s of an i n s t i t u t i o n .

EM/ RSR/ 16 EM/MG/3 EM/WKP.RCH .MGT/4 page 10 I n t h e f i r s t S e s s i o n t h e E x e c u t i v e D i r e c t o r of t h e N I H p r e s e n t e d an overview of i t s o b j e c t i v e s , o r g a n i z a t i o n of c u r r e n t a c t i v i t i e s and development p l a n s f o r t h e n e x t f i v e y e a r s . I t was d e c i d e d t h a t t h e

p a r t i c i p a n t s i n two g r o u p s would a s s e s s t h e s c i e n t i f i c a c t i v i t i e s of t h e D i v i s i o n s of N u t r i t i o n and P u b l i c H e a l t h , r e s p e c t i v e l y . I n t h e second S e s s i o n e a c h of t h e two g r o u p s , working i n d e p e n d e n t l y ,

p r e p a r e d p l a n s f o r e v a l u a t i n g t h e s c i e n t i f i c a c t i v i t i e s of t h e D i v i s i o n s o f NIH a l l o t t e d t o thern. These a r e g i v e n i n Annex V.

I n t h i s S e s s i o n i t was p o i n t e d o u t t h a t p u b l i c a t i o n s a r e a n i m p o r t a n t i n d i c a t o r f o r a s s e s s i n g t h e s c i e n t i f i c a c t i v i t i e s of a n i n s t i L u t i o n . It

was f e l t t h a t t h e r e s u l t s of r e s e a r c h must be w r i t t e n up e i t h e r a s p a p e r s p u b l i s h e d i n s c i e n t i f i c j o u r n a l s o r e v e n a s monographs o r r e p o r t s . I t was c o n s i d e r e d t h a t a n imporsant t a s k u L a l e s e a r c h manager was

t o a s s i s t younger s c i e n t i s t s i n p l a n n i n g t h e i r a c t i v i t i e s towards s t a t e d t a r g e t s , which s h o u l d be d e f i n e d a s c l o s e l y a s p o s s i b l e . This w i l l t a c l l l On a r e g u l a r

t a t e t h e e v a l u a t i o n ( b o t h s e l f and e x t e r n a l ) of t h e i r work.

b a s i s t h e r e s e a r c h manager s h o u l d d i s c u s s t h e performance o f e a c h of t h e s c i e n t i s t s f o r whom h e i s r e s p o n s i b l e . The o u t l i n e o f t h e p l a n p r e p a r e d by t h e two g r o u p s f o r a s s e s s i n g t h e s c i e n t i f i c a c t i v i t i e s of t h e two D i v i s i o n s of t h e NIH, i s g i v e n i n Annex V.

During t h e t h i r d S e s s i o n , s e t a s i d e f o r t h i s c a s e s t u d y , t h e two g r o u p s v i s i t e d t h e concerned D i v i s i o n s of t h e NIH. Due t o t h e l i m i t e d t i m e

a v a i l a b l e f o r t h i s v i s i t (two h o u r s ) , and t o f a c i l i t a t e t h e p r o c e s s of uL intormatlon gathering, the o u t l i ~ ~ e s the evaluation p l a n s mentioned abovb~

had been handed o v e r p r e v i o u s l y t o t h e Heads of each of t h e two D i v i s i o n s .

EM/RSR/ 16 EM/MG / 3 EM/wKP.RCH.MGT/~ page 11 I n a d d i t i o n , b o t h t h e g r o u p s had s u b - d i v i d e d t h e m s e l v e s t o c o l l e c t i n f o r m a t i o n and r e v i e w d a t a r e g a r d i n g s p e c i f i c p o i n t s i n t h e e v a l u a t i o n plan. I n t h e f o u r t h and f i n a l S e s s i o n on t h i s j o i n e d by t h e D i r e c t o r of t h e NIH. The p r o c e d u r e adopted was f o r e a c h g r o u p t o p r e s e n t i t s e v a l u a t i o n r e p o r t and a l s o t o comment on how w e l l t h e y were a b l e t o f o l l o w t h e i r intended evaluation plans. Members o f t h e o t h e r g r o u p were t h e n i n v i t e d Case S t u d y , t h e g r o u p was

t o a s k q u e s t i o n s o r make comments, f o l l o w i n g which t h e NIH D i r e c t o r spoke on t h e v a r i o u s p o i n t s r a i s e d , and s u g g e s t i o n s made. The s t y l e and c o v e r a g e of t h e two r e p o r t s were s i g n i f i c a n t l y d i f f e r e i , . p a r t l y l i n k e d t o t h e v e r y d i f f e r e n t s u c c e s s t h e g r o u p s had e x p e r i e n c e d i n r x t ~ a c t i n g t h e r . e l e v a ~ ~i111urrna L Lion t h e y r e q u e s t e d .

Group I ( P u b l i c H e a l t h D i v i s i o n ) had a t t e m p t e d a v e r y broad t a s k , covering the e n t i r e Division. They c l e a r l y had a good u n d e r s t a n d i n g of

t h e ~ i v i s i o n ' swork, b u t b e c a u s e of t h e b r e a d t h o f t h e i r approach (and t h L l i m i t e d t i m e ) i t was i n e v i t a b l e t h a t t h e r e p o r t would be l a c k i n g i n d e t a i l e d points. I n t h e d i s c u s s i o n , i t was a g r e e d t h a t i t m i g h t have S e v e r a l examples

been b e t t e r i f more l i m i t e d o b j e c t i v e s had been s e t . of such d e t a i l were o f f e r e d and m o s t l y a c c e p t e d .

Nevertheless, t h e Direc

a p p r e c i a t e d some o f t h e s u g g e s t i o n s made, and spoke a t l e n g t h on t h e point r a i s e d on s t a f f i n g problems and l i b r a r y s e r v i c e s . Group I1 ( ~ u t r i t i o n D i v i s i o n ) c h o s e t o s u r v e y t h e whole D i v i s i o n muck more b r i e f l y , and tllrll t u c u l ~ c e ~ ~ L r a L or1 t: L w u s p e c i S i c a r e a s u f work.

The!

were t h u s a b l e t o make d e t a i l e d p o i n t s on t h e s e a r e a s , and i n p a r t i c u l a r

EM/RSR/ 16 EM/MG/ 3 EM/WKP.RCH.MGT/~ page 1 2

c o m e n t e d on improvements t h e y t h o u g h t n e c e s s a r y i n t h e i m p l e m e n t a t i o n and d i s s e m i n a t i o n o f r e s e a r c h r e s u l t s . Though t h i s a p p r o a c h was a g r e e d

t o be a good one i n t h e t i m e a v a i l a b l e , i t was p r e j u d i c e d by t h e i n f o r m a t i o n p r o v i d e d t o t h e group. It was n o t c l e a r why more complete and a c c u r a t e

i n f o r m a t i o n had n o t been p r o v i d e d , b u t a l l a g r e e d t h a t i t was most u n f o r tunate. I n h i s r e s p o n s e , t h e D i r e c t o r was a b l e t o d e m o n s t r a t e t h a t most

o f t h e c r i t i c i s m s were unfounded, and g a v e d e t a i l s o f t h e ways i n which t h e r e s e a r c h r e s u l t s had i n f a c t been pursued v i g o r o u s l y . Where t h e r e

had been d e f i c i e n c i e s , t h e s e were a t t r i b u t a b l e t o s p e c i f i c s t a f f v a c a n c i e s , which were p r o v i n g e x t r e m e l y d i f f i c u l t t o f i l l . Session 7

Network Diagrams

T h i s was a ~ L r a i g h t f u r w a r r l L e c l ~ ~ l i c a Session l on the

use

of these

methods i n t h e p l a n n i n g and c o n t r o l o f complex programmes. A s i m p l i f i e d example o f a c o n s t r u c t i o n p r o j e c t was used t o d e m o n s t r a t e

t h e p r o c e d u r e s and c o m p u t a t i o n a l methods.

The p a r t i c i p a n t s were g i v e n The

s e v e r a l v a r i a t i o n s o f t h i s b a s i c example a s e x e r c i s e s t o work through.

r e s u l t s s u g g e s t e d some p l a c e s where t h e p r o c e d u r e needed f u r t h e r c l a r i f i c a t i o n , b u t i n t h e f i n a l d i s c u s s i o n most p a r t i c i p a n t s had a good g r a s p of t h e i d e a s and c o u l d a p p l y them i n s i m p l e c a s e s . I t was p o i n t e d o u t t h a t t h e b a s i c methods o f t e n need e x t e n s i o n s i n

p r a c t i c e t o take account of :

u n c e r t a i n t y i n t h e i n d i v i d u a l a c t i v i t y times t h e a l l o c a t i o n of l i m i t e d r e s o u r c e s between a c t i v i t i e s d i f f e r e n t p a t h s t h r o u g h a network b e i n g p o s s i b l e , depending on t h e outcome o f e a r l i e r a c t i v i t i e s .

EM/RsR/ 16 EM/MG/3 EM/WKP.RCH.MGT/~ page 13 (These p o i n t s were d i s c u s s e d i n l a t e r S e s s i o n s of t h e Workshop.) F i n a l l y it was noted t h a t network a n a l y s i s methods were u s e f u l i n :

i n i t i a l programme planning re-scheduling m o n i t o r i n g p r o g r e s s and r e - p l a n n i - n g

f o c u s s i n g management a t t e n t i o n s n t h e c r i t i c a l a c t i v i t i e s where changes can have r e a l e f f e c t s .

S e s s i o n s 819

Research Planning E x e r c i s e

The e x e r c i s e was introduced w i t h two s h o r t o u t l i n e s on t h e background. F i r s t l y , t h e importance of c o n t r o l of d i a r r h o e a 1 d i s e a s e s was emphasized and t h e r e c e n t advances i n medical knowledge i n t h e a r e a d i s c u s s e d . This

concerned t h e e f f e c t i v e n e s s of o r a l r e h y d r a t i o n , t h e v i r o l o g i c a l and pathoa s p e c t s and t h e e f f e c t of environmental c o n d i t i o n s , i n c l u d i n g water p o t a b i l i t y . S ~ r n n d l y , t h e t y p e o f c o n t r i b u t i o n s hnped f o r was i l l u s t r a t e d by

r e f e r r i n g t o t h e s t e p s i n t h e management process d i s c u s s e d i n S e s s i o n 4. I t was emphasized t h a t p a r t i c u l a r a t t e n t i o n should be given t o t h e p l a n n i n g , implementation and e v a l u a t i o n a s p e c t s t o g e t h e r w i t h an i n d i c a t i o n of how t h e p o t e n t i a l v a l u e of t h e r e s e a r c h programme suggested could be a s s e s s e d . It was a l s o pointed o u t t h a t t h e emphasis should be on t h e methodology

adopted i n t h e r e s e a r c h proposals r a t h e r than on t h e t e c h n i c a l v a l i d i t y of t h e medical a s p e c t s

The groups were i n v i t e d t o p r e p a r e t h e i r p r o p o s a l s w i t h group I , s e l e c t i n g a progranane r e l e v a n t t o t h e f i r s t e i g h t "main p r i o r i t i e s " i n

EM/RSR/ 16

EM/MG/ 3 EM/WKP.RCH.MGT/~ page 1 4 F i g u r e 2 of t h e document W H O DDC 80.1, t h e second e i g h t . and g r o u p 11, s e l e c t i n g from

O t h e r w i s e no l i m i t a t i o n s on t h e s i z e o r c o n t e n t of

t h e r e s e a r c h p r o p o s a l s were imposed, and i t was n o t e d t h a t t h e s e would be used l a t e r i n t h e Workshop i n S e s s i o n s 1 9 / 2 0 , d e a l i n g w i t h formu-

l a t i o n and e v a l u a t i o n o f r e s e a r c h p r o p o s a l s . Sessions 10/11

Decision-Making and U n c e r t a i n t y

It was s u g g e s t e d t h a t t h e e x i s t e n c e o f u n c e r t a i n t y need n o t i n -

validate quantitative analysis.

The n a t u r e of u n c e r t a i n t y , t h e u s e and

d e r i v a t i o n of p r o b a b i l i t y e s t i m a t e s , and t h e meaning o f " c o r r e c t " and " r a t i o n a l " d e c i s i o n s were d i s c u s s e d . The need t o d e f i n e management o b j e c t i v e s p r e c i s e l y was u n d e r l i n e d and a number o f examples showing how t h e s e i n f l u e n c e t h e d e c i s i o n were d i s c u s s e d by p a r t i c i p a n t s . The u s e of d e c i s i o n t r e e s f o r u s e i n more complex c a s e s was p r e s e n t e d and i t was shown how t h e n u m e r i c a l c a l c u l a t i o n s c o u l d be c a r r i e d o u t . The p a r t i c i p a n t s were t h e n d i v i d e d i n t o s m a l l working g r o u p s t o d i s c u s s a n e x e r c i s e i n which t h e r e were two s e p a r a t e s t a g e s :

The i d e n t i f i c a t i o n o f t h e d a t a t o c a r r y o u t t h e a n a l y s i s The development of t h e a p p r o p r i a t e d e c i s i o n t r e e .

By t h e r e s p o n s e s p a r t i c i p a n t s showed t h a t t h e y were r e a s o n a b l y f a m i l i a r with t h e ideas presented i n t h e Session. Although t h e c o m p l e t e n u m e r i c a l

c a l c u l a t i o n s t o r t h e e x e r c i s e were n o t worked t h r o u g h , f u l l n o t e s on t h e s e were d i s t r i b u t e d .

