RFI: District Health System Management (2)
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David, your question raises very important issues about research at
the district level. I will share with you some of my experience with
working with several districts in Uganda.
1. conditions for developing an effective health research system at
the district level?
Whereas several factors come into play in developing good research
system at the district, the main ones are: good leadership, good will
of the politicians, and availability of financial resources. The
three are interrelated because it is the politicians who recommend
which aspects of the annual district plans should have priority fund-
ing. If they realise the importance of research for the district,
then they will recommend it for priority funding. There should also
be some district staff or staff from projects in the district who
have research skills and can be easily trained as trainer of trainers
(TOT).
2.the research management mechanism needed to create and maintain a
research culture at the district level
There should be a department in the district, which has the responsi-
bility to handle all matters related to information collecting, dis-
semination and storage. In the case of Uganda, with UNFPA support,
most district have a planning unit composed of the population offi-
cer, statistician, and economist. Most of these cadres just like
other district staff have postgraduate training, are well equipped
with the necessary computer skills and accessories, and are competent
to handle research issues in their districts. Other donors and non-
government projects have also created capacity for research in almost
all districts including the remote ones. Hence, with good coordina-
tion there is capacity for developing effective research systems ate
district level.
3. identifying district research priorities
All departments in the district prepare annual plans, which include a
component of research. Unfortunately year after year the research
components of their plans are not implemented because of lack of
funding. So the district research priorities can be identified from
the respective department plans. In addition, there is a district
technical planning committee, which is composed of all heads of de-
partments and gives technical assistance on the district plans in-
cluding the research agenda.
4. capacities needed to implement the research agenda at the district
level
Like all other people interested in research, district staff need to
have basic training in the research process from prioritising prob-
lems to dissemination of results. The districts however have special
needs to be supported in translating the research results into action
through practical dissemination strategies such poetry, drama, role-
plays, music, story telling, and other participatory approaches.
Their training should be participatory and donors should avoid pes-
tering district staff into writing technical reports with a lot of
scientific jargon.
5. role of international agencies/donors in stimulating district
health research
The international/donor community can play an important role in pro-
viding financial and technical assistance to the district. They
should support the research component in the district work plans. Be-
tween 1997 and 1999 WHO and UNICEF through the Child Health and De-
velopment Centre, a research and training unit in the Medical School
of Makerere University supported several district mid and operation
manager to carry out research. Like wise under the TORCH project, an
ENRECA/DANIDA supported program, the Centre also has a novice re-
search component where district based researchers are supported to
carry out research. The results have been very encouraging and sev-
eral lessons have been learnt.
For more details contact John Arube-Wani, the Community Section Head
e-mail <johnarube@hotmail.com>, or Dr. Jessica Jitta the director
<jitta@chdc-muk.com>.
--
George Washington Kivumbi
Dept. International Health
University of Copenhagen, Denmark
mailto:k.washington@pubhealth.ku.dk
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