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Assessment of recommendations of the 5 past ACHR sessions 26 th – 30 th. Dulitha N. Fernando. ToR of the APW. To develop tools to assess the quality of the ACHR recommendations implementation of the recommendations Conduct an assessment of the 5 past ACHR recommendations using the above
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Assessment of recommendations of the 5 past ACHR sessions 26th – 30th Dulitha N. Fernando.
ToR of the APW • To develop tools to assess • the quality of the ACHR recommendations • implementation of the recommendations • Conduct an assessment of the 5 past ACHR recommendations using the above • Prepare a report based on the findings
ToR of the ACHR • Advice the Regional Director on : • Formulation and implementation of health research policies and health research (HR) agenda • Coordination and harmonization of HR activities of national bodies with those of WHO • Development, management and improvement of HR information system • Collection , analysis and dissemination pof existing HR findings
Method • Review of available documents • Using the tools developed, assessment of the recommendations : • numbers, technical areas, clarity, relevance to countries of the region, follow up required etc. • obtain information from relevant technical units • assessment at the country level ( not carried out due to issues related to feasibility) • Summarize the observations re. the assessment of the recommendations • Obtain views from ACHR members using a tool developed for the purpose • Prepare the report
Findings - summary • Number of recommendations per session – ranged from 8 -14. • Total number of recommendations - 5 sessions :55 • Of them, • 27( 49%) - on topics related to health research development • Others - : on selected technical areas
Of the recommendations, • 35 : to be followed up at SEARO • 15 : follow up at country level • 05 : SEARO with HQ / countries
Recommendations related to research development • General observations • A wide range of focus areas • Some degree of overlap • Some recommendations include several follow up actions • Some are stated in general terms, making follow up less clear.
Recommendations related to health research - Broad areas • Activities supporting national health systems ( updating profiles of national health research systems, identifying strengths and weaknesses, knowledge dissemination etc.) • Strengthening country capacity for health research • Strengthening research management capacities • Resources for research • Links with HQ research programmes • Research ethics • Collaborating centres
Review of recommendations on research , focusing on : • Relevance to countries of the region • All recommendations are relevant to all countries, to varying extents. • Clarity and ease of interpretation • Varied with each recommendation • Writing style varied between different reports • Some are clearly stated ‘focused’ statements with others stated in more general terms • Follow up required • Some require several follow up actions, spread over a period while others are “targeted “ • Most of them clearly indicate the follow up required , SEARO, Country or SEARO in collaboration with the country or with HQ units.
Recommendations in technical areas • 26th Session Human Genetics(5) • 27thArsenic poisoning (2) Health Impact Assessment (2) CVD (2) • 28thTB (1) Thalassaemia ( 5) • 29th EID (5) • 30thAvian Influenza (1) Vaccine development (1)
26th ACHR -Recommendations on human genetics ( 5) • Relevance – Contributes to a vast area of research. Relevant to all countries, Resource availability varies. • Clarity : All 5 recommendations are clearly stated , no overlap • Follow up : with SEARO. Required F.U. is feasible.
27th ACHR • Arsenic poisoning ( 2) • Relevant to several countries of the region. Cause debilitating disease, high burden of disease, preventable • Clarity and follow up : Two recommendations to be implemented at the country level. Areas of research grouped as : immediate, medium term and long term.
27th ACHR – continued.. • Health impact assessment (2) : Relevant to all countries of the region. Two recommendations – clearly stated, identified SEARO to take f.u. action • CVD (2) : relevant to all countries. Need for research on prevention and management. Clearly stated. WHO to work in partnership with relevant institutions to promote research
28th ACHR • Tuberculosis – one recommendation which includes two components, one -which includes technical inputs and another , requiring financial inputs. • Thalassaemia – 5 recommendations made. Relevant to several countries of the region. 3 of the recommendations were to be f.u. at SEARO, one of them to be linked with collaborating centres.
29th ACHR • EID – 5 recommendations. Relevant to all countries of the region. Recommendations clearly stated . Identifies several inputs to be carried out by the countries and /or by the WHO. Two recommendations focus on SEARO support for countries in public policy analysis, others for SEARO to take follow up action.
