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PubMedDate not supplied

Building health services research capacity in nursing: views from members of nursing's leadership [interview by Candice Cook Bowman and Deborah Gardner].

BACKGROUND: Despite a short history that dates back to the 1960s, health services research (HSR) has become an important force in shaping the delivery system in the current health care environment. Nursing has been noticeably absent from this endeavor, and if it does not increase its presence, it risks missing an important opportunity to influence future directions of health care delivery. PURPOSE: Our purpose was to evaluate the state of nursing's HSR contributions and to consider ways to increase its capacity in this arena. METHOD: An interview with four members from nursing's leadership was conducted. DISCUSSION: Nurses can increase the capacity by becoming better collaborators with those who are currently contributing to HSR, both nurses and members of other healthcare disciplines. Also, by reshaping undergraduate and graduate curricula and creating mentorships, nursing can increase its involvement through an informed workforce. CONCLUSIONS: Solutions that were offered in this discussion are presented.

Curriculum↗
PubMedDate not supplied

Building global environmental health capacity through international scientific cooperation and partnerships.

Sponsored by the Fogarty International Center, the NIEHS, and NIOSH, the International Training and Research Program in Environmental and Occupational Health (ITREOH) supports training of health professionals worldwide. The program grants awards to U.S. academic institutions, which partner with institutions in low- and middle-income countries to address health threats of regional importance.

Environmental Health↗
PubMedDate not supplied

Families for children: international strategies to build in-country capacity in the Philippines, Thailand, Romania, and India.

Holt International Children's Services was founded in the 1950s to facilitate the adoption of Amerasian children in the aftermath of the Korean War. Today, its vision has expanded to encompass international policies, programs, and practices that will help establish nurturing, lifelong relationships for children. Working together with child welfare professionals and advocates, non-governmental organizations, and governments, Holt has helped to develop in-country, self-sustaining family resources for thousands of children. Efforts in the Philippines, Thailand, India, and Romania are highlighted.

Adolescent↗
PubMedDate not supplied

State efforts to measure the health care safety net.

This article describes the role states could play in a national effort to measure and monitor the public health safety net. The authors developed a data collection framework using information from five states on two components of the safety net: structure and demand. Because states are the primary vehicle for access expansions and programs to care for the poor, the authors suggest that they be the primary coordinating mechanism for data collection on the safety net. Because the necessary mechanisms for more uniform standards or criteria to evaluate state data collection activities and capacity remain undeveloped, they recommend using existing data to begin building state capacity to measure and monitor the safety net.

Adult↗
PubMed2003

Assessment of the epidemiologic capacity in state and territorial health departments--United States, 2001.

Epidemiology is essential for the detection, control, and prevention of major health problems. Described as the foundation of all public health functions, epidemiology provides information needed to perform the 10 essential public health services. One of the national health objectives for 2010 calls for increases in the proportion of tribal, state, and local public health agencies that provide or ensure comprehensive epidemiology services to support essential public health services (objective 23-14). Although national infectious disease capacity has been assessed, no comprehensive national assessment of epidemiologic capacity has been conducted. To assess core epidemiology and infectious disease capacity of public health departments, the Council of State and Territorial Epidemiologists (CSTE) surveyed state and territorial health departments in November 2001, immediately before the release of approximately 1 billion dollars in federal funding to state health departments for terrorism and public health emergency preparedness. This report summarizes the results of that survey, which indicate that the national epidemiology infrastructure in state and local health departments is far below optimal capacity and that approximately 42% of epidemiologists working in public health have no formal epidemiologic training. Although recent terrorism preparedness initiatives have improved capacity in infectious disease epidemiology, increased resources are needed to build epidemiologic capacity necessary to address the major causes of morbidity and mortality.

Epidemiologic Methods↗
PubMed2005

Response to "Metrics of rehabilitation research capacity": within and beyond our borders.

This commentary responds to Dr. Allen Heinemann's paper on "Metrics of Rehabilitation Research Capacity." We follow his outline. Because Dr. Heinemann focuses primarily on training capacity, we take a panoramic view addressing the balance between training new researchers and the support of established investigators. We explore challenges, barriers, and solutions to enhancing research capacity in rehabilitation within contexts of the larger scientific enterprise. Our main premise is that the best way to build a strong and sustainable research capacity in the United States is to study and adopt component strategies developed by other medical disciplines and other nations. We propose a model referred to as the "dynamic cycle of research capacity-building" by adapting a framework for studying the eradication of infectious diseases in developing countries to concepts of disability recovery. The concept of career mapping is proposed as a means to measure research productivity among faculty according to "standardized" academic tracks with different balance among research, educational, and clinical activities. The first and most important step in building rehabilitation capacity is developing an understanding of and belief in the mission and the need for research to support it.