EM/RSR/ 16

EM/MG/ 3 EM/WKP.RCH. / M G T / ~ page 15 It was pointed o u t t h a t t h e r e was no need f o r r e s e a r c h managers t o

become e x p e r t s themselves i n handling t h e a n a l y s i s of complex problems involving uncertainty; be o b t a i n e d elsewhere. s p e c i a l h e l p on t h e t e c h n i c a l a s p e c t s can always

However, i t was thought t h a t they should a p p r e c i a t e

t h e r o l e of t h e s e methods and be a b l e t o i d e n t i f y s i t u a t i o n s where they could be u s e f u l l y a p p l i e d . S e s s i o n 12

S t a f f Planning and Development

I n t h i s S e s s i o n t h e importance of developing and r e t a i n i n g an adequate complement of r e s e a r c h workers w i t h i n t h e i r c o u n t r i e s was emphasized. The p a r t i c i p a n t s d e f i n e d a " r e s e a r c h worker" a s an i n d i v i d u a l who i s

a b l e t o g e n e r a t e new knowledge by t h e a p p l i c a t i o n of t h e s c i e n t i f i c method. The d e s i r e d a t t r i b u t e s of a r e s e a r c h worker were considered t o be a s follows :

systematic thinking capabiliLy in r e s e a r c h methodology, i n v o l v i n g observations

e x p e r i m e n t a t i o n and l o g i c a l d e d u c t i o n t h e p e r s i s t e n t d e s i r e t o d i s c o v e r new f a c t s honesty of purpose, o b s e r v a t i o n and e x p r e s s i o n a b i l i t y t o withstand c r i t i c i s m energy an adequate l e v e l of knowledge i n h i s f i e l d and i n management.

F a c t o r s suggested a s h e l p i n g t h e r e t e n t i o n of r e s e a r c h workers were :

f o m a l , s o c i a l and p r o f e s s i o n a l r e c o g n i t i o n

EM/RSR/ 16 EM/MG/3 EM/WKP. RCH. / M G T / ~ page 16

suitable salaries a s y s t e m o f promotion w i t h i n t h e r e s e a r c h f i e l d s u i t a b l e r e s e a r c h environment good management a v a i l a b i l i t y o f l i t e r a t u r e and i n f o r m a t i o n absence of s e r i o u s resource c o n s t r a i n t s .

F a c t o r s t h o u g h t r e s p o n s i b l e f o r l o s i n g r e s e a r c h w o r k e r s were :

a t t r a c t i o n from o t h e r c o u n t r i e s o f f e r i n g b e t t e r income and p r o s p e c t s o r a b e t t e r r e s e a r c h environment a t t r a c t i o n from l o c a l n o n - r e s e a r c h p o s i t i o n s o f f e r i n g b e t t e r income, p r o s p e c t s and p r e s t i g e .

The s o u r c e s of p o t e n t i a l r e s e a r c h w o r k e r s i n most c o u n t r i e s o f t h e Region were ;

s t u d e n t s ( n o r m a l l y g r a d u a t e s ) from m e d i c a l and o t h e r h e a l t h r e l a t e d c o l l e g e s , e.g. social sciences, etc. b i o l o g i c a l s c i e n c e s , v e t e r i n a r y medicine,

a l l i e d health profession i n s t i t u t e s v i s i t i n g n a t i o n a l s working a b r o a d i n r e s e a r c h s h o r t - t e r m v i s i t s fro111 n o n - n a t i o n a l s a s s o c i a t e d w i t h t h e c o u n t r y under i n t e r n a t i o n a l o r b i l a t e r a l arrangements.

The t y p e s o f t r a i n i n g c o n s i d e r e d a p p r o p r i a t e f o r r e s e a r c h w o r k e r s i n m o s t c o u n t r i e s o f t h e Region were :

EM/RSR/ M EM/MG/ 3 EM/WKP. RCH. /MGT/4 page 17 1 . Pre-service training As most graduates do not receive an adequate training in research methods or the use of information sources or an appreciation of the scientific method during their undergraduate years, it was desirable

for them to undergo a period of training before starting to work in a research projec t/organization.

2 .

In-service training Because of the rapid rate ofdevelopment, "up-dating" courses are

necessary from time to time.

These should emphasize familiarization relevant to the field

with technological advances in the discipline(s) of research. 3 .

Primarily for senior levels, appropriate management training,

aimed at developing the following skills and attitudes : Skills :

innovative ability ability to plan, monitor and evaluate research ability to act as a team-leader ability to train members of the research team

Attitudes :

ability to convince others ability to comunlcarre wich dlfferenr: levels/ca~egories of people.

The participants also discussed how research manpower planning might be initiated in the various countries. It was the unanimous opinion that such

a planning e x e r c i s e should n o t be undertaken i n i s o l a t i o n , but a s p a r t of a well-planned e f f o r t aimed a t upgrading and s t r e n g t h e n i n g n a t i o n a l c a p a b i l i t i e s f o r medical r e s e a r c h . I n c o u n t r i e s where an MRC o r analogous i n s t i t u t i o n e x i s t s , t h i s should have t h e r e s p o n s i b i l i t y f o r such planning. should a l s o be involved i n t h i s e x e r c i s e : However, t h e f o l l o w i n g bodies

M i n i s t r i e s of H e a l t h , Higher

Education, S c i e n c e and Technology

Schools and I n s t i t u t e s of H e a l t h S c i e n c e s I n t e r n a t i o n a l O r g a n i z a t i o n s , e.g. capacity. WHO, i n a c o n s u l t a t i v e

As a f i r s t s t e p a n assessment of t h e e x i s t i n g s i t u a t i o n r e g a r d i n g r e s e a r c h manpower should be c a r r i e d ouc. During t h i s phase t h e research

a c t i v i t i e s i m p l i c i t i n t h e n a t i o n a l h e a l t h p l a n and n a t i o n a l medical r e s e a r c h p l a n ( i f t h e s e e x i s t ) should be reviewed. The n e x t s t e p s a r e t o i d e n t i f y t h e f u t u r e requirements of v a r i o u s c a t e g o r i e s of r e s e a r c h workers, a c c o r d i n g t o d i s c i p l i n e and l e v e l of professional qualifications. I n f o r m a t i o n should a l s o be compiled r e g a r d i n g

t h e e x i s t i n g number of r e s e a r c h workers i n v a r i o u s c a t e g o r i e s , and of research f a c i l i t i e s . The p r o j e c t e d a v a i l a b i l i t y of medical and s c i e n c e

g r a d u a t e s and o t h e r h e a l t h - r e l a t e d p r o f e s s i o n a l s , over t h e n e x t t e n t o twenty y e a r s , should a l s o be a s c e r t a i n e d . Following t h e comparison of needs w i t h a v a i l a b i l i t i e s , d e t a i l s of t h e t r a i n i n g programmes r e q u i r e d t o product: the necessary research workers could t h e n be worked o u t , i n c l u d i n g t h e modes f o r t h e i r s e l e c t i o n . This would

i n c l u d e i d e n t i f y i n g t h e i n s t i t u t i o n s where t r a i n i n g programmes could be o r g a n i z e d , and t h e r e s o u r c e s r e q u i r e d t o s t r e n g t h e n them where a p p r o p r i a t e . The deployment of s c i e n t i s t s on completion of t r a i n i n g should a l s o be spelled out a t t h i s stage.

A mechanism f o r e v a l u a t i o n of t h e proposed p l a n f o r r e s e a r c h manpower development could be :

Follow up t h o s e who have been t r a i n e d and a s c e r t a i n whether t h e y a r e s t i l l engaged i n r e s e a r c h ; and i f n o t , why ?

Assess t h e q u a l i t y of r e s e a r c h a s being published i n i n t e r n a t i o n a l l y recognized p e r i o d i c a l s Assess t h e r e l e v a n c e t o and impact upon h e a l t h problems of the research.

I n t h e d i s c u s s i o n i t was emphasized t h a t t h e above was a v e r y t e n t a t i v e o u t l i n e of how planning f o r r e s e a r c h manpower c o u l d be approached i n a country. What i s now r e q u i r e d i s t o develop a d e t a i l e d s t e p - b y - s t e p p l a n , I n view of t h e

and t o a p p l y i t i n one o r two c o u n t r i e s o f t h e Region.

e x p e r i e n c e t h u s gained t h e p l a n could be amended and recommended f o r w i d e r use.

S e s s i o n s 13/14

System Comparisons

Q u a n t i t a t i v e and S u b j e c t i v e

The c o n t e x t f o r t h i s

S e s s i o n comprised making e f f e c t i v e c h o i c e s The advantages In

between a l t e r n a t i v e s t r a t e g i e s i n d e c i s i o n s i t u a t i o n s .

(and l i m i t a t i o n s ) of formal q u a n t i t a t i v e comparisons were d i s c u s s e d . t h e s e , t h e u s e of c o s t / e f f e c t i v e n e s s r a t i o s was o u t l i n e d , and t h e d i f -

f i c u l t i e s encountered when t h e r e a r e s e v e r a l i n p u t s o r o u t p u t s were p o i n t e d

EM/RSR/ 16 EM/MG/~ EM/WKP.RCH. /MGT/~ page 20 T h i s l e d t o t h e r o l e of s u b j e c t i v e judgements i n d i f f i c u l t s i t c a t i o n s , and p a r t i c u l a r l y t h o s e where no q u a n t i t a t i v e measures were r e l e v a n t . u s e o f t h e D e l p h i t e c h n i q u e t o g i v e a good b a l a n c e between i n d i v i d u a l judgements and g r o u p d i s c u s s i o n s was d i s c u s s e d i n d e t a l l . The method was i l l u s t r a t e d i n a n e x e r c i s e i n which p a r t i c i p a n t s were a s k e d t o r a n k t e n alternative r e s e a r c h t a s k s i n o r d e r of p r e f e r e n c a . These The

t a s k s were r e l e v a n t t o t h e a c h i e v e m e n t of t h e g o a l H e a l t h For A l l by t h e Year 2000 (HFA/2000), i n . a Member S t a t e of t h e Region. After the f i r s t individual

r a n k i n g s , t h r e e t a s k s , on which s u b s t a n t i a l d i f f e r e n c e s of view a r o s e , were s e l e c t e d f o r more i n t e n s i v e s m a l l - g r o u p d i s c u s s i o n . These h e l p e d

t o c l a r i f y t h e r e a s o n s f o r t h e d i f f e r e n c e s , and a f t e r r e p o r t i n g back t o t h e f u l l m e e t i n g , t h e r e were v e r y i n f o r m a t i v e and c o n s t r u c t i v e d i s c u s s i o n s . P a r t i c i p a n t s t h e n a g a i n ranked t h e t e n t a s k s i n d e p e n d e n t l y , and t h e r e s u l t s showed t h a t some minor changes i n t h e r a n k i n g s had o c c u r r e d . a n t l y , t h e measure o f agreement had i n c r e a s e d s i g n i f i c a n t l y . More i m p o r t However, t h e

second round r e s p o n s e s showed t h a t t h e r e w e r e s u b s t a n t i a l d i f f e r e r l c e s i n views c o n c e r n i n g t h e two t a s k s ranked most h i g h l y . I t was n o t e d t h a t , i f

t i m e had a l l o w e d , t h e n e x t s t a g e would have aimed t o r e s o l v e and c l a r i f y these differencies i n f u r t h e r discussions. Although t h e e x e r c i s e was not

t a k e n f u r t h e r , i t was c l e a r t h a t p a r t i c i p a n t s u n d e r s t o o d t h e p r o c e d u r e and t h e r e was g e n e r a l r e c o g n i t i o n o f i t s p o t e n t i a l u s e f u l n e s s .

S e s s i o n 16

Network P l a n n i n g w i t h U n c e r t a i n t y

I t was p o i n t e d o u t t h a t t h i s S e s s i o n was t h e most d i f f i c u l t ( t e c h n i c a l l : : )

o f a l l t h o s e i n t h e Workshop.

I n f a c t , t h e c a l c u l a t i o n s involved u s u a l l y

EM/RSR/ 16

EM/MG/~ EMIWKP RCH /MGT/4 page 21

became too complex for manual methods, and computers were necessary. Nevertheless, it had been thought worthwhile to outline the basic methods which were used to handle the following two main types of uncertainty :

In the estimates of activity durations In the sequence of activities where this may be influenced by early stages in the network.

On aspect 1, the PERT method was described, using the same example

. as in Session 7 could be estimated.

It was shown how the variations in total project time The difficulties of using PERT were also described.

On point 2, the use of flow diagrams similar to computer progranrmes was described, using an example. The similarities to some of the notions

of decision trees were noted and to the diagnosticltreatment process in medicine. The main concepts of these rather difficult procedures seemed to be appreciated by most participants. Sessions 19/20

Formulation and Evaluation of Research Proposals

Ethical Review Procedures Ethical considerations form an important component of the evaluation and monitoring of research projects when human subjects are used in the research. The basic 'principles and approaches have been presented in the

~elsinki/~okyo Declaration of the World Medical Association (WHO Chronicle 30:360-62, 1976).

