The Health Research Triangle

Research and development in the health sector has always been mentioned as a pillar important for improvements in the sector. From clinical diagnosis and disease management to domestic manufacturing of pharmaceuticals and other health products to behavior change in people for prevention – all these aspects require research to have informed development especially considering the resource constraints in low- and middle-income countries like Tanzania. Of course, the challenge of resources also impairs research in itself however there is an element that I haven’t seen being discussed too much.

Having studied my Pharmacy degree in Tanzania I know that every health degree program has a requirement for students to do some form of research as practical experience. Undergraduate students have electives or final year projects (as I did in my Bachelor of Pharmacy Degree), and Postgraduate students have their dissertations. All of these have the intention of improving the skills of students in research that can be done quantitatively, qualitatively or as some sort of laboratory work (especially for students in programs such as Pharmacy that have industrial components).

On the other hand, having worked within the health system for quite a few years now I also know that the Ministry of Health and their various programs related to health areas such as HIV/AIDS, Malaria, Reproductive and Child Health etc. all have research questions that come up through implementation of these programs. Many a times the challenge with doing research comes back to the question of resources.

Now, my question for quite some time has been why there isn’t a match between these needs. We have all these students every year searching for research topics for their electives, projects, and dissertations and so many research questions and agendas on the program implementation side and yet somehow there is no clear connection between these. I will acknowledge that we do have Supervisors within these health education institutions that do share some questions based on their connection to other research areas and projects that they are a part of, but this is not something that every student benefits from necessarily.

Hence the Health Research Triangle that I believe we should think about a bit more strategically. We have to bring together the Ministry of Health and its programs, the health education institutions and the students so that we can improve research and development in the country.

Pros

-???????Many of these students are already supported by public funding to conduct their education and related research in the institutions. Providing them with research topics that are relevant to the different programs allows for better use of public funding to help solve national challenges in health.

-???????The students will not have to go around and search for topics or pick topics that aren’t strongly relevant to the challenges of the health sector in-country.

-???????Because support from donors and other organizations is usually attached to Ministry of Health implementation and related research the students may also benefit from working with other organizations doing work in the space and may also receive further support to publish their findings and be able to see the impact the findings have on implementation.

Cons (and thoughts on solutions)

-???????There might be concerns about the quality of the work that students do since they are still in a learning stage. I believe the connection to different organizations and to the Ministry of Health however can help both with oversight of these research studies and increase the responsibility and seriousness of the students.

What can be done?

-???????The Ministry of Health can develop a list of research questions across health areas that can be shared with all the health education institutions on an annual basis so that the institutions have access to these questions and can share with students.

-???????Representatives from universities – both from academia and from the students – can be invited to the various technical working groups and other forums that are organized by the Ministry of Health and respective programs so that they can participate and learn from the discussions as well.

-???????Creation of a database across health education institutions where students can upload their projects, electives, and dissertations for viewing by the various Ministry of Health programs and other students (this idea was actually shared with me today by a young health professional and it sounded great, so I added it to the article).

-???????The above-mentioned database can also become a source of resources for students wanting to enhance their research skills and can be used as an overall health research portal in the country.

Other thoughts

-???????As mentioned, before I do acknowledge that what I mention in this article may already be happening in some shape or form however a formalization of this process in my opinion would be very helpful for all parties involved.

-???????While the triangle focuses on these three primary groups there is definitely roles to be played by other actors as well such as the National Institute of Medical Research (NIMR), private sector actors etc.

-???????Being a health professional, this article focuses on health however I think the same ideology can be used for other sectors as well (if it is not already being used for this purpose).

Call to Action: Let us all work together to ensure that we can use research and development as an effective tool to improve health outcomes in the country.