Education, Medical, Graduate↗
PubMed2005

Sources of contraceptive commodities for users in Nigeria.

BACKGROUND: Understanding the sources of contraceptive commodities is an important aspect of the delivery of family planning services and is required by planning programme managers for strategic planning purposes. Findings from the 2003 Nigeria Demographic and Health Survey have previously showed that the private sector was the most frequently reported source of contraceptive supply, providing contraception to two and a half times as many women as the public sector. We conducted a community-based study to examine further the sources of contraceptive commodity for users in Nigeria with a view to identifying their preferences for distribution centres. This information would be useful to improve commodity distribution and to build the necessary capacity for satisfactory delivery of contraceptives. METHODS AND FINDINGS: A multi-stage random sampling technique was used. A state was randomly selected to represent each of the four health zones in Nigeria. Two local government areas (LGAs) were then selected representing both urban and rural areas. Ten enumeration areas were subsequently selected from each LGA. Of the 2,001 respondents aged 15-49 years, 1,647 (82.3%) were sexually active, out of which 244 were found to be using contraceptive methods at the time of the study, giving a contraceptive prevalence of 14.8%. The commonest source of information on contraceptives was through friends (34%), followed by the radio (11.5%) and husbands (10.2%). Most respondents procured their contraceptives from chemist/patent medicine shops (19.7%), while only 0.8% obtained them from designated family planning clinics. The younger groups in this study (15-24 years), single people, Catholics, and Muslims, showed a greater preference for chemist/patent medicine shops for their sources of contraceptives. The older groups and married respondents, however, made use of government and private hospitals to obtain their contraceptives. CONCLUSION: Strategies to increase contraceptive use must take into consideration these identified sources of contraceptives with a view to enhancing the quality, quantity, and variety of methods available, and to building capacity for effective service delivery. There is also a need to encourage the establishment of adolescent-friendly clinics where young people can go for counselling and obtain contraceptives of their choice, including emergency contraceptive pills.

Adolescent↗
PubMed2002

Research capacity strengthening in the South.

Active promotion of evidence-based decision-making at all levels of the health field is a necessary step in the direction of improving the health of the population. Recent studies have shown that the burden of disease in developing countries is high particularly the burden of infectious, communicable and non-communicable diseases and health problems of mothers and children. There is presently, a mismatch between this increased disease and health burden and the technical and human capacity of developing countries to use existing knowledge and to generate new knowledge to combat these diseases and health problems. It is therefore necessary to assist developing countries to build indigenous research capability so they can undertake studies in their own national settings the results of which will lead to the development of appropriate control strategies in their countries. Building indigenous research capacity will enable developing country scientists to translate results of studies carried out elsewhere into their individual national settings. Eventually results of such studies will increase the global knowledge base about the particular health problems and contribute to finding appropriate solutions to them. The research will, finally, increase knowledge-based decision-making by their health leadership of the country. This paper has set out to describe some experiences in capacity strengthening over the last few decades and to propose from these, mechanisms for building these capacities in a sustainable manner. This paper has described the steps in capability strengthening with special emphasis on identification of trainees, their training and deployment on return. The paper has described mechanisms of research sustainability including creation of suitable career structures, remuneration of researchers and the importance of building up suitable infrastructure for research to meet increasing demands and competence. The place of partnerships South-South, South-North and networking has been stressed. Finally, the paper calls for greater involvement by policy makers in developing countries in the entire capacity building process. They should set highly focussed research priorities, identify competence not already existing and proceed to fill these gaps along the lines described.

Decision Making, Organizational↗
PubMed1998

Measuring community capacity: where do we go from here?

Goodman et al. have set us off on our journey to articulate and measure the dimensions of community capacity. While we have tried to identify some of the areas for future exploration, it is clear that this should be an ongoing process. Moreover, it is important that the process used to develop measures, assess capacity, and use the information to intervene be consistent with the intended outcome--building community capacity. In other words, at a minimum, the process should be cognizant of the history of the community, be participatory (i.e., incorporate the multitude of voices involved, particularly those of the community members themselves) and use the skills and resources available in professional, academic, and community settings. Perhaps most important, this dialogue must begin from a place of respect for the multitude of perspectives that need to be brought to bear to enhance community capacity to create healthful changes.