EM/RSR/ 16 EM/MG/~ EM/wKP.RCH./MGT/~ p a g e 22

The a p p r e c i a t i o n o f t h e s e p r i n c i p l e s i n t h e c o n t e x t o f t h c l o z a l c o n d i t i o n s o f a c o u n t r y r e q u i r e s c a r e f u l c o n s i d e r a t i o n and m o d i f i c a t i . o n t o c o n f o r m t o t h e norms o f t h e community. D r a f t WHO G u i d e l i n e s ( A m

22180.7) d e a l i n g w i t h t h e s u b j e c t w e r e examined and d i s c u s s e d i n t h e Workshop. The m o s t i m p o r t a n t mechanism f o r t h e a p p l i c a t i o n o f t h e H e l ~ i n k ~ f Tokyo c o d e i s t h e s e t t i n g up o f a n I n d e p e n d e n t Review Committee by t h e M i n i s t r y of Health. This Committee s h o u l d b e s e t up u n d e r a p p r o p r i a t e

l e g i s l a t i o n a n a s h o u l d examine and m o n i t o r a l l r e s e a r c h p r o j e c t s s u p p o r t e d by p u b l i c f u n d s , wheli u s e o f human s u b j e c t s i s i n v o l v e d . It should rilso

m o n i t o r a l l o t h e r p r o j e c t s i n w h i c h r e s e a r c h i n v o l v i n g human , u b j t c t s is included.

The membership s h o u l d i n c l u d e , among o t h e r s , b i o m e d i c a l s c i e n t i s t s , a jurist, a sociologist, 3

t h e o l o g i a n and o t h e r communitv

lead:'rt,.

l e a s t one o f t h e members s h o u l d be a woman.

The members s h o u l d work a ?

i n d e p e n d e n t e x p e r t s and n o t a s r e p r e s e n t a t i v e s o f t h e i r i n s t i t u t i o n s o r profess ions. T h i s Committee s h o u l d n o t b e s u b o r d i n a t e d i n a n y way t o t h e M e d ~ ~ a l Research Council o r comparable body. The e t h i c a l r e v i e w s h o u l d b e

i n d e p e n d e n t and n o t a s s o c i a t e d w i t h t h e t e c h n i c a l r e v i e w o f p r o j e c t s . One p a r t o f t h i s S e s s i o n was d e v o t e d c o t h e e v a l u a t i o n c f r e s e a r c h proposals prepared a s an e x e r c i s e e a r l i e r i n t h e 819.

Workshop, i n S e s s i o n s

The p r o p o s a l s w e r e :

Group I:

A t t i t u d e s towards o r a l r e h y d r a t i o n

t h e r a p y , and Group 11: A e t i o l o g i e s o f d i a r r h o e a s i n c h i l d r e n . Thc proccdurc followed W ~ E for

e a c h g r o u p to d i s c u s s the propns-1

EM/RSR/16 EM/MG/ 3 EM/WKP.RCH./ M G T / ~ page 23 p r e p a r e d by t h e o t h e r , and t h e n t o i n i t i a t e a g e n e r a l d i s c u s s i o n on t h e r e l a t i v e s t r e n g t h s and weaknesses. It was p o i n t e d o u t a g a i n t h a t t h e main emphasis s h o u l d be on t h e

o v e r a l l methodology of t h e p r o p o s a l s , from d e m o n s t r a t i n g t h a t i t would be a w o r t h w h i l e u s e o f r e s o u r c e s , t h r o u g h t h e d e s i r e d p l a n of o p e r a t i o n s , t o i m p l e m e n t a t i o n and e v a l u a t i o n . The p r o p o s a l s themselves were r a t h e r d i f f e r e n t i n c h a r a c t e r . Group I s t r e s s e d t h e o v e r a l l o r g a n i z a t i o n a l a s p e c t s , and covered t h e t i m e r e q u i r e d f o r a l l p h a s e s of t h e work, i n c l u d i n g p r e p a r a t i o n and report writing. I n d i s c u s s i o n , however, i t was a g r e e d t h a t t h e number It a l s o

o f committees proposed would be r a t h e r cumbersome i n p r a c t i c e .

emerged t h a t , due t o s h o r t a g e of t i m e , t h e r e v i s i o n s i n t h e g r o u p ' s p l a n n i n g had n o t been f u l l y r e f l e c t e d i n t h e p r o p o s a l , which was incons i s t e n t a t times. F u r t h e r m o r e , t h e r e was l i t t l e a t t e n t i o n g i v e n t o t h e

main t o p i c o f t h e p r o p o s a l

t h e a t t i t u d e s of t h e p o p u l a t i o n .

Finally,

a l t h o u g h t h e i n c l u s i o n o f a G a n t t c h a r t was welcomed, i t was more o f a n a d d i t i o n t o t h e p r o p o s a l , r a t h e r t h a n a d e v i c e f o r h e l p i n g t o frame t h e p r o p o s a l ( i n d e e d , t h e c h a r t i t s e l f h i g h l i g h t e d some i n a d e q u a c i e s i n t h e proposal). Group 11's p r o p o s a l was m o s t l y concerned w i t h t h e c l i n i c a l p r o c e d u r e s and r e s o u r c e r e q u i r e m e n t s a t t h a t l e v e l . I t was n o t e d t h a t t h e r e was no

provision f o r securing i n i t i a l approval f o r the study, nor f o r j u s t i f y i n g t h e g e n e r a l s t r a t e g i e s of t h e r e s e a r c h s u g g e s t e d . agreed t h a t such elements should be included, I n d i s c u s s i o n it was

and i t emerged t h a t t h e s e The o t h e r main

p o i n t s had i n f a c t been d i s c u s s e d w i t h i n t h e g r o u p .

EM/RSR/ 16 EM/MG/ 3 EM/wKP.RCH. /MGT/4 page 24 o b s e r v a t i o n s made on t h e p r o p o s a l were t h a t no i n f o r m a t i o n on t h e o v e r a l l t i m e s c a l e o r on e v a l u a t i o n procedure was g i v e n , and t h a t perhaps i n s u f f i c i e n t a t t e n t i o n had been g i v e n t o t h e "management" a s p e c t s .

The p a r t i c i p a n t s d i s c u s s e d t h e c r i t e r i a f o r a good r e s e a r c h p r o p o s a l . These were c o n s i d e r e d t o be a s f o l l o w s :

The g o a l and o b j e c t i v e of t h e p r o p o s a l should be c l e a r l y s t a t e d and i n accordance w i t h n a t i o n a l p o l i c i e s .

The p r o p o s a l should be r e l e v a n t t o an i d e n t i f i e d h e a l t h development p r o j e c t o r t o a n a t i o n a l h e a l t h problem.

The p r o p o s a l should be f e a s i b l e w i t h i n t h e a v a i l a b l e r e s o u r c e s . Expected c o s t s should be c o n s i s t e n t t o t h e expected outcome. I t should be e t h i c a l l y a c c e p t a b l e . T l ~ rLurmat o f the proposal should b c c l c a r , p r e c i s e , o r g a n i z e d ,

e a s i l y understandable.

T h i s f ormat s h o u l d i n c l u d e :

A c l e a r s t a t e m e n t of t h e problem and c l e a r o b j e c t i v e s i n t h e form of r e s e a r c h a b l e outcomes. The methodology should be w e l l o r g a n i z e d , e x p l a i n i n g t h e

e x p e r i m e n t a l d e s i g n , sampling p r o c e d u r e s , t y p e of r e s e a r c h i n s t r u m e n t s t o be used f o r d a t a c o l l e c t i o n , and t h e v a r i a b l e s t o be s t u d i e d .

A c r i t i c a l review of r e l e v a n t l i t e r a t u r e , and i f needed,

i d e n t i f y i n g gaps i n e x i s t i n g knowledge.

The methods proposed f o r d a t a p r o c e s s i n g and s t a t i s t i c a l analysis.

EM/RSR/ 16 EM/MG/3 EM/WKP RCH. / M G T / ~ page 25

- The r e s o u r c e s needed, e.g. manpower, equipment, s u p p l i e s , a d m i n i s t r a t i v e c o s t s , s h o u l d be c l e a r l y s t a t e d t o g e t h e r with their justification.

A system f o r monitoring t h e implementation, g i v i n g continuous f e e d b a c k c o n c e r n i n g day-to-day i m p l e m e n t a t i o n . Where r e l e v a n t

a l t e r n a t i v e s s h o u l d be s u g g e s t e d t o c o v e r p o s s i b l e d i f f i c u l t i e s .

E v a l u a t i o n s h o u l d be s p e l l e d o u t i n terms o f e v a l u a t i o n i n s t r u m e n t s , and t h e a s s e s s m e n t o f achievements compared t o the stated objectives.

T e c h n i c a l r e v i e w s of r e s e a r c h p r o j e c t s s h o u l d be c a r r i e d o u t by e x p e r t s i n the field. When many p r o j e c t s r e l a t i n g t o a g i v e n a r e a a r e t o be reviewed

a t t h e s a m e t i m e , t h i s c a n b e s t be done t h r o u g h s Committee of e x p e r t c convened f o r t h i s purpose. O t h e r w i s e s i n g l e p r o j e c t p r o p o s a l s may o f t e n be The e x p e r t s r e v i e w i n g t h e p r o j e c t s s h o u l d be

h a n d l e d by correspondence.

asked t o make c o n s t r u c t i v e comments, which may be p a s s e d t o t h e a p p l i c a n t f o r modifying o r amending h i s p r o p o s a l .

Session 21

P r o j e c t M o n i t o r i n g and G a n t t

Charts

A f t e r a s h o r t d i s c u s s i o n on t h e r o l e , purpose and i m p o r t a n c e o f monit o r i n g , most o f t h e S e s s i o n was g i v e n t o a d e s c r i p t i o n o f t h e p r o c e d u r e s used i n G a n t t c h a r t i n g . The way i n which t h i s was r e l a t e d t o network diagrams was p o i n t e d o u t , and s e v e r a l p a r t i c i p a n t s s e e m e d t o f i n d t h i s a m o r e u n d e r s t n n d a h l ~method of presentation. E x t e n s i o n s to t h e b a s i c procedure f u r d e t e r m i n i r ~ g t o t a l ments a c r o s s a l l a c t i v i t i e s of a p r o j e c t were d i s c u s s e d . resource require-

These were used t o

EM/RSR/16 3 EM/MG/ EM/wKP. RCH. / M G T / ~ page 26 show how G a n t t c h a r t s ( p e r h a p s i n c o n j u n c t i o n w i t h n e t w o r k d i a g r a m s ) c o u l d b e used t o smooth r e s o u r c e r e q u i r e m e n t s o r t o work w i t h i n s t a t e d r e s o u r c e c a p a c i t i e s , w h i l e m i n i m i z i n g t h e e f f e c t on t h e t o t a l p r o j e c t d u r a t i o n . O v e r a l l t h i s method o f p r o j e c t p l a n n i n g seemed a c c e p t a b l e t o participants.

S e s s i o n 22

B e h a v i o u r a l A s p e c t s o f R e s e a r c h Management and t h e R o l e o f Communication i n Management

Behavioural a s p e c t s While t h e i m p o r t a n c e of human r e l a t i o n s i n i n c r e a s i n g p r o d u c t i v i t y

i n i n d u s t r y h a s been r e c o g n i z e d f o r a l o n g t i m e , i t i s j u s t b e g i n n i n g t o b e a p p r e c i a t e d i n t h e management o f m e d i c a l r e s e a r c h . The p a r t i c i p a n t s had r e c e i v e d a s background a n i n f o r m a t i v e paper on human a s p e c t s and management, which c o v e r e d i t e m s s u c h a s t h e e v o l u t i o n of t h e i n d i v i d u a l and human n e e d s , s t y l e s o f management and communication. During t h e d i s c u s s i o n i n t h i s S e s s i o n i t was f e l t t h a t a r e s e a r c h

manager should a t t e m p t to define the t a s k s of all t h o o c p c r s o n a for whom

he is responsible; 'esprit-de-corps'

however, h e s h o u l d a t t h e same t i m e t r y t o d e v e l o p a A manager s h o u l d b e j u s t and h e l p i n a v o i d i n g t h e

development of f r i c t i o n s and p e t t y j e a l o u s i e s between r e s e a r c h w o r k e r s . I n f o r m a l m e e t i n g s a r e a g r e a t h e l p i n improving c o m u n i c a t i o n and u n d e r s t a n d i n g t h e o t h e r p e r s o n ' s p o i n t o f view. be c u l t i v a t e d . The q u a l i t y o f "empathy" s h o u l d

O c c a s i o n a l l y i t may b e v e r y u s e f u l t o l i s t e n t o t h e p e r s o n a l

t r o u b l e s o f r e s e a r c h e r s and make a t t e m p t s t o r e s o l v e them.

EM/RSR/16 EM/MG/ 3 EM/WKP.RCH.MGT./~ page 27 The manager s h o u l d t r y t o s e t a n example f o r o t h e r s t o f o l l o w r e g a r d i n g p u n c t u a l i t y , h o n e s t y and d i l i g e n c e . Where f e a s i b l e , i n

a d d i t i o n t o p r o v i d i n g a good working e n v i r o n m e n t , a manager s h o u l d i n s c i t u c e a s y s t e m o f a w a r d s / i n c e n c i v e s l i n k e d t o performance.

