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Health Research for the Population Health improvement

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Health Research for the Population Health improvement building capacities Elena Varavikova, scientist, Department of Human Resources for Health – PowerPoint PPT presentation

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Title: Health Research for the Population Health improvement


1
Health Research for the Population Health
improvement building capacities

Elena Varavikova, scientist, Department of Human
Resources for Health Evidence and Information for
Policy
2
Health research - definitions
  • "Research is a system involving people,
    Institutions and processes. Its pursuit depends
    on systematic analysis, creativity and
    exploration"
  • (Comission on health Research for
    Development, 1990)

3
Challenges for Kazakhstan
  • MDG by 2015
  • State Program on reform and development of Public
    Health of the Republic of Kazakhstan
  • 2005-2010
  • Population Health analysis and improvement
  • (LE, Infant maternal mortality, CVD etc)
  • Monitoring and Evaluation of the health system
  • Research, education and training

4
Working in the Public Health Field
  • Survey methods
  • Evidence-based recommendations, info.
  • Continuous education
  • Planning
  • Working with expert advisory group
  • Team building
  • Maximising health gain with available resources
  • Working conditions

5
Who are doing the job of population health
analysis and evaluation? Education and Training?
  • MOH ?
  • National Public Health Institute?
  • Health leaders?
  • Politicians?
  • Professional Associations?
  • NGO's, Donors?
  • Who are working in this area and who prepared
    them?
  • System of continuous education available?

6
WHO Knowledge for better Health - " know-do " gap
  • Research is an investment, not a cost
  • A broader, more inclusive view of health research
    is needed
  • Research should be applied to improve health
    equity
  • Research must be conducted according to universal
    ethical standards
  • Knowledge derived from research must be
    accessible to all
  • Civil societyhas a vital part to play in setting
    resear

7
Acute care hospital admissions per 100     
           Kazakhstan
           Kyrgyzstan
           Russian Federation
           Tajikistan
           Turkmenistan
           Uzbekistan
           EU
Source WHO/Europe, HFA Database, January 2005
8
Live births per 1000 population
Kazakhstan
Kyrgyzstan
Russian Federation
Tajikistan
Turkmenistan
Uzbekistan
EU
9
Autopsy rate in , for hospital deaths
10
SDR, diseases of circulatory system, 0-64 per
1000000
           Kazakhstan
           Kyrgyzstan
           Russian Federation
           Tajikistan
           Turkmenistan
           Uzbekistan
           EU
Source WHO/Europe, HFA Database, January 2005
11
SDR, cerebrovascular diseases, 0-64 per 100000
12
SDR, trachea/bronchus/lung cancer, 0-64 per
100000     
           Kazakhstan
           Kyrgyzstan
           Russian Federation
           Tajikistan
           Turkmenistan
           Uzbekistan
           EU
Source WHO/Europe, HFA Database, January 2005
13
Role of PH Professional
  • To study, understand and report on the scale of
    the health situation and to raise public and
    political awareness
  • To interpret patterns of health and morbidity e.g
    smoking, alcohol, social dislocation
  • To advise on what should be done, drawing on best
    available evidence of effectiveness of
    interventions from different settings e.g. folic
    acid, community vs. hospital care
  • To monitor the impact of new policies, adapting
    them for changing circumstances

14
Understand Social Determinants of Disease and
Outcomes
  • Lifestyle issues e.g. smoking, diet, exercise
  • Societal issues e.g. unemployment, family income
  • Complex mechanisms e.g. transition and self image
  • Widening social and regional inequities
  • Crucial roles of education, pensions, social
    policy, political economics, health policy
  • Partnerships to deal with complexity
  • Analysis and monitoring
  • What can the health system do to alleviate the
    negative results of individual and societal
    states?

15
Political and Societal Context
  • Shift toward market economy
  • Reduced job and societal security
  • Administrative decentralization (vs decapitation)
  • Undervaluing of health e.g. health expenditures
    as GDP under 5 vs. 7-9 in industrial
    countries
  • Reduced role of the state
  • Switch from Semashko to Bismarckian models
  • Stress on individual responsibility
  • Role of the hospital oriented health system vs.
    shift to community oriented system

16
Whats outside of the SPHs walls?
  • Globalisation social and economics instability
  • Changing role of the National Health Systems
  • Health Threats HIV/AIDS, TB, Malaria ...
  • Macroeconomics and Health
  • 10/90 and Health Research
  • Evidence-based decision-making

17
What are objectives of KSPH ?
  • Centers of excellence training, research,
    service
  • International standards and participation
  • Academic independence i.e. not a function of
    state
  • Attractive to students and stakeholders
  • Sustainability
  • Culture of quality
  • Acceptance by graduates and faculty
  • Accountability and reward - not by hours but
    program and results
  • Internal and external peer review

18
Potential Contribution of Schools of Public
Health
  • Train people (skills and competencies) to
  • Analyze health system and PH problems
  • Develop evidence-based policies
  • Assist governments in re-alignment of health
    priorities
  • Work with public and private sector
  • Research and develop tools to deal with new
    issues, e.g. globalization, communications
    technology, internet
  • Continuous professional and public education
  • Develop policy, programs, models and actions
    driven by national and community needs (e.g.
    poverty and inequity reduction)
  • Create a demand for professionalism in public
    health

19
Role of Research in SPHs
  • Set standards of evidence from past and current
    international experience
  • Identify avoidable morbidity/mortality in
    individual and population health
  • Identify individual and societal risk factors
  • Explore ways to prevent disease and promote
    health
  • Find the ways of improving primary prevention and
    delivery of health services (efficiency,
    effectiveness, evidence-based)
  • Promote quality in management in health systems

20
Research Capacity development
  • Careful selection of trainees
  • Capable scientific leadership
  • Continuity of research funding
  • Good equipment
  • Supplies in the institutions including
    communication facilities

21
Research in SPHs
  • Publications in local and international peer
    reviewed scientific journals
  • Develop culture of peer review and a
    self-critical attitude (Research Forum) for
    students and faculty
  • Disseminate findings to those who can benefit
  • If in national language, abstract in English
    invites comment and criticism from a wider
    audience
  • If funding of a SPH is tied to teaching hours,
    need to provide incentives and time for active
    research to be valued and rewarded

22
Conclusion
  • High mortality and morbidity from preventable
    diseases cannot be addressed without training
    large numbers of public health professionals
  • Need for research impossible overestimate
  • Attention to the cadres
  • Needs time, resources, international support, and
    adaptation from successful experience to local
    circumstances
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