Alec Ekeroma FRANZCOG, FRCOG , MBA, PhDcandidate

1. Building Reproductive Health Research and Audit Capacity and Activity in the Pacific (BRRACAP). Alec Ekeroma FRANZCOG, FRCOG, MBA, PhDcandidate Pacific Women’s Health Research & Development Unit Department of Obstetrics & Gynaecology South Auckland Clinical School University of Auckland

2. PSRH Research Workshop 2009, Auckland

3. Mapping of research systems in the Pacific • Low priority • Lack of research skills • Lack of human resources • Lack of funding • No infrastructure • No research culture

4. BRRACAP Study Goal Build Reproductive health Research and Audit Capacity and Activity in the Pacific (BRRACAP).

5. BRRACAP Study Objectives • Map health research systems and research activity. • Identify effective interventions that increases research activity by clinicians in developing countries. • Administer a research training workshop for Pacific clinicians • Support participants

6. BRRACAP Study Objectives • Monitor and evaluate using a composite of outputs • Identify personal, professional and environmental enablers and barriers to research activity • Construct a theoretical framework for building research capacity in the Pacific.

7. Participants • Selected by Ministries of Health/PSRH • Active clinicians (doctors, midwives and managers) working in reproductive health in one of the five participating countries • Must want to learn and do research/clinical audit • Preferably: • in a leadership role • a team player • has performed research • a member of PSRH

8. Participants • Have the support of their manager, MOH, funding agency to perform research, with the support including: • fund airfare and stipend to the research workshop • allocate half a day a week to perform only research/audit related work • provide internet access 

9. Pacific Island Publications in the Reproductive Health Literature 2000‐2011: with New Zealand as a reference. Ekeroma, A. Pollock, T. Kenealy, T. Boaz, S. Sopoaga, F. Montorzi, G. McCowan, LME. Hill, A. • South Auckland Clinical School, Department of O&G UoA, University of Otago, University of New South Wales, Council on Health Research for Development (COHRED) Geneva

11. Findings • PNG has the most publications because it has a funded research institute • Pacific authors tend to publish in Pacific journals • Small nations (< 20,000 pop.) difficult to build capacity • 34% of all authors of PFIC papers were Pacific; 34% of all authors were Australian or Australian institution affiliated.

12. Findings • Collaborations encouraged - resources and expertise are leveraged • Important in capacity building • Local partners, and • where there is evidence of local commitment to health research.

13. The PSRH Research Workshop as part of the Building Reproductive Research and Audit Capacity and Activity in the Pacific islands (BRRACAP) Study The Ministries of Health in the Cook Islands, Samoa, Solomon Islands, Tonga and Vanuatu.

14. Research Workshop Participants

19. Barriers - verbatim • “people who have done research do not really help other colleagues in these areas; the process that needs to be followed; eg. asking a consultant that I wanted to do research, I was told that I could only assist another Masters student” • “no time allocated for research; no supervision and mentoring; inadequate support from management” • “MOH does not work hand in hand with University; most clinicians see research as barrier and waste of time – they don’t want to realise that research is important for good patient care; most feel we can’t do it”

20. Barriers • “I do not have skills to do research; do not have knowledge to write proposal; do not know how to analyseor interpret data; other work roles take priority” • “I lack the knowledge and skills to perform research/audit; I don’t know how to use research software to analyse data; I don’t have a supervisor to help me at work place; lack of motivation from my department” • “poor support - no internet access/no library; poor record/information/data system/politician not involving; key people in MOH thinking that research is not important (so no support)”

21. Solutions - Themes • Time Management/Prioritising work • Support from management • Research Training • Research Mentoring • Research coordination

22. Solutions - Themes • Reproductive Health Research in the MOH • Funding • Research Collaborations • Infrastructure • Develop local champions

23. Solutions • “champions - awareness that research is important for good patient care; Education that research is possible – change mindset; Start early – MBBS curriculum – ask questions, criticisms – research; Incorporate research as part of practice – not taking up time; Rewards for research” • “government should allocate funds for research; trainings like this will equip us to do research; we should be taught how to use research software; a research expert should be available”

24. What do you expect from a research mentor? • “I need them to look at my proposal and help me to develop a good one; Help me to secure funds; Help me with analysis and guidance. I will do reflection but need their support always; Publication – help. We are looking at midwifery curriculum. I have already given my suggestion that research (small one) to be part of the curriculum; To do big multidisciplinary study with overseas university, also have students involved” • “free access to search engines and articles; provide computer; be a mentor or direct to appropriate people to help with research; convince our administrators that research is important”

26. What will motivate you to do research? • “I have always wanted to do research for a long time and have always desired for an opportunity; I have set my goals for an abstract in 4 months and to present a research paper in 2 years time; there have been incidences in the clinical setting that has bothered me that I want to do research on.” • “Frequent visit and contact by mentor; Getting some qualifications or credit for doing research; Research to be published in journals; Training in research like the one happening now.”

27. Summary • Reproductive health research in the Pacific is needed • Research training is welcomed • Significant barriers at work • Solutions and motivators for research have been identified