Communications

A s p a r t of t h i s S e s s i o n a "game" was used t o i l l u s t r a t e some of t h e d i f f i c u l t i e s and h a z a r d s of communications. I n t h i s , e a c h g r o u p o f s i x was s p l i t i n t o sub-groups o f f o u r " p l a n n e r s " and two "Opera t o r s " . The p l a n n e r s had f o r t y - f i v e m i n u t e s t o p l a n a s i m p l e t a s k

the

c o n s t r u c t i o n of a g e o m e t r i c a l p u z z l e i n v o l v i n g s i x t e e n p i e c e s of c a r d . They t h e n had f i v e m i n u t e s t o g i v e v e r b a l o r w r i t t e n i n s t r u c t i o n s t o t h e i r o p e r a t o r s , who had t o a t t e m p t t o c o m p l e t e t h e t a s k a s soon a s p o s s i b l e , w i t h no f u r t h e r i n s t r u c t i o n from t h e p l a n n e r s . I n t h e e v e n t , one g r o u p a l m o s t completed t h e t a s k c o r r e c t l y , w h i l e t h e o t h e r was q u i t e u n a b l e t o do s o . I n t h e following discussion, points

which were o b s e r v e d i n t h e e x e r c i s e i n c l u d e d :

Poor management i n t h e p l a n n i n g p h a s e ( o n e g r o u p r a n o u t of t i m e ) . Use of i m p r e c i s e t e r m s i n t h e i n s t r u c t i o n s . Not t e l l i n g t h e o p e r a t o r s t h e o v e r a l l n a t u r e o f t h e t a s k , b u t going d i r e c t l y i n t o d e t a i l .

Not u s i n g t h e i n s t r u c t i o n t i m e e f f e c t i v e l y

f o r example, i n

e n s u r i n g t h a t t h e w r i t t e n i n s t r u c t i o n s c o u l d be r e a d and u n d e r s t o o d .

EM/RsR/IG EM/MG/3 EM/WKP.RCH.MGT./~ page 28

Giving f a r more v e r b a l i n f o r m a t i o n t h a n c o u l d p o s s i b l y be r e t a i n e d by t h e o p e r a t o r s .

The tendency w i t h many i n s t r u c t i o n s t o be ambiguous.

The e q u i v a l e n t problems i n communications between management and s t a f f were r e a d i l y a p p r e c i a t e d . S e s s i o n 24

Research I n f o r m a t i o n

I n t h i s S e s s i o n i t was p o i n t e d o u t t h a t t h e r e s e a r c h manager i s u s u a l l y concerned w i t h t h e p r o v i s i o n of two t y p e s of i n f o r m a t i o n s e r v i c e s , i. e: a) b) health literature services i n f o r m a t i o n needed f o r m o n i t o r i n g t h e v a r i o u s r e s e a r c h activities. Regarding h e a l t h l i t e r a t u r e s e r v i c e s , t h e p a r t i c i p a n t s were aware of t h e d i f f i c u l t i e s i n o b t a i n i n g u p - t o - d a t e s c i e n t i f i c i n f o r m a t i o n , due t o

a l a c k of o r g a n i z e d m e d i c a l l i b r a r y s e r v i c e s . C o n s i d e r i n g t h a t t h e c o s t of j o u r n a l s and r e f e r e n c e books have s h o t up enormously d u r i n g t h e l a s t d e c a d e , i t was proposed t h a t a C e n t r a l Medical L i b r a r y should be e s t a b l i s h e d . I t s h o u l d be w e l l - s t o c k e d , having

t h e v a r i o u s i n d e x i n g o r a b s t r a c t i n g j o u r n a l s , r e f e r e n c e books and p e r t i n e n t b i o m e d i c a l and h e a l t h s e r v i c e s j o u r n a l s , and equipped t o make photocopies and i f p o s s i b l e m i c r o - f i l m s , and be s t a f f e d by a p r o f e s s i o n a l l i b r a r i a n . I n t h i s c o n n e c t i o n i t was mentioned t h a t i t may n o t be o u t o f p l a c e t o a l s o o r i e n t and t r a i n a s e ~ t i o rr e s e a r c h e r o r s t a f f member from t h e I n s t i Lute w h e r e the Ccntral Library

would bc l o c a t c d , in l i b r a r y and information

EM/RSR/~~ EM/MG/3 EM/wKP.RCH.MGT./& page 29 science. Similarly it was felt that research workers at the beginning

of their service should be trained in the use of libraries and in how to obtain access to the various international or national bibliographical services. The information system for monitoring research should aim at collecting and periodically up-dating information on research projects, manpower engaged in research according to level and background, and establishing an inventory of the more sophisticated equipment available for research in various parts of the country. The sources of such information were

identified as research institutes and medical and allied health sciences institutions. The information collected should be limited to elucidating pertinent factors, where they are really needed. questionnaires was decried. The use of lengthy

A control library for such management information could be established in the Office of the central national body responsible for medical research. The information collected should be up-dated at least

once a year and a manual retrieval system should be evolved for responding to requests for such information. Sessions 25/26

Development of Programme for Training in Research Management in Participants' Countries

The participants, as a whole group, discussed and came up with the following general guidelines for programme development. 1. Objectives 1.1 TO train research workers in modern methods nf research management.

EM/RSR/16 EM/MG/3 EM.WKP.RCH.MGT./~ page 30

1.2

To u p - d a t e and improve management s k i l l s f o r s e n i o r research advisers.

P e r s o n s t o be t r a i n e d They s h o u l d i n c l u d e :

D i r e c t o r and a d m i n i s t r a t o r s of r e s e a r c h and h e a l t h s e r v i c e s i n s t i t u t e s , p r o f e s s o r and a s s i s t a n t deans of r e s e a r c h i n medical schools.

Senior p r o f e s s i o n a l s t a f f involved i n d i s e a s e c o n t r o l programmes.

S e n i o r s c i e n t i s t s i n v o l v e d i n managing r e s e a r c h g r o u p s . There s h o u l d be a p p r o x i m a t e l y 15-20 p a r t i c i p a n t s i n e a c h t r a i n i n g programme.

N a t i o n a l body r e s p o n s i b l e f o r c o o r d i n a t i n g and implementing t h i s programme

M i n i s t r y of H e a l t h a n d / o r M e d i c a l such e x i s t s OR

R e s e a r c h C o u n c i l , where

a Committee, which c a n be formed by nominees from t h e M i n i s t r y of H e a l t h and i n s t i t u t i o n s a c t i v e l y i n v o l v e d i n b i o m e d i c a l and h e a l t h s e r v i c e s r e s e a r c h , t o p l a n and o r g a n i z e t h e t r a i n i n g programme i n r e s e a r c h management.

4.1

Those t r a i n e d i n t h e Islamabad Workshop on Management of Research.

EM/RSR/16 EM/MG/~ EM/W. RCH.MGT. / 4 page 31 4 . 2

Staff from institutes of planning and management.

4.3 5.

WHO experts.

Approaches for implementing the programme A Workshop lasting for 1-2 weeks.

Hand-outs should be sent to the participants before the Workshop, so that they are informed of the contents of the training programme. 6. The curriculum 6.1 Contents Modern management techniques, as covered in the Research Management Workshop at Islamabad. Identification of local biomedical and health services research needs. Implementation and utilization of modern technology in research, including an idea about the use of the computer in research. Research planning and programming. Basic principles of biostatistics and epidemiology, if the background of the trainees warrant this. Evaluation of scientific activities. Man management, including leadership and motivation. Comunications and information.

EM/RSR/16 EM/MG/~

EM/WKP.RCH.MGT./4 page 32 6.2

The l e a r n i n g m a t e r i a l s

Hand-outs r e l e v a n t t o t h e t o p i c s ;

t h e m a t e r i a l s used

i n the Management Workshop h e l d i n Islamabad c a n be used.

Research m a t e r i a l s from l o c a l s o u r c e s would be used f o r exercises.

R e l e v a n t m a t e r i a l s from a v a i l a b l e l i t e r a t u r e .

The e s t i m a t e d c o s t s

These should i n c l u d e :

Incentives f o r faculty. P e r diem f o r p a r t i c i p a n t s . Transportation a n d cnmmunicatinns.

S e c r e t a r i a t and p r i n t i n g .

A l l t h e s e would be e s t i m a t e d a c c o r d i n g t o t h e s i t u a t i o n s p r e v a i l i n g i n

e a c h country.

P r e p a r a t o r y phase :

6 months. 2 months.

I n v i t i n g a p p l i c a t i o n s and making s e l e c t i o n s : Workshop: 1-2 weeks.

E v a l u a t i o n and r e p o r t :

1 month.

P o t e n t i a l c o n t r i b u t i o n of WHO

Educational materials. Experts.

EM/ RSR/ 1 6 EM/MG/3 EM/WKP.RCH.MGT/~ page 33

Notwithstanding t h e above, i t was f e l t t h a t a n o t h e r approach t o exposing and t r a i n i n g n a t i o n a l s i n r e s e a r c h management would be t o u n d e r t a k e a r e s e a r c h programming e x e r c i s e , l a s t i n g f o r about two weeks. During t h i s e x e r c i s e t h e v a r i o u s n a t i o n a l r e s e a r c h a c t i v i t i e s , b o t h ongoing and planned, can be reviewed and m o d i f i e d , u t i l i z i n g t h e v a r i o u s management p r i n c i p l e s and t e c h n i q u e s employed i n t h e Islamabad Workshop.

I11 UTILIZATION OF THE RESULTS O F RESEARCH

During t h e Workshop t h e poor o r n e g l i g i b l e u t i l i z a t i o n of t h e r e s u l t s of r e s e a r c h was s t r e s s e d on s e v e r a l o c c a s i o n s . Towards t h e end of t h e Workshop,

time was a l l o t t e d f o r a s h o r t d i s c u s s i o n on p o s s i b l e mechanisms t o e n s u r e a g r e a t e r u t i l i z a t i o n of t h e f i n d i n g s of r e s e a r c h . emerged a s p o s s i b l e f a c i l i t a t i n g mechanisms : A t t e n t i o n should be paid t o t h e u t i l i z a t i o n of r e s e a r c h r e s u l t s a t t h e t i m e of p l a n n i n g of r e s e a r c h p r o j e c t s . The f o l l o w i n g p o i n t s

For r e s e a r c h being f i n a n c e d through p u b l i c f u n d s , e s p e c i a l l y h e a l t h s e r v i c e s r e s e a r c h , t h e r e s e a r c h worker should be involved and work c l o s e l y w i t h t h e concerned h e a l t h s e r v i c e s o f f i c i a l s i n t h e s e l e c t i o n of r e s e a r c h t o p i c s and t h e f o r m u l a t i o n of r e s e a r c h p r o p o s a l s .

C l o s e l i a i s o n should be m a i n t a i n e d w i t h t h e h e a l t h s e r v i c e s s t a f f throughout t h e d u r a t i o n of t h e p r o j e c t . I n t h i s way

t h e r e a r e i n c r e a s e d changes of r e s e a r c h r e s u l t s being fed i n t o t h e h e a l t h system, even b e f o r e t h e p r o j e c t i s over and a f i n a l r e p o r t submitted.

EM/RSR/16 EM/MG/ 3 EM/WKP.RCH.MGT/~ page 34

R e s e a r c h w o r k e r s , where f e a s i b l e , s h o u l d a l s o b e i n v o l v e d i n service functions. I n most of t h e c o u n t r i e s of t h e Region where r e s o u r c e s f o r r e s e a r c h a r e l i m i t e d , t h e r e s e a r c h w o r k e r s ' manager and t h e h e a l t h s e r v i c e s manager s h o u l d j o i n t l y d e c i d e on o n l y a few p r i o r i t i e s f o r r e s e a r c h and t h e n work t h r o u g h them a l l t h e way t h r o u g h f o r t h e u t i l i z a t i o n of t h e r e s u l t s of r e s e a r c h u n d e r t a k e n on t h e s e p r i o r i t y i t e m s .

Many r e s e a r c h e s a r e o f t e n t e r m i n a t e d a t a p r e m a t u r e s t a g e , when t h e r e s u l t s a r e n o t s u f f i c i e n t l y v a l i d f o r t h e i r a p p l i . c a t i o n w i t h i n t h e h e a l t h system.

The e v e n t u a l r e s p o n s i b i l i t y f o r u t i l i z a t i o n s h o u l d r e s t w i t h b o t h che r e s e a r c h and h e a l t h s e r v i c e s manager.

I n t h e n a t i o n a l body r e s p o n s i b l e f o r r e s e a r c h , e.g.

MRC

o r a n a l o g o u s body, t h e H e a l t h M i n i s t r y s h o u l d b e r e p r e s e n t e d a t t h e most s e n i o r p r o f e s s i o n a l l e v e l .

EVALUATION OF THE WORKSHOP

An e v a l u a t i o n of t h e Workshop was c a r r i e d o u t by a s k i n g t h e p a r t i c i p a n t s t o f i l l o u t a n E v a l u a t i o n Form (Annex VI). The r e s p o n s e s showed

t h a t , f o r n e a r l y a l l t h e p a r t i c i p a n t s , t h e Workshop had m e t t h e i r expect a t i o n s and a l s o t h e s t a t e d o b j e c t i v e s . N e a r l y h a l f of t h e p a r t i c i p a n t s the others f e l t

f e l t t h a t t h e d u r a t i o n of t h e Workshop was j u s t r i g h t ;

t h a t i t was t o o long and s h o u l d have l a s t e d 6 ( 1 r e s p o n s e ) , 7 ( 3 r e s p o n s e s ) or 0 ( 1 r e s p o n s e ) d a y s .

O n e o f t h e p a r t i c i p a n t s thought t h a t t h e Workshop

EM/RSR/ 16 EM/MG/~ EM/WKP RCH. M G T /4 page 35

should have l a s t e d f o r 20 days. The p a r t i c i p a n t s were asked t o g r a d e e a c h o f t h e t o p i c s c o v e r e d , r e g a r d i n g i t s r e l e v a n c e , t i m e a l l o t t e d t o i t , background m a t e r i a l p r o v i d e d , f o r m a l p r e s e n t a t i o n s / l e c t u r e s and t h e e x e r c i s e s planned f o r t h e t o p i c s (where a p p l i c a b l e ) . The p a r t i c i p a n t s were unanimous i n c o n s i d e r i n g a l l t h e t o p i c s covered a s being relevant. From t h e r e s p o n s e s i t appeared t h a t more t i m e s h o u l d Case Study on Assessment o f S c i e n t i f i c A c t i v i t i e s . Nearly

have been a l l o t t e d t o t h e

For o t h e r t o p i c s t h e time a l l o t t e d was c o n s i d e r e d t o be a b o u t r i g h t .

h a l f t h e p a r t i c i p a n t s f e l t t h a t t h e u s e of f o r m a l l e c t u r e s and e x e r c i s e s was about r i g h t .

