The political undertones of building national health research systems--reflections from The Gambia.
The political undertones of building national health research systems--reflections from The Gambia.
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DOI：
10.1186/1478-4505-7-13
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发表时间：
2009-05-29
影响因子：
4
通讯作者：
Bloch, Paul
中科院分区：
文献类型：
--
作者：
Palmer, Ayo;Anya, Samuel E;Bloch, Paul
在发展中国家，建立国家卫生研究系统是一项类似于政治领导权竞赛的运动。选举领导人的政治运动越来越少地依赖于意识形态和政治信息，而更多地依赖于有望迅速改善选民生活质量的变革。在这个过程中，候选人的每一个行动和声明的利益和风险都会被仔细评估。目前在发展中国家卫生部内推广的加强卫生研究的方法强调实施建立国家卫生研究系统的合理步骤，包括制定国家卫生研究政策和战略计划，对该国的研究进行情况分析，制定国家卫生研究议程，建立研究伦理和科学委员会，建设卫生研究管理和行为的人力和机构能力。尽管这些进程在某些环境中成功地提高了卫生研究的标准，但许多发展中国家仍在努力推动这一进程。一个原因是，这种方法没有处理卫生部内部提出的基本问题，即“该部控制这一进程的政治利益是什么？”和“如果另一个机构带头这一进程，对该部的政治影响是什么？”从试图支持加强国家卫生研究系统进程的非政府组织、学术机构和捐助者的角度来看，需要进行的最重要的活动之一是分析国家卫生研究的政治背景，并在此基础上规划和执行适当的政治卫生研究宣传倡议。这包括制定明确的信息，说明卫生部领导在国内开展、管理和传播卫生研究方面的作用所带来的政治利益。与政府和非政府组织都有联系的民间社会组织完全有能力发挥倡导者的作用。只有通过利益攸关方的广泛和积极参与，发展有效和可持续的国家卫生研究系统的进程才能真正成为一项由卫生部激励、领导和维持的国家运动。
In developing countries building national health research systems is a movement similar to a political leadership contest. Increasingly, political campaigns to select leaders depend less on ideologies and political messages and more on promising change that will promptly improve the quality of life of the voters. In this process the benefits and risks of every action and statement made by the candidates are carefully assessed.Approaches currently promoted to strengthen health research within ministries of health in developing countries place emphasis on implementing logical steps towards building national health research systems including developing a national health research policy and strategic plan, conducting a situational analysis of research in the country, setting a national health research agenda, establishing research ethics and scientific committees, and building human and institutional capacity for health research management and conduct. Although these processes have successfully improved the standards of health research in some settings, many developing countries struggle to get the process going. One reason is that this approach does not deal with basic questions posed within a ministry of health, namely, "What is the political benefit of the ministry assuming control of the process?" and "What are the political implications for the ministry if another institution spearheads the process?"Seen from the perspective of non-governmental organizations, academic institutions and donors trying to support the processes of strengthening national health research systems, one of the foremost activities that needs to be undertaken is to analyze the political context of national health research and, on that basis, plan and implement appropriate political health research advocacy initiatives. This includes the development of explicit messages on the political benefits to the leadership in the ministry of health of their role in the conduct, management and dissemination of health research within the country. Civil society organizations, with links to both government and non-governmental organizations, are well placed to play the role of advocates.It is only through broad and active participation of stakeholders that the process of developing effective and sustainable national health research systems will truly become a national movement inspired, led and sustained by ministries of health.