The emergence and current performance of a health research system: lessons from Guinea Bissau.
The emergence and current performance of a health research system: lessons from Guinea Bissau.
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DOI：
10.1186/1478-4505-10-5
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发表时间：
2012-02-09
影响因子：
4
通讯作者：
de Haan S
中科院分区：
文献类型：
--
作者：
Kok MO;Rodrigues A;Silva AP;de Haan S
低收入国家的卫生研究系统是如何随着时间的推移而产生和发展的，以及这一过程与它们的绩效之间的关系，人们知之甚少。了解国家卫生研究系统是如何产生的，对于发展运作良好的国家卫生研究系统（NHRS）非常重要。这项研究的目的是评估几内亚比绍的卫生登记制度是如何随着时间的推移而产生和发展的，以及目前的系统是如何运作的。我们使用定性案例研究方法，利用国家卫生制度框架，探讨了国家卫生制度的出现和当前的表现。我们审查了文件并进行了39次深入访谈，范围从卫生研究到政策和实践利益攸关方。使用迭代方法，我们对数据进行了专题分析。几内亚比绍的研究实践导致了一项具有地方和国际联系并强烈依赖国际伙伴和捐助者的人力资源管理制度的出现。后殖民时期、动荡和依赖资源的环境、捐助者政策的变化、对当地研究人员的培训以及研究结果的性质影响了人力资源登记制度的演变。研究重点主要是由“外派”的研究人员确定的，重点是了解和降低儿童死亡率。研究经费几乎完全由外国捐助者和国际机构提供。几内亚研究人员的培训始于九十年代中期，此后加强了与卫生系统的联系，扩大了研究议程，并加强了当地对研究的利用。虽然一些研究对全球卫生作出了重要贡献，但由于卫生系统薄弱和依赖捐助者，政府不稳定，国际机构自上而下的政策以及一些研究结果的争议性，几内亚比绍国内研究的使用受到限制。在几内亚比绍，通过研究实践和共同演变的国家和国际研究与发展动态，已经出现了一个事实上的研究“系统”。如果研究的目的是为地方决策做出贡献，那么就必须通过设定国家研究优先事项、调整资助、建设国家研究能力和将研究与决策过程联系起来来调整这个新兴的系统。捐助者和国际机构可以通过协调其努力和与国家优先事项保持一致来促进这一进程。
Little is known about how health research systems (HRS) in low-income countries emerge and evolve over time, and how this process relates to their performance. Understanding how HRSs emerge is important for the development of well functioning National Health Research Systems (NHRS). The aim of this study was to assess how the HRS in Guinea Bissau has emerged and evolved over time and how the present system functions. We used a qualitative case-study methodology to explore the emergence and current performance of the HRS, using the NHRS framework. We reviewed documents and carried out 39 in-depth interviews, ranging from health research to policy and practice stakeholders. Using an iterative approach, we undertook a thematic analysis of the data. The research practices in Guinea Bissau led to the emergence of a HRS with both local and international links and strong dependencies on international partners and donors. The post-colonial, volatile and resource-dependent context, changes in donor policies, training of local researchers and nature of the research findings influenced how the HRS evolved. Research priorities have mostly been set by 'expatriate' researchers and focused on understanding and reducing child mortality. Research funding is almost exclusively provided by foreign donors and international agencies. The training of Guinean researchers started in the mid-nineties and has since reinforced the links with the health system, broadened the research agenda and enhanced local use of research. While some studies have made an important contribution to global health, the use of research within Guinea Bissau has been constrained by the weak and donor dependent health system, volatile government, top-down policies of international agencies, and the controversial nature of some of the research findings. In Guinea Bissau a de facto 'system' of research has emerged through research practices and co-evolving national and international research and development dynamics. If the aim of research is to contribute to local decision making, it is essential to modulate the emerged system by setting national research priorities, aligning funding, building national research capacity and linking research to decision making processes. Donors and international agencies can contribute to this process by coordinating their efforts and aligning to national priorities.
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影响因子：
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作者：
Biai, Sidu;Rodrigues, Amabelia;Aaby, Peter
通讯作者：
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影响因子：
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