A l l t h e p a r t i c i p a n t s who responded found t h e l e a r n i n g m a t e r i a l provided f o r t h e Workshop u s e f u l . The a d m i n i s t r a t i v e arrangements made f o r t h e Work-

shop were r a t e d a s e x c e l l e n t . I n t h e o p i n i o n o f some of t h e p a r t i c i p a n t s , t h e f o l l o w i n g t o p i c s could have been i n c l u d e d i n t h e Workshop :

Manpower p l a n n i n g Monitoring u t i l i z a t i o n o f r e s e a r c h r e s u l t s A p p l i c a t i o n of management t e c h n i q u e s i n m e d i c a l r e s e a r c h More on planning P e r s o n n e l management M o t i v a t i o n and l e a d e r s h i p Computering and s t a t i s t i c s Feedback a f t e r s i x weeks Role of WHO i n n a t i o n a l r e s e a r c h p l a n n i n g .

EM/RSR/ 1 6

EM/MG/~ EM/WKP.RCH.MGT/4 page 36 V

CONCLUDING SESSION

The Concluding S e s s i o n was a t t e n d e d by H.E. of H e a l t h , Government of P a k i s t a n .

D r N. J o g e z a i , M i n i s t e r

He was welcomed by t h e Chairman of t h e Mohydin. A summary

P a k i s t a n M e d i c a l Research C o u n c i l , Major G e n e r a l M.A.Z. o f t h e Workshop was p r e s e n t e d by D r J .

ashm mi, R e g i o n a l A d v i s e r on Research

Promotion and Development, WHO EMRO, and C o o r d i n a t o r o f t h e Workshop. The M i n i s t e r i n h i s c l o s i n g remarks s a i d t h a t he was p l e a s e d t h a t t h e Workshop had been s u c c e s s f u l l y c o m p l e t e d , and complimented t h e p a r t i c i p a n t s and r e s o u r c e s t a f f on t h e i r h a r d work. sponsored t h i s i m p o r t a n t a c t i v i t y . importance of r e s e a r c h , b o t h i n H e a l s o thanked WHO f o r h a v i n g

D r Jogezai i n conclusion stressed the

m e d i c a l e d u c a t i o n and i n t h e d e l i v e r y of

h e a l t h s e r v i c e s and promised t o e x t e n d f u r t h e r c o l l a b o r a t i o n w i t h WHO i n the future.

Annex I page i ANNEX I LIST OF PARTICTPANTS

EGYPT

Dr Abdel Ghafal: Khallaf Ministry of Health Cairo

Under-Secretary for Development and Research

Dr Taha Abou Shousha Director Documentation Department Ministry of Health Cairo Dr Mohamed El Alami Director Field Research, Qaliub Ministry of Health Cairo Dr Yahya El Battawi Chief Faculty of Medicine Cairo University Cairo IRAN

Bacteriology Sect ion

Dr Jalil Zarrabi Mofid Hospital c/o Ministry of Health and Welfare Teheran Dr Hossein Ali Askari Institute of Endocrinology and Metabolism c/o Ministry of Health and Welfare Teheran

* **

attended 4-9 April did not attend

EM/RSR/16 EM/MG/~ EM/WKF.RCH.MGT/4 Annex I page ii

PAKISTAN

Dr Inam Kazmi Director Pakistan Medical Research Council Islamabad Bashirul Haque * Assistant, Chief Health Planning Division Government of Pakistan Islamabad Dr

Dr Abdul Aziz Deputy Director General of Health Health Division Ministry of Health and Social Welfare Islamabad Professor M. Ataur Rahman Department of Biochemistry Jinnah Postgraduate Medical Centre Karachi Dr Zulfiqar Haider Rcscarch Director

Pakistan Medical Research Centre Fatima Jinnah Medical College Lahore SUDAN

Dr Ahmed Mahmoud Abbas Head Vaccine and Sera Department National Health Laboratories Ministry of Health Khartoum Dr Babiker Mohammed El Tahir Head Department of Virology Ministry of Health (National Health Laboratories) Khartoum

* attcnded only

a fcw

3c33ion3

EM/RSR/ 16

EM/MG/ 3 EM/WW .RCH.MGT/~ Annex I page iii

S U D A N (cont ' d)

D r Saad Darrag Osman Director Khartoum North Testing Laboratory National Health ~ a b o t a t o r i e s Ministry of Health Khartoum D r Gala1 Mohammed Osman Director P o r t Sudan Regional Laboratory Ministry of Health Khartoum

OBSERVERS F R O M H O S T C O U N T R Y Col. S.E. Rana Director Research and Professor of Anatomy Armed Forces Medical College Rawalpindi Col. I . A . Malik Professor of Pathology Army Medical College Rawalpindi

D r S.J. Zuberi Research Tli rector

PMRC, Research Centre Jinnah Postgraduate Medical Centre Karachi D r T. Akhtar Research Director PMRC, Research Centre Khyber Medical College Peshawar D r Z . Hussain Chief Research O f f i c e r Pakistan Medical Research Council Karachi

E?I/RSR/~~ EM/MG/3 EM/WKP.RCH.MGT./~ Annex I page iv WHO SECRETARIAT

Dr M.O. Shoib Dr J. Hashmi

Director, Programme Management

WHO Eastern Mediterranean Regional Office

Regional Adviser, Research Promotion and Develupri~erl L; Workshop Coordinator

WHO Eastern Mediterranean Regional Off ice

Dr B.A. Jayaweera

Regional Adviser, Research promotion and Development Chairman of the E1I Advisory Committee on lledical Research

WHO South-East Asian Regional Office, New Delhi Director, International and Scientific Cooperation, Institute of Veterinary i!edicine, Robert von Ostertag Institut, Berlin (West) Professor and Head of the Department of Operational Research, University of Lancaster, England WHO Eastern Mediterranean Regional Office

Professor Dr M. ~bdussalam

Professor M.G.

Simpson

WHO Consultant

Mrs C. Putnoky

Secretary, Research Planning and Development Unit

**Did

*~ttended on 7, 8 and 9 ~pril. not attend

EM/RSR/ 16

EM/MG/~ EM/WKP.RCH.MGT/~ Annex 11 page i ANNEX I1

MESSAGE OF DR A.H. TAM DIRECTOR WHO EASTERN MEDITERRANEAN REGION to the

WORKSHOP ON RESEARCH M A N A G E M E N T Islamabad, 4-14 A p r i l 1981

I deeply r e g r e t my i n a b i l i t y , due t o p r e s s i n g commitments, t o be p e r s o n a l l y

p r e s e n t on t h i s occasion.

However, i t g i v e s me g r e a t p l e a s u r e t o send t h i s

Message o f welcome t o t h e d i s t i n g u i s h e d p a r t i c i p a n t s a t t e n d i n g t h e WHO-sponsored Workshop on Research Management. I wish t o extend my p e r s o n a l and t h e O r g a n i z a t i o n ' s thanks t o t h e M i n i s t r y o f Health, and t o t h e P a k i s t a n Medical Research Council, M i n i s t r y o f Science and Technology, Government o f P a k i s t a n , f o r h o s t i n g t h i s Workshop. Medical Research, both d i s e a s e and h e a l t h s e r v i c e s o r i e n t e d , i s becoming an i n c r e a s i n g l y important component i n t h e World Health O r g a n i z a t i o n ' s

c o l l a b o r a t i v e programme w i t h i t s Member S t a t e s , e s p e c i a l l y w i t h r e g a r d t o i t s r o l e i n achievement o f t h e g o a l "Health f o r A l l by t h e Year 2000". S i n c e t h e mid-70s t h e Organization h a s been making a c o n c e r t e d e f f o r t t o develop and s t r e n g t h e n medical r e s e a r c h c a p a b i l i t i e s i n developing c o u n t r i e s throughout t h e world. of national s c i e n t i s t s This i s being c a r r i e d o u t through t h e a c t i v e involvement i n t h e Regional Advisory Conunittee f o r Medical Research,

EM/RCR/16 EM/MG/~ EM/WKP .RCH . M G T / ~ Annex I1 page ii

and i n t h e planning and implementation of g o a l - o r i e n t e d r e s e a r c h , and a l s o i,, t r a i n i n g young and promising s c i e n t i s t s i n t h e newer techniques o f l a b o r a t o r \ c l i n i c a l and h e a l t h s e r v i c e s r e s e a r c h . While promoting t h e s e r e s e a r c h - o r i e n t e d a c t i v i t i e s , i t soon became apparz-.

: t h a t a major c o n s t r a i n t i n implementing them a t t h e country l e v e l was t h e 1 o f t h e r e q u i s i t e e x p e r t i s e i n managing r e s e a r c h programmes, and r e s e a r c h i n s t i t u t i o n s , and of e n s u r i n g e f f e c t i v e u t i l i z a t i o n of t h e s c a r c e human and f i n a n c i r e s o u r c e s c u r r e n t l y a v a i l a b l e f o r medical r e s e a r c h . With t h i s i n view, i t was decided t o p l a n and sponsor a t r a i n i n g p r o g r a r i i n r e s e a r c h management f o r some o f t h e Member S t a t e s o f t h e E a s t e r n M e d i t e r r l Region. These p l a n s were reviewed by a S p e c i a l C o n s u l t a t i o n l a t e l a s t y e a r , T t was rQrnr L : .

then by the EM Rcgional Advisory Committee on Medical Researrh.

t h a t , a s an i n i t i a l s t e p , t h i s Workshop would be organized.

While focussin;

r e s e a r c h , L l ~ i sactivity i s part of our collaborativc progrannne to up-grade a . s t r e n g t h e n t h e management o f h e a l t h s e r v i c e s and r e s e a r c h i n t h e Member SLatc During plannlng f o r Chis Workshop, we were sLruck Ly the fact that there a p a u c i t y o f published m a t e r i a l , d e a l i n g with t h e management o f r e s e a r c h anci development e f f o r t s i n t h e h e a l t h s e c t o r , r e l e v a n t t o t h e e x i s t i n g s i t u a t i o r most o f o u r Member S t a t e s . Therefore, a n important t a s k f o r t h e p a r t i c i p a n t s i

i n t h i s Workshop i s t o p r e p a r e l e a r n i n g m a t e r i a l which r s u l d be used f o r t r a j o t h e r n a t i o n a l s i n r e s e a r c h management.

A s you w i l l n o t e from t h e P r o v i s i o n a l Programme, t h i s Workshop w i l l not

c!,

w i t h t h e d i s e a s e - s p e c i f i c r e s e a r c h , o r c o n t e n t s o f r e s e a r c h and r e s e a r c h :net111 . logy, b u t w i t h mechanisms which could improve t h e planning and i m p l e m e n t a t i c ~ ~ ~ of r e s e a r c h programmes.

EM/RSR/~~ EM/MG/~ EM/WKP .RCH .MGT/4 Annex 11 page iii

Even though Medical Research Councils o r analogous bodies e x i s t i n some o f t h e Countries of our Region, t h e q u a l i t y o f r e s e a r c h planning a t t h e c e n t r a l l e v e l and i t s e f f e c t i v e link-up with t h e h a t i o n a l development and h e a l t h p l a n s s t i l l need improvement. Perhaps t h e r e i s a need f o r c o u n t r i e s t o c a r r y o u t

d e t a i l e d r e s e a r c h programming e x e r c i s e s i n o r d e r t o formulate r e a l i s t i c r e s e a r c h p l a n s commensurate w i t h n a t i o n a l needs and r e s o u r c e s . I would l i k e t o make i t c l e a r , t h a t by planning and sponsoring t h i s Workshop, we a r e n o t t r y i n g t o propose o r even suggest t h a t our Member S t a t e s follow a

articular

o r given s t y l e o f r e s e a r c h management.

WHO'S

aim, on a medium-term

b a s i s , i s t o improve t h e planning and implementation o f n a t i o n a l medical r e s e a r c h programmco, u t i l i z i n g the appropriate management s k i l l , w i t h i n the e x i s t i n g a d m i -

nistrative structure.

This would permit r e s e a r c h t o be c a r r i e d o u t i n a n e f f e c t i v e This Workshop should bc a b l e t o provide

manner on s o c i a l l y r e l e v a n t i s s u e s .

p a r t i c i p a n t s with a n o p p o r t u n i t y t o s h a r e and l e a r n from each o t h e r ' s experience. A s an ouccome o f c h i s Workshop, I w i l l look Lurwarrl L u r e c e i v i n g your plarlti

f o r f u r t h e r s t r e n g t h e n i n g of r e s e a r c h management c a p a b i l i t i e s i n your c o u n t r i e s , and would be g l a d t o c o l l a b o r a t e , should t h i s be r e q u i r e d , i n implementation o f t h e s e plans.

I wish you a l l a p l e a s a n t s t a y i n Islamabad, and s i n c e r e l y hope t h a t you w i l l f i n d t h i s Workshop a u s e f u l e x e r c i s e .

ANNEX 111

TIME

TABLE

Date

Session no.

