On November 2006 OCHRC organized a Satellite session on systematic priority setting approach in child health research investments at the 10th annual meeting of Global Forum for Health Research at Cairo. Eight renowned child health researchers presented the preliminary findings of their work on priority setting on behalf of their respective teams.
The presenters in the session said the number of
possible avenues in health research is growing continuously and the proposals for research funding far exceed the potential of the countries to fund them. This is especially the case in developing countries where health needs are large and health research budgets are small.
The imbalance between unmet need and available funds are in greater magnitude in the child health research which still remains as one of the main focuses due to unacceptable burden of child mortality. Recent UNICEF estimation shows neonatal mortality rate, Infant mortality rate and under-5 mortality rates are very high. This is especially important because of the fact that in most cases the cost effective health intervention and financial support are available but still not much has been gain in terms of mortality reduction.
One of the major reason is the current research priority decision making is not driven by an explicit frame work and value system and is too open to research interest biases of individuals who influences funding priorities in large donor agencies without an unbiased focus on reducing disease burden and improving global health inequities. Another reason is limited interest and funding on implementation research. Up until now not much has been done to increase research on how to implement already available cost effective intervention in the context of health services in countries with limited resources.
In early 2005 OCHRC proposed a new systematic approach to address these challenges in research priority setting. The major conceptual advance of OCHRC's priority-setting methodology is the recognition that there should be a broader definition of health research investments as activities not limited to producing new knowledge, but primarily focused on results in terms of the effective use of this knowledge in a sustainable manner in order to reduce disease burden. The OCHRC methodology builds on existing approaches to establish research priorities in child health and nutrition, using a rationale, conceptual framework, application guidelines and strategies to address the needs of various stakeholders, as described in greater detail elsewhere. The methodology quantitatively assesses five key dimensions of research: answerability in an ethical way, efficacy and effectiveness, deliverability and affordability, maximum potential to reduce disease burden and effect on equity.
Later in that year OCHRC invited a group of experts (50-60) each with a prominent track record of relevant publications in leading international journals to form seven priority-setting working groups on seven major causes of child deaths and identify research investment priorities using the newly developed OCHRC systematic priority setting tool.
Although the different working groups of technical experts worked separately to list Research options and members within each group scored the research investment options Independently from each other, they all reached similar general conclusions within each group and also across groups. In each case the expert working groups considered that the largest equitable gains in child mortality reduction could be achieved through health policy and systems research to address more creative and efficient implementation of the existing child health interventions in low-resource settings. This is followed in priority by collecting basic epidemiological information where it is still lacking, and also by research on improving affordability, deliverability and sustainability of existing interventions that are not being delivered.