Community Networks↗
PubMed2001

Building local research and development capacity for the prevention and cure of neglected diseases: the case of India.

This paper examines the proposal to build research and development (R&D) capabilities for dealing with neglected infectious and tropical diseases in countries where they are endemic, as a potentially cost- and time-effective way to fill the gap between the supply of and need for new medicines. With reference to the situation in India, we consider the competencies and incentives needed by companies so that their strategy can be shifted from reverse engineering of existing products to investment in R&D for new products. This requires complex reforms, of which the intellectual property rights agreement is only one. We also consider whether Indian companies capable of conducting research and development are likely to target neglected diseases. Patterns of patenting and of R&D, together with evidence from interviews we have conducted, suggest that Indian companies, like multinational corporations, are likely to target global diseases because of the prospect of much greater returns. Further studies are required on how Indian companies would respond to push and pull incentives originally designed to persuade multinational corporations to do more R&D on neglected diseases.

Communicable Diseases↗
PubMed2001

Capacity for research in minority health: the need for infrastructure plus will.

Cardiovascular mortality has continued to decline, but racial disparities in cardiovascular diseases (CVD) continue to grow. To build the capacity to address these racial disparities, two things will be required. First, a research and policy infrastructure must be in place to provide guidance on what to do and how to do it. Second, the will to implement and activate this infrastructure must be present at the community and policy-making levels. The Jackson Heart Study is an example of a research infrastructure with the economic resources, scientific expertise, and technical manpower required to monitor, organize, assess, and follow a cohort of individuals over time to study the burden, natural history, predictive factors, and level of care for CVD in an African American community. The creation of will within the community for CVD research may require additional strategies than in the majority community, such as community organization and local policy development. These additional efforts at the community level should create a fertile environment to develop research and, ultimately, test strategies for reducing national disparities in cardiovascular health.

Attitude to Health↗
PubMed2001

Capacity for research in minority health: the need for infrastructure plus will.

Cardiovascular mortality has continued to decline, but racial disparities in cardiovascular diseases (CVD) continue to grow. To build the capacity to address these racial disparities, two things will be required. First, a research and policy infrastructure must be in place to provide guidance on what to do and how to do it. Second, the will to implement and activate this infrastructure must be present at the community and policy-making levels. The Jackson Heart Study is an example of a research infrastructure with the economic resources, scientific expertise, and technical manpower required to monitor, organize, assess, and follow a cohort of individuals over time to study the burden, natural history, predictive factors, and level of care for CVD in an African American community. The creation of will within the community for CVD research may require additional strategies than in the majority community, such as community organization and local policy development. These additional efforts at the community level should create a fertile environment to develop research and, ultimately, test strategies for reducing national disparities in cardiovascular health.

Black People↗
PubMed2003

Research capacity development for CVD prevention: the role of partnerships.

Recent studies have demonstrated an increase in the burden of cardiovascular diseases on developing countries. This increased disease prevalence and health burden has far exceeded the technical and human capacity of developing countries to use existing global knowledge, and to generate new strategies for their own countries to use in combating these diseases. Therefore, it is necessary to assist developing countries in building indigenous research capacity in order to undertake studies within their own boundaries, the results of which will lead to the development of appropriate local management and control strategies. It is important to explore ways of enhancing research capacity in developing countries, in order to narrow the research gap between the rich, developed countries, and the poor, developing countries. Partnerships, both North-South, and South-South, lend themselves to the use of suitable modern tools and strategies, as well providing a promotional approach for strengthening research capacity in developing countries. This review describes prerequisites for building successful research capacity, and, in particular, details the process for building such capacity in the area of cardiovascular diseases (CVDs). Some of the constraints and challenges in research capacity strengthening (RCS) have also been summarized. When correctly utilized, partnerships are probably the most egalitarian form of research collaboration, offering mutual advantages to both partners. International and bilateral agencies funding research in developing countries are urged to include a RCS component in new projects, in order to ensure the sustainability of these projects through the training of those who will carry out the research, and to support the national institutional framework where the research will be conducted.

Cardiovascular Diseases↗