Topic

lbkgmmd mterlal

Aativity

4.4 1.

bglstration md Iarugumtion Introduatom m a r k s

Cla orie con Country papers prep.red by p a r t i c i p m t s i n accordance wlth Wdelines sent t o t h e m h d o u t in f i l e A p r t i o i p . n t from each cowtry presents a s-rg of paper

2 .

lRrs eatrblishmcnt and management of mrdiaal research i n the countries of participants Nmed and impoft.noe of mdloal research

App invo rese cou

Introduction - Maaussion Presentation - Dlsoussion -

An I

T i m nargement process and

of re-

- Qroup earraise on assessing l v t i a r v l needs f o r medical re808rch

the in h

Handout i n f i l e together with Olossary of terns raLsted t o - ~ t

Awa of ~ and Imp

-tion searah

- Handout I n f l l e - h p o r on I n b r m t i PraeNllss

- Introduction -raise a) QuldeiiiPhs f o r foxmilation of natiolrl medical research pollor b) B v e l o p s n t of research aprbllitj in a medical school and disoussion on t h e i r findings

Amr

aal Coopamtion i n Biabdioal R6sbamh

app dev lim

FM!RSR/

CM/MG/3 EM/wKP.RCH.MGT/~ Annex I11 page ii t

--.-c, E lc

X d

% t u I L . I

d 0 bl

d 0

. 9 d

h t e

Session no.

Topic

Bnokground m t e r i a l

8.4 -

13 & 14.

Measures of system e f featlveness

- Handout i n f i l e - Note on HFA/~OOO - Kealth and health-

related inf ormation on Yemen Arab R e p u b l i c

Qse Study 1 1 .

The two groups of participants will present t h e i r plans for the s c i e n t i f i c assessment of the Mvision of NM, respectively allotted t o them &clout in file Presentation

9.4

1 6 .

Network planning w i t h unoertainty

17. 18. 10.4 11.4 -

Research planning 11. Case Study 111. H O L I D A Y

Participants working i n groups flnalise t h e i r project proposals The assessment plan f i nalized in Session 15.

19 & 20.

Fornulation of evaluation of research proposals

- WHO -

d r a f t Ouidelines f o r e t h i c a l redew procedures f o r research involving human subjects Ethical coasidenrtions in bianedica. research Handout on Scientific information guidelines f o r project formulation

. -

Activity

- Presentation

- Delphi exercise

To a spec outp of i

mak

ject the gati able

App aspe of s

To b aert proc We pre

participants will visit the two con

the required information, and s t a r t pre

F'resentation on ethical considerations in medical research Review of project proposals prepared e a r l i e r by the two grollps

The shou the mul prop view

hte

Sessicn no. 21.

Topic

Background material

Activity

ProJect monitoring and c o n t r o l

Handout i n f i l e

Presentation and discussion

To cha con tur prob the awa men of

1 2 . 4 -

22.

B e h a ~ i o u r a la s p e c t s o f research management and t h e r o l e of cotmnunication in managenent

- Handout i n f i l e -

Paper on I n t r o duction t o h m a s p e c t s o f management Booklet on r e p o r t writing

- Mscussion - An e x e r c i s e

demonstrating d i fficulty i n comunication

To a of rese imp in m the cou oth tion cul oth of

23.

Case S t u d y IV.

- The two groups w i l l r e p o r t on t h e i r assessment of t h e s c i e n t i f i c a c t i v i t i e s of t h e two D i v i s i o n s of NIH - Discussion on t h e r e p o r t s , including t h e usefulness of procedures employed and proposals made Handout i n f i l e

hil pla asse tie

24.

Research Information

Intro&~ction Group e x e r c i s e on o r g a n i z a t i o n of health l i t e r a t u r e services and a n information system f o r researmh management, and d i s cussion of f i n d i n g s

EM/RSR/ 16 EM/MG/~ EM/WKP.RCH.MGT/~ Annex 111 page v

EM/RSR/16 EM/MG/ 3 EM/WKP.RCH.MGT/~ Annex I V page i

ANNEX I V SUMMARIES OF THE PAPERS PRESENTED BY THE PARTICIPANTS ON T H E ESTABLISHMENT AND M A N A G E M E N T O F MEDICAL RESEARCH I N THEIR COUNTRIES EGYPT

Background Egypt h a s long e x p e r i e n c e i n medical r e s e a r c h , which h a s developed from t h e

e s t a b l i s h m e n t o f t h e f i r s t Medical School i n Cairo, more than 150 y e a r s ago. Most of t h i s r e s e a r c h h a s been problem-oriented. Medical and h e a l t h r e s e a r c h

r a p i d l y f l o u r i s h e d w i t h t h e e s t a b l i s h m e n t o f new medical c o l l e g e s and o f t h e M i n i s t r y o f H e a l t h i n 1936. 2.

The N a t i o n a l P o l i c y o f Medical Research I n h e r N a t i o n a l P o l i c y f o r Development, Egypt p l a c e s emphasis on t h e r o l e t h a t

t h e r c s c a r c h c o r n u n i t y can play.

The Egyptian C o n s t i t u t i o n s t a t e s t h e n e c e s s i t y

of o r g a n i z i n g r e s e a r c h .aiming a t u t i l i z i n g a l l a v a i l a b l e r e s o u r c e s t o t h e f u l l e s t exLent p o s s i b l e .

For t h i s reason t h e N a t i o n a l Research Council was e s t a b l i s h e d i n The M i n i s t r y o f S c i e n t i f i c Research

1948, and t h e N a t i o n a l Research C e n t r e i n 1956. was e s t a b l i s h e d i n 1961, Lo

be the body r e s p o n s i b l e f o r o r g a n i e i n g r e s e a r c h and

guiding i t towards s o l v i n g n a t i o n a l problems. The main i n s t i t u t i o n s c a r r y i n g on medical r e s e a r c h a r e : t h e U n i v e r s i t i e s , t h e M i n i s t r y of H e a l t h and t h e Academy o f S c i e n t i f i c Research and Technology. The main f e a t u r e s o f t h e N a t i o n a l P o l i c y f o r medical and h e a l t h r e s e a r c h a r e : a) b) T o s u p p o r t r e s e a r c h and d i r e c t i t towards s o l v i n g n a t i o n a l h e a l t h problems.

To c o o r d i n a t e a l l medical r e s e a r c h a c t i v i t i e s and t o e s t a b l i s h l i n k s between

a l l medical r e s e a r c h i n s t i t u t i o n s . C)

To develop r e s e a r c h manpower.

EM/RSR/~~ EM/MG/3 EM/WKP.RCH.MGT/~ Annex I V page ii

To encourage c o o p e r a t i o n w i t h f o r e i g n and i n t e r n a t i o n a l o r g a n i z a t i o n s i n

medical r e s e a r c h f i e l d s . e) To o r g a n i z e t h e a c q u i s i t i o n , p r o c e s s i n g and d i s s e m i n a t i o n of i n f o r m a t i o n

r e l e v a n t to medical research. f) To

encourage t h e e s t a b l ishment n f new r e d e a r r h r e n t r e c i n m a jar health

problems.

Medical Research P r i o r i t i e s

3 . 1 I n Medical S c h o o l s : Research i n Medical Schools i n one o f t h e t h r e e t a s k s o f t h e f a c u l t y , namely: e d u c a t i o n , medical c a r e s e r v i c e and r e s e a r c h . Research t h e s e s a r e

p r e r e q u i s i t e s f o r h i g h e r academic d e g r e e s and f o r promotion o f t h e f a c u l t y staff. Thus, r e s e a r c h i n Medical Schools i s m o s t l y c e n t r e d on c l i n i c a l t o p i c s .

and t h e f i r s t p r i o r i t y i s g i v e n t o r e s e a r c h which would add new knowledge i n d i s e a s e p a t t e r n s and m e d i c a l t r e a t m e n t . 3.2

I n the Ministry o t Health: P r i o r i t i e s o f r e s e a r c h a r e g i v e n t o s o l v i n g n a t i o n a l h e a l t h problems acc:

t o t h e magnitude and p o t e n t i a l h a z a r d s o f each problem. r e s e a r c h i s focussed a r e : a ) p a r a s i t i c diseases

The main problems o r

b) n u t r i t i o n a l diseases C ) paediatric diseases d) i n f e c t i o u s diseases e) chest diseases

EM/RSR/ 16 EM/MG/~ EM/W.RCH.MGT/& Annex I V page iii f ) Environmental and i n d u s t r i a l h e a l t h

g ) P o p u l a t i o n problems and family planning h ) Primary h e a l t h , c a r e d e l i v e r y problems i) Drugs, b i o l o g i c a l products and s e r a .

3 . 3 I n t h e Academy o f S c i e n t i f i c Research and Technology P r i o r i t i e s o f medical r e s e a r c h a t t h e National Research Centre and t h e Theodore B i l h a r z Research Centre a r e : a ) Parasitic diseases b) Environmental p o l l u t i o n problems c ) N u t r i t i o n a l problems d ) Occupational h e a l t h e ) Pharmaceutical s c i e n c e s , medical chemistry and n a t u r a l products.

O r g a n i z a t i o n of Medical Research The i n s t i t u t i o n s conducting medical r e s e a r c h a r e :

Universities 9 Medical Colleges

6 Pharmacy Colleges

5 D e n t i s t r y Colleges 2 High I n s t i t u t e s of Nursing 1 High I n s t i t u t e of P u b l i c Health, Alexandria 1 N a t i o n a l I n s t i t u t e of Tumours, Cairo

1 Higher I n s t i t u t e o f P h y s i c a l Therapy 1 D i v i s i o n o f Biomedical Engineering, College o f Engineering, Cairo U n i v e r s i t y .

b) Ministry of Health 8 Research I n s t i t u t e s

4 Research C e n t r e s 1 N a t i o n a l O r g a n i z a t i o n f o r Drug Research and Control 1 O r g a n i z a t i o n f o r B i o l o g i c a l and Vaccine Products

'EMIRSRI 16 EM/MG/~ EM/WKP.RCH.MGT/~ Annex I V page i v c ) The Academy o f S c i e n t i f i c Research and Technology

1 The N a t i o n a l Research C e n t r e 2 The Theodore B i l h a r z Kesearch I n s t i t u t e

A d m i n i s t r a t i o n o f Research i n t h e M i n i s t r y o f H e a l t h ;.I Kesearch p o l i c i e s and p l a n s a r e developed by t b e Permanent Committee on Reseal

The Committea i n c l u d e s r e p r e s e n t a t i v e s o f t h e M i n i s t r y o f H e a l t h , Medical Schools, The Academy o f S c i e i ~ t i f l c Kesearch and Technology and t h e M i l i t a r y Pledical Corps. 5.2 Recently a Department o f Research was e s t a b l i s h e d i n t h e M i n i s t r y o f H e a l t h a t e c h n i c a l s e c r e t a r i a t f o r t h e Permanent Committee. E

'LPhe Research Department w i l :

e n s u r e coordirlation b?cween r e s e a r c h i n s t i t u t i o n s , c o l l e c t and d i s s r m l n a t e r e s e a r c i n f o r m a t i o n , and s u p p o r t r e s e a r c h p r o j e c t s i n t h e M i n i s t r y o f Health.

5.3 Recearch agreements w i t h i n t e r n a t i o n a l i n s t i t u t i o ~ ~ ar se rapidly increasing Egypt.

i . .

The N M T J 3 u n i t i s working on i n f e c t i o u s d i s e a s e s .

Five Sub-comntittes

conduct j o i n t r e s e a r c h p r o j e c t s w i t l - t h e US Department o f H e a l t h and Human S e r v L . i c i n : h e a l t h s e r v i c e s , biomedical r e s e a r c h and i n f e c t i c u s d i s e a s e s , pharmaceuticand b i o l o g i c a l p r e p a r a t i o n s , environmental and o c c u p a t i o n a l h e a l t h and n u t r i t i o n ,

Research Review Committees Technical Review Committees a r e formed i n every r e s e a r c h i n s t i t u t i o n . Ethic: '

review

i s done i n c e r t a i n c a s e s , b u t e t h i c a l review committees a r e n o t y e t deve.

Research Informa t i o n The main s o u r c e s f o r i n f o r m a t i o n p e r t i n e n t t o medical r e s e a r c h a c t i v i t i e s i n

Egypt a r e a v a i l a b l e a t t h e l i b r a r i e s o f Medical Schools, t h e C e n t r a l L i b r a r y o f

:l>t

Minis t r y o f H e a l t h , t h e NIDOC ( N a t i o n a l Information and Documentation C e n t r e ) , t h e NAMRU 3 L i b r a r y and t h e WHO E M R O L i b r a r y i n t h e Regional O f f i c e .