30th ACHR • One on Avian influenza and another on vaccine development. • Relevant to all countries to varying extents • Less clarity . • Each recommendation has several components which are inter related and covers a wide scope.
Implementation of recommendations • Sources of information • Report of the ACHR session that follows the session in which the recommendation is made • From relevant technical units at SEARO • From countries – ( not feasible during this review, even though a tool was developed for the purpose) • From 29th ACHR : an Agenda item titled “Follow up of recommendations of the previous ACHR” was included.
Status of implementation • Total of 12 recommendations made at the 26th ACHR • Report of the 27th ACHR – 4 have been implemented. • Information from RPC and other technical units - follow up action has been taken in respect of all recommendations.
Status of implementation • 27th ACHR • Of the 12 recommendations, no information on follow up of 5 , including those on Arsenic poisoning. • Of the other 7, two recommendations on CVDs have been implemented and on 5 others, the available information is inadequate to assess the status of implementation.
28th session • 14 recommendations made • Report presented at the 29th ACHR session indicated that only 2 recommendations were implemented. • Additional information shows that, for three others , follow up action has commenced and are on going. • The recommendation on vaccine policy has been followed up in 2009 with the establishment of sub committee of SEA-ACHR on vaccines and drug development • Available information on the recommendations on Thalassaemia and TB are not adequate to make an assessment of the status of implementation.
29th ACHR • 8 recommendations made. • 5 of them were related to EIDs, detailed information on their implementation is available. • Information from RPC indicate the implementation of the other three recommendations.
30th ACHR • 9 recommendations • Follow up action taken in respect of 6. Of them, follow up of 4 recommendations are on going. • Two others focus on broad based activities aimed at promoting health research in the region. There is no information to assess the implementation of these recommendations.
31st ACHR – an overview • A total of 12 recommendations were made ( some of them , with several components) • Follow up meetings held: at the 1st follow up meeting 8 recommendations were identified for early action. • Recommendations revised and included in the report of the 31st ACHR ( published)
2nd F.U. Meeting held - Presentations on Regional strategy and guidelines for developing a national health research strategy were presented. • Sub committee on drugs and vaccine development established • Regional consultation on ‘strategy for health’ held in July 2011. Final draft ready. • Review of the regional policy on immunization – being undertaken. • Action to strengthen research capacity in three countries – commenced.
Summary • Nearly half the recommendations are related to aspects relevant to health research. • Many recommendations include several follow up actions by different implementing agencies within and outside SEARO. • Some recommendations are very specific and clear. • Of the 55 recommendations, 35 were to be followed up at SEARO, 5 at SEARO in collaboration with relevant units at HQ and 15 at country level. • Follow up action varied – some of them requiring “one time “ action while others - “ implementation over a period of time”. • Information on follow up action taken was not readily accessible • Of the 55 recommendations, 35 have been implemented and some are ongoing. 4 – not implemented and4 – no information. • On 12 recommendations – information inadequate to make an assessment of the status of implementation.
Considerations for the future • Introduction of an agenda item titled ‘follow up of recommendations of the previous ACHR” has to be continued and monitored to ensure that the information provided is “comprehensive”. • Mechanism to disseminate the recommendations at SEARO and at country level – to be streamlined. • Develop a mechanism to follow up at SEARO, through sharing of information with all relevant technical units and obtaining their views on the priority areas, within those recommendations. • Feasibility of implementing the recommendation at SEARO and at country level needs to be assessed. • A “forum” to be established to follow up at SEARO level. RPD unit to take the role of the Coordinator
Financial requirements needed for implementation to be considered in biannual financial planning. • Develop a mechanism to follow up at country level. Suggested that ‘ the focal point for research’ at country level be strengthened and be provided with a clear set of responsibilities so that he/she could establish links with the country focal point, all other relevant research institutions and with RPC at SEARO.
31st ACHR session – an overview • A number of recommendations were made during the session. • WHO Representatives to play a key role • Follow up meetings held. • Action taken to : established ACHR Sub Committee on vaccine and drugs development • Review the regional policy on vaccine development • Regionla strategy for researcj for health - initiated.