EM/RSR/16 EM/MG/~ EM/wKP .RCH.MGT/~ Annex IV Each o f t h e 32 s p e c i a l i z e d medical s o c i e t i e s h a s a p e r i o d i c a l magazine p u b l i s h i n g r e s e a r c h a c t i v i t i e s , l i t e r a t u r e s o u r c e s and b i b l i o g r a p h i e s . Recently t h e M i n i s t r y o f H e a l t h h a s a r r a n g e d w i t h E M R O t o gain f r e e access t o t h e computerized d a t a b a s e s such a s MEDLARS, 8. CONCLUSION Research r e s o u r c e s i n Egypt a r e a b l e t o a i d i n t h e implementation o f n a t i o n a l Nevertheless t h e following p o i n t s should be g i v e n more

medical r e s e a r c h p l a n s . cons i d e r a t i o n :

a ) c o o r d i n a t i o n among medical r e s e a r c h i n s t i t u t i o n s b) development of manpower f o r r e s e a r c h a c t i v i t i e s c ) o r g a n i z a t i o n o f a N a t i o n a l H e a l t h Information System. IRAN Background

I r a n (a c o u n t r y w i t h a p o p u l a t i o n o f f o r t y m i l l i o n r e c o v e r i n g from long y e a r s or p o l i L i c a l oppression) i s now I n t h e p r o c e s s of planning t o r a N a t i o n a l H e a l t h

System t o b r i n g medical c a r e t o t h e f a r - o u t l y i n g v i l l a g e s where two t h i r d s o f t h e p o p u l a t i o n l i v e , a s w e l l a s t o t h e poor i n d u s t r i a l a r e a s o f t h e towns. Changes i n

medical education a r e a l s o under s t u d y by t h e c o u n c i l f o r t h e c u l t u r a l r e v o l u t i o n . The n a t i o n a l p o l i c i e s f o r medical r e s e a r c h a r e introduced i n t h e new system o f medical c a r e and education. The new e r a o f organized medical r e s e a r c h i n I r a n began w i t h t h e e s t a b l i s h m e n t of t h e P a s t e u r I n s t i t u t e i n Teheran more than h a l f a c e n t u r y ago.

Medical r e s e a r c h

expanded and developed a l o n g w i t h t h e r e n o v a t i o n and modernization of t h e thene x i s t i n g o l d medical school i n Teheran. L a t e r came t h e formation of n i n e more

medical schools, a school o f p u b l i c h e a l t h , p o s t - g r a d u a t e programmes, and

EM/RSR/~~ EM/MG/~ EM/WKP.RCH.MGT/~ Annex IV page v i

s p e c i a l i z e d i n s t i t u t e s both i n s i d e t h e u n i v e r s i t i e s , and o u t s i d e them.

Until

now t h e l a c k o f a c o n c r e t e n a t i o n a l m e d i c a l r e s e a r c h p o l i c y h a s been an o b s t a c l ' , t o o b t a i n i n g f u l l u t i l i z a t i o n o f a v a i l a b l e human r e s o u r c e s . The c u r r e n t p r i o r i t i e s f o r r e s e a r c h a r e ;

?he t r a i n i n g o f r e s e a r c h manpower; t h e d e l i v e r y and d i s t r i b u t i o n o f h e a l t h c a r e ; c l i n i c a l r e s e a r c h .

Areas d e s e r v i n g s p e c i a l a t t e n t i o n a r e :

i n f e c t i o n s and i n f e s t a t i o n s ;

- epidemiology; - p r e v e n t i v e medicine; - environmental h e a l t h ; - nutrition. New developments i n t r a i n i n g r e s e a r c h e r s I n t h e new n a t i o n a l h e a l t h system provisions a r e being made f o r t h c i n t ~ ~ ; . I, . o f r e s e a r c h w i t h m e d i c a l e d u c a t i o n and t h e m e d i c a l c a r e s e r v i c e s . d u c t i n n o f t h e community-oriented m e d i c a l c c h o o l c u r r i c u l a ,

With the i , ~ r , -C

t h e students,

~ I I - C - L

. ,..

and r e s i d e n t s w i l l spend a p a r t o f t h e i r t r a i n i n g i n t h e f i e l d w i t h t h e i r t e a c l l t r The r e s i d e n t s w i l l p a r t i c i p a t e i n t h e r e s e a r c h p r o j e c t s i n t h e i r a r e a s o f under t h e g u i d a n c e o f t h e i r t e a c h e r s .

Such a d d i t i o n a l work f o r t h e academic ; t ~ _

i s encouraged by supplementing t h e i r s a l a r i e s . I n s t i t u t i o n s i n v o l v e d i n Medical Research Beside t h e m e d i c a l s c h o o l s and t h e School o f P u b l i c H e a l t h i n t h e U n i v e r s i t : , o f Teheran, t h e f o l l o w i n g i n s t i t u t i o n s i n t h e M i n i s t r y o f H e a l t h a r e a c t i v e i n research:

EM/RSR/~~ EM/MG/3 EM/WKP .RCH .MGT/& Annex I V page v i i

- Pasteur I n s t i t u t e - Nutrition I n s t i t u t e I n s t i t u t e o f endocrinology and metabolism: t h i s i n c l u d e s t h e hormone a s s a y and c y t o g e n e t i c l a b o r a t o r i e s and a l s o

t h e WHO-supported human reproduction u n i t and t h e I r a n i a n Diabetes A s s o c i a t i o n which i s r e s p o n s i b l e f o r t h e c a r e of d i a b e t i c s and r e l a t e d r e s e a r c h .

- National

Trans f u s i o n Organization: t h i s covers a c t i v i t i e s

p r i n c i p a l l y i n t h e f i e l d o f immunology and plasma p r o t e i n s fractionation. - R a z i I n s t i t u t e : this i s a parL ul: Lhe M i n i s t r y o f Agricul-

t u r e , which i s a c t i v e i n immunological r e s e a r c h r e l a t e d t o L h e p r o d u c t i o n o f vaccines and a n r i r o x i n s .

U n t i l r e c e n t l y , a l l t h e proposed r e s e a r c h p r o j e c t s have been reviewed and evaluated i n the r e s e a r c h ~ o u n c i l s o tt h e medical schools and of u n i v e r s i t i e s , o r i n t h e National Council f o r Medical Research, according t o t h e sources of funds. The s h o r t a g e of epidemiologists and b i o s t a t i s t i c i a n s , i n p a r t i c u l a r and o f b a s i c medical s c i e n t i s t s i n g e n e r a l has hampered t h e development o f medical r e s e a r c h . PAKISTAN

1 . O r i g i n a l l y medical r e s e a r c h was mostly a s s o c i a t e d w i t h i n d i v i d u a l r e s e a r c h workers, but with t h e growth of i n t e r e s t and importance, t h e emphasis of r e s e a r c h has now shifted t o medical i n s t i t u t i o n s . These o r g a n i z a t i o n s d e r i v e t h e i r mandate from t h e

EM/KSK/ 16 EM/MG/ 3 EM/WKP .RCH . M G T / ~ Annex I V page v i i i

p o l i c y g u i d e l i n e s given i n t h e n a t i o n a l p l a n s .

According t o t h e f i f t h Five-Year

plan (1978-83) "medical r e e e a r c h is a n i n t e g r a l part o f h e a l t h c a r e and medical

education.

The p r i o r i t i e s f o r medical r e s e a r c h i n P a k i s t a n a r e d i c t a t e d by

pressing h c a l t h problems on the ullr €land and t h e l i m i t e d number of r e s e a r c h

workers on t h e o t h e r .

Medical r e s e a r c h d u r i n g t h e p l a n w i l l be geared so a s t o

( 1 ) develop a s t r o n g i n f r a s t r u c t u r e f o r r e s e a r c h ( 2 ) i n c r e a s e understanding o f t h e epidemiology and ecology o f t h e commonly p r e v a l e n t d i s e a s e s , w i t h a view t o c o n t r o l and prevention and ( 3 ) provide r e s e a r c h support t o t h e programme o f primary h e a l t h c a r e i n r u r a l areas". 1 1 . P a k i s t a n Medical Research Council

The P a k i s t a n Medical Research Council (PMRC) was c o n s t i t u t e d on t h e recommentla t i o n s of t h e Medical Reform and S c i e n t i f i c Commissions i n March 1962. The

Council has been charged by t h e Government w i t h t h e r e s p o n s i b i l i t y o f promoting, developing and c o o r d i n a t i n g medical r e s e a r c h a c t i v i t y i n t h e country. c e n t r e s of r e s e a r c h a c t i v i t i e s o f t h e Council a r e t h e medical c o l l e g e s . The main

I n order

t o promote r e s e a r c h a c t i v i t i e s and t o i n c u l c a t e research-mindedness among s t a f t and s t u d e n t s , t h e Council h a s s e t up r e s e a r c h c e n t r e s / c e l l s i n a l l medical c o l l e g e s i n t h e country, p l u s t h e National I n s t i t u t e o f Health. The Council promotes i t s a c t i v i t i e s through a n n u a l r e p o r t s , the P a k i s t a n J o u r n a l o f Medical Research, monographs, t e c h n i c a l r e p o r t s , seminars and symposia and brochures. The o t h e r c e n t r e s involved i n medical r e s e a r c h a r e :

- Planning -

Commission

Malaria Control Programme

EM/RSR/~~ EM/MG/~ EM/WKP .RCH.MGT/~ Annex I V page i x

P a k i s t a n S c i e n c e Foundation P a k i s t a n Medical Research C e n t r e ( u n i v e r s i t y o f Maryland), Lahore.

1II.The P a k i s t a n Medical Research Council h a s prepared medium-term p l a n s keeping i n view n a t i o n a l h e a l t h p r i o r i t i e s a s l a i d down i n n a t i o n a l p l a n s .

I t s e t s up

e x p e r t p a n e l s t o t r a n s l a t e t h e s e p l a n s i n t o problem-solving p r o j e c t s . I V . T e c h n i c a l review o f t h e p r o p o s a l s and r e s u l t s o f t h e work i s done by e x p e r t

p a n e l s a p p o i n t e d by t h e P a k i s t a n Medical Research Council, b u t no n a t i o n a l review committees e x i s t a t t h e moment. V.

The r e s u l t s o f r e s e a r c h a r e d i s s e m i n a t e d through n a t i o n a l and i n t e r n a t i o n a l S p e c i f i c recommendations a r e p u t

seminars, symposia and r e s e a r c h p u b l i c a t i o n s .

up t o t h e M i n i s t r y o f H e a l t h f o r c o n s i d e r a t i o n and p o s s i b l e a c t i o n .

VI. The P M R C i s a c t i v e l y engaged a t t h e moment i n compiling a r e s e a r c h i n v e n t o r y o f ongoing and completed r e s e a r c h p r o j e c t s . VII.Research O r g a n i z a t i o n s have s o f a r been working i n r e l a t i v e i s o l a t i o n and t h e r e i s no a c t i v e c o o r d i n a t i n g mechanism. VII1,Research management problems a r e due t o l a c k o f t r a d i t i o n s f o r r e s e a r c h . haphazard and unplanned development o f n a t i o n a l r e s e a r c h i n s t i t u t i o n s , l a c k o f s u f f i c i e n t r e s o u r c e s , absence o f c a r e e r s t r u c t u r e and s a t i s f a c t o r y i n c e n t i v e s . These l a t t e r p o i n t s reduce f u r t h e r t h e a v a i l a b i l i t y of r e s e a r c h t a l e n t i n t h e country. There i s no p r o p e r system f o r t r a i n i n g medical r e s e a r c h workers, and

managerial s k i l l s a r e b o t h p o o r l y developed and n o t e f f e c t i v e l ~ u~ tilized in medical r e s e a r c h .

EM/RsR/ 1 6

EM/MG/~ EM/WKP.RCH . M G T / ~ Annex I V page x SUDAN Background and c u r r e n t p r i o r i t i e s Medical r e s e a r c h i n t h e Sudan s t a r t e d i n 1908 on an i n d i v i d u a l b a s i s and c o n t i n u e d t h i s way u n t i l t h e end o f t h e 1960s when t h e Sudan N a t i o n a l Council far Research and t h e Medical Research Council were e s t a b l i s h e d .

A n a t i o n a l p o l i c y and p l a n f o r medical r e s e a r c h was f o r m u l a t e d by t h e M i n i s t r y o f H e a l t h i n 1975, under t h e name o f N a t i o n a l H e a l t h Programme 1977178 t o g e t h e r w i t h a 6-year p l a n f o r development. I n November 1980 t h e Congress o f H e a l t h For A l l by t h e Year 2000, h e l d i n Khartoum, a l s o l a i d down t h e g e n e r a l p o l i c y f o r h e a l t h and r e s e a r c h development i n t h e Sudan. Research p r i o r i t i e s i n c l u d e : 1.

1983189,

cormnunicy medicirtr, r . g . u l a l a ~ i a , schistoaomiasis, tubcrculooio, wotor-borne

diseases. 2.

Development of f u l l y t r a i n e d medical p e r s o n n e l . N u t r i t i o n , through s t u d y of n a t i o n a l f o o d s and t h e i r v a l u e s . Maternal and c h i l d w e l f a r e s t u d i e s . Immunization programme, i n c l u d i n g e f f i c a c y o f v a c c i n e s , t h e i r p r o d u c t i o n ,

3. 4.

p r e s e n t a t i o n and import i n t o developing c o u n t r i e s .

C u r a t i v e a s p e c t s : t h e i n c i d e n c e and t r e a t m e n t o f such d i s e a s e s a s c o r o n a r y

h e a r t disease, diabetes m e l l i t i s , cancer. 7. Drug i n d u s t r y : s t u d i e s on t h e u s e and a b u s e o f drugs. T r a d i t i o n a l medicine: l o c a l l y used h e r b s , t h e i r e f f e c t s and t o x i c o l o g y . Environmental h e a l t h medicine.

8. 9,

EY/I<SR/ 1 6

CPI/?IG/ 3 EM/WKP .RCH .HGT /il Annex I V Pa. e ?i 10. I n d u s t r i a l m e d i c i n e

1 1 . Ilea 1t'l e d u c c l t i o n 1 2 , Plannine; and management

1 3 . P s y c h o l o g i c a l m e d i c i n e and m e n t a l i l l n e s s O r ~ a n i z a t i o no f m e d i c a l r e s e a r c h i n t h e Sudan 'iedical r e s e a r c h i n t h e Sudan i s o r g a n i z e d t h r o u g h t h e ? f i n i s t r y st b c a l t ~ z r . , .

the following bodies:

1. 2. 3.

N a t i o n a l C o u n c i l f o r R e s e a r c h (?]KC) Sudan M e d i c a l R e s e a r c h C o u n c i l (MRC) National Health Laboratories Khartoum U n i v e r s i t y T h e s e b o d i e s a r e u s u a l l y f i n a n c e d by t h e S l i n i s t r y o f I f e a l t h , S1iii117 ( ; o v c i r i ~ ~ - i ~ , - : .

WHO a n d / o r o t h e r i n t e r n a t i o n a l o r g a n i z a t i o n s a n d f r i e n d ' . , c o u n t r i e s . fo The S a t i o n a l C o u n c i l i o r R e s e a r c h , t h e ? l e d i c a l C c ~ ~ n c i l r Reci'nrch a n d :if.. Advisory Council t o t h e M i n i s t e r o f Health hold a n annual meeting i n w h i c h a : ; t o p i c s f o r r e s e a r c h a r e d i s c u s s e d and p r i o r i t i c . . Procr.dl!rer, f n r t erhniral

!sid

Jnwn.

and ~ t hi c n lrexri.-i< o .i . i---

research proposals R C by j o i n t a n d r e g u l a r m e t i t i g . : ;:nd d i , 7 c u s s i o n s r e ~ i i e i . : I - h c The NCR a n d M ~,nkroing r e s e a r c h p r o j e c t s and folloru. them lip , * ; t i 1 tll 7 x

.Ire i n r 3 n l i t

ct4.

I n f o r m a t i o n n e e d s o f r e s e a r c h w o r k e r s arc- met- from t h e Khartouni ' l i r i i v e r s i t . , Library, t h e N a t i o n a l H e a l t h L a b o r a t o r i e s L i b r a r y , tile iJHO ;cp -,

; ti

i c e en<'

o t h e r s o u r c e s a v a i l a b l e f o r p a p e r s and j o ~ ~ r n : i l s .

EM/RSR/16

EM/MG/~ EM/WKP.RCH.MGT/h Annex IV page xii

The results of completed research are presented and disseminated in several ways: (a) as papers printed by the NCR and delivered to the appropriate fields or to the MRC; (b)

through the medical press; and reported at local or regional meetings.

(c)

The Minister of Health, the NRC and the MRC all collaborate in the evaluation of ongoing projects of programmes of research.

EM/RSR/16 EM/MG/3 E M / W .RCH.MGT/4 Annex V page i

ANNEX V

PLANS DEVELOPED BY THE TWO GROUPS OF PARTICIPANTS FOR ASSESSING THE SCIENTIFIC ACTIVITIES OF THE PUBLIC HEALTH AND NUTRITION DIVISIONS OF THE N.I.H. GROUP I PUBLIC HEALTH DIVISION 1. 2. Background

historical and general

Policies, strategies, plans 2.1 What are the policies and strategies of the Division? 2.2 To what extent have they been developed within the context of the National Policies? 2.3 Who developed the plan? H a s it been developed on the national level only, or woe there an input from the local regions? 2.4 2.5

What is the original plan? Have any modifications been induced?

If so, why?

Was the plan based on a realistic "needs" assessment? On what criteria were the priorities identified?

Activities 3.1 What is the scope of activities? - Research?

- Provision of Public Health Services?

3.2

Teaching and Training?

What are the objectives originally planned for each activity?

3.3 How are the plans of action for each activity implemented and monitored?

EM/RSR/16 EM/MG/~ EM/WKP . R C H . M G T / ~ Annex V page ii

Management 4.1 Organization 4.1.1. What i s t h e s t r u c t u r e of t h e o r g a n i z a t i o n ? W h a t a r e i t s h i e r a i - c , , and divisions?

4.1.2 4.1.3 4.1.4

Who has t h e a u t h o r i t y f o r decision-making? What a r e t h e a d m i n i s t r a t i v e r e g u l a t i o n s ? How a r e t h e a c t i v i t i e s c o o r d i n a t e d o r i n t e g r a t e d with o t h e r r e s e a r institutions? '

4.2 F i n a n c i a l r e s o u r c e s 4.2.1 4.2.2 What a r e t h e r e s o u r c e s ? What a r e t h e commitments of t h e Federal Government, l o c a l r e g i o c n a t i o n a l i n s t i t u t i o n s , and i n t e r n a t i o n a l o r g a n i z a t i o n s ? 4.2.3 To what e x t e n t a r e t h e f i n a n c i a l needs f u l f i l l e d ? measures taken t o meet a l l t h e f i n a n c i a l needs? 4.3 S t a f f 4.3.1 What a r e the

. . What a r e t h e p r o p o r t i o n s of t e c h n i c a l , a d m i n i s t ~ a t i v e and a ~ x i l personnel?

4.3.2

What a r e t h e sources of t e c h n i c a l personnel? To what e x t e n t a r e available?

4.3.3 4.3.4

A r e a l l manpower needs f u l f i l l e d ?

D o s t a f f members l e a v e t o o t h e r c a r e e r s ? For example: what p r o p o r t 1 from each c a t e g o r y have l e f t d u r i n g t h e l a s t 5 y e a r s ?

4.3.5 4.3.6

What c r i t e r i a a r e used t o s e l e c t and r e c r u i t s t a f f ? What t r a i n i n g programmes a r e c a r r i e d o u t f o r t h e s t a f f ?

EM/RsR/~~ EM/MG/~ EM/WKP.RCH.MGT/~ Annex V Page iii

4.3.7

What i n c e n t i v e s a r e a v a i l a b l e i n o r d e r t o keep t h e t e c h n i c a l personnel?

4.3.8

job s a t i s f a c t i o n ? career structure? other incentives? Is t h e r e a t a s k d e s c r i p t i o n f o r each job? What a r e t h e s t a n d a r d s o f performance? How a r e t h e s e a p p r a i s e d ?

5. Equipment 5.1

What types o f equipment a r e used? o r t h e more simple?

i.e.

t h e most s o p h i s t i c a t e d ?

5.2

What a r e the c o s t o o f o b t a i n i n g cquipment and m a i n t a i n i n g i t ?

5.3 5.4

Are maintenance t e c h n i c i a n s a v a i l a b l e ? What i s the c o s t / e £ f e c t i v e n e s s o f the s o p l l i s L i ~ a L e dapparatus a s

compared t o t h a t o f t h e more simple ones? 5.5

Is equipment used co i c s full c a p a c i t y ?

Physical f a c i l i t i e s 6.1 Are they s u i t a b l e f o r t h e work? s p e c i f i c purposes? 6.2 6.3 What a r e t h e c o s t s o f maintenance? Are t h e r e p l a n s f o r f u t u r e expansion? Had they been planned t o s u i t

Communications 7.1 Are adequate communication channels a v a i l a b l e ?

EM/RSR/ 16

EM/MG/ 3 EM/WKP. R C H.MGT/~ Annex V page i v

Informa t i o n and documentation 8 . 1 How can r e s e a r c h e r s g e t a c c e s s t o i n f o r m a t i o n s o u r c e s ? t h e r e a n i n f o r m a t i o n system i n t h e D i v i s i o n ? i.e. is

Is t h e r e a l i b r a r y ?

Are t h ~ rrnbl r ~ ems in getting access to internatinnal d a t a - h a s p s ?

8.2 How i s information a c q u i r e d ?

How i s i t s t o r e d and r e t r i e v e d ? Who a r e t h e main u s e r s ?

8 . 3 What p u b l i c a t i o n s does t h e D i v i s i o n i s s u e ?

What i s t h e c o n t e n t of t h e p u b l i c a t i o n s ? What i s t h e feedback from users? 9. Evaluation 9.1 What i s t h e e v a l u a t i o n system i n t h e D i v i s i o n ? 9.2 How have c r i t e r i a f o r e v a l u a t i o n been developed? 9 . 3 To whom a r e t h e e v a l u a t i o n r e s u l t s submitted?

9.4 What has been t h e e f f e c t o f e v a l u a t i o n on t h e D i v i s i o n and i t s activities?

EM/RSR/ 16 EM/MG/ 3 EM/WKP.RCH.MGT/4 Annex V

GROUP I1 NUTRITION DIVISION

1. 2 .

I d e n t i f i c a t i o n o f t h e problems o f n u t r i t i o n i n P a k i s t a n . s e t - u p of t h e Unit and i t s r e l a t i o n w i t h f i e l d programmes. What have been t h e programmes o f r e s e a r c h i n t h i s U n i t over t h e l a s t

5 years?

S e l e c t two o f t h e programmes f o r e v a l u a t i o n .

O b j e c t i v e o f t h e programme

11. P l a n of a c t i o n

1II.Resaurces (human, f i n a n c i a l , m a t e r i a l ) IV.

Implementation phase Results

V I . A p p l i c a t i o n s and d i s s e m i n a t i o n VII.Constraints VIII.Is t h e r e any system o f monitoring t o t h e programme?

IX. Previous e v a l u a t i o n s , i f any, o f t h e u n i t a c t i v i t i e s . C r i t e r i a for evaluation

1. Impact of r e s e a r c h on h e a l t h problems 2. F u l l u t i l i z a t i o n o f r e s o u r c e s i n a l l o c a t e d time

3. Undue expenses

4. Experience gained and p o s s i b l e u t i l i z a t i o n 5. Q u a l i t y o f s c i e n t i f i c r e s e a r c h a s judged by p u b l i c a t i o n i n s c i e n t i f i c journals o r o t h e r s c i e n t i f i c a c t i v i t i e s of the s t a f f .

EM/RSR/ 16 EM/MG/ 3 EM/WKP. RCH..MGT/~ Annex V I page i

ANNEX V I EVALUATION FORM

To what e x t e n t d i d t h e Workshop a ) meet your e x p e c t a t i o n s :

Not very well

Moderately well

Very well

b) meet the o b j e c t i v e s a s s t a t e d i n t h e f i r s t Session:

a ) I n your opinion t h e d u r a t i o n o f t h e Workshop was: Too long Just right Too s h o r t

b) I n c a s e you considered i t "Too long" o r "Too short",

p l e a s e g i v e your e s t i m a t e of a d e s i r a b l e d u r a t i o n :

.......... days 3. Individual topics W e wish t o have your views on each o f t h e t o p i c s handled d u r i n g t h e Workshop, i n several respects. The t a b l e below i s provided f o r t h i s .

(Note, however, t h a t n o t a l l q u e s t i o n s a r e r e l e v a n t t o a l l t o p i c s ; f o r example, d i s c u s s i o n s a r e n o t a p p r o p r i a t e f o r some t o p i c s , and e x e r c i s e s n o t appropriate for others). I n t h e Table, p l e a s e g i v e your responses a s follows: a) Relevance and u s e f u l n e s s o f t h e t o p i c f o r r e s e a r c h managers:

Put A

v e r y much s o

EM/RSR/ 16

EM/MG/~ EM/wKP.RCH.MGT/~ Annex VI page ii

or B : or C : b)

moderately s o only a l i t t l e o r not a t a l l

Amount o f time a l l o c a t e d t o t h e t o p i c . P u t A : more time s h o u l d be g i v e n o r B : t i m e about r i g h t o r C : l e s s time should be g i v e n

U s e f u l n e s s o f background m a t e r i a l and n o t e s g i v e n o u t on t h e t o p i c . P u t A : very u s e f u l o r B : o n l y moderately u s e f u l o r C : not r e a l l y u s e f u l

Formal l e c t u r e s / p r e s e n t a t i o n s . P u t A : should be used more o r B : about r i g h t o r C : should be used l e s s

Exercises P u t A : should be used more o r B : about r i g h t o r C : s h o u l d be used l e s s

EM/RSR/16 EM/MG/~ EM/WKP.RCH . M G T / ~ Annex V I page iii Table Topic (Session)

(a) Relevance

(b) Ti n ~ e allocated

(dl Lectures

(e) Excercis e s

Medical r e s e a r c h in participants' countries ( 2 ) Need and importance o f medical r e s e a r c h (3) Management process (4) Organization o f r e s e a r c h (5) Case s t u d y (6, 15, 18, 23) Network diagrams (7) Research planning (8, 9 ) U n c e r t a i n t y (10, 11) S t a f f planning (12) Delphi technique (13) Planning and u n c e r t a i n t y (16) E v a l u a t i o n of r e s e a r c h proposals (19, 20) P r o j e c t monitoring and c o n t r o l (21) Behavioural a s p e c t s (22) Comunica t i o n s (22)

EM/RSR/ 16 EM/MG/ 3 EM/WKP .RCH .MGT/~ Annex VI page iv

.. .

Table Topic (session) (a> Relevance (b) Time alluca ~ r d

(c Background lunLariill

(d) Lectures

\ I

Fs+i

Research information ( 2 4 ) Development of research management programmes (25, 26)

4. Please mention any topics which were missing and in your opinion should have been included in this Workshop:

Taken as a whole, what is your assessment of t h e l e a r n i n g m a t e r i a l p r o v i d e d f n r t h e Wnrkshop:

Of little value

- Marginally useful - Useful 6. How would you rate the administrative arrangements made for the Workshop: - Poor

- Satisfactory

Excellent

7. Any further comments that you may wish to add:

Основные сведения

Организация Всемирная организация здравоохранения (ВОЗ / WHO)

Тип документа Meeting reports

Дата принятия 31 декабря 1981 г.

Источник Всемирная организация здравоохранения