Capacity-building for health research in developing countries: a manager's approach / Formación de la capacidad de investigación sanitaria en los países en desarrollo: el enfoque de un gestor

Research may be viewed as rigorous inquiry to advance knowledge and improve practices. An international commission has argued that strengthening research capacity is one of the most powerful, cost-effective, and sustainable means of advancing health and development. However, the global effort to promote research in developing countries has been mostly policy driven, and largely at the initiative of donor agencies based in developed countries. This policy approach, although essential, both contrasts with and is complementary to that of research managers, who must build capacity "from the ground up" in a variety of health service settings within countries and with differing mandates, resources, and constraints. In health organizations the concept of research is broad, and practices vary widely. However, building research capacity is not altogether different from building other kinds of organizational capacity, and it involves two major dimensions: strategic and operational. In organizations in the health field, if reference to research is not in the mission statement, then developing a relevant research capacity is made vastly more difficult. Research capacities that take years to develop can be easily damaged through inadequate support, poor management, or other negative influences associated with both internal and external environments. This paper draws from key international research policy documents and observations on the behavior of research and donor agencies in relation to developing countries. It examines capacity-building primarily as a challenge for research managers, realities underlying operational effectiveness and efficiency, approaches to resource mobilization, and the need for marketing the research enterprise. Selected examples from South Asia and Latin America and the Caribbean are presented

La investigación se puede considerar como un examen riguroso para profundizar el conocimiento y mejorar las prácticas. Una comisión internacional ha sostenido que el fortalecimiento de la capacidad de investigación es una de las formas más poderosas, eficientes y sostenibles de hacer progresar la salud y el desarrollo. Sin embargo, los esfuerzos mundiales para promover la investigación en los países en desarrollo han sido guiados sobre todo por la política y, en gran parte, por iniciativa de organismos donantes de los países desarrollados. Aunque esencial, este enfoque político es complementario de y al mismo tiempo contrasta con el de los gestores de la investigación, que deben fortalecerla "sobre el terreno", en servicios de salud que varían mucho según el país, y con mandatos, recursos y limitaciones muy diferentes. El concepto de investigación de las organizaciones sanitarias es amplio y las prácticas son muy variables. Sin embargo, la formación de la capacidad de investigación no es muy diferente de la formación de otros tipos de capacidad organizativa y tiene dos grandes aspectos: el estratégico y el operativo. En las organizaciones del campo de la salud, la creación de una capacidad de investigación importante se hace mucho más difícil cuando no se menciona la investigación en el enunciado de su misión. Capacidades de investigación que tardan años en crearse pueden ser fácilmente dañadas por un apoyo insuficiente, una mala gestión u otras influencias negativas internas o externas. Este artículo se basa en documentos clave sobre la política internacional de investigación y en observaciones sobre el comportamiento de los organismos donantes y de los organismos de investigación en relación con los países en desarrollo. Se analizan la formación de la capacidad de investigación, fundamentalmente como un reto para los gestores, los hechos reales detrás de la eficacia y la eficiencia operativas, los métodos de movilización de recursos y la necesidad de la empresa de investigación de realizar actividades de mercadeo, y se presentan algunos ejemplos del sur de Asia, América Latina y el Caribe.

The control of tuberculosis in the Caribbean

A survey of the Ministries of Health in the English-speaking Caribbean countries was conducted with the purpose of collecting information about current capacity in the prevention and control of tuberculosis. A response rate of 78.9 per cent was achieved. The results of this survey indicate that tuberculosis control programmes in the English-speaking Caribbean are limited, and inadequately address issuse relating to multi-drug resistant disease and co-infection with human immunodeficiency virus (HIV). Limitations and implications of this survey are discussed.

Attitudes and practices of pesticide users in Saint Lucia, West Indies

This article reports the results of a Saint Lucia survey, part of a larger program, that was the first to document the prevalence of suboptimal safety practices among vector control and farm workers using pesticides in the English-speaking Caribbean. Among other things, the survey found that many of 130 pesticide users surveyed were unaware that the skin and eyes were important potential routes of absorption. Over a quarter said had felt ill at some point as a result of pesticide use. About half the respondents said they had received more than "introductory" training in safe pesticide use, and most said they always found labels or directions affixed to pesticide containers. However, about half said they never or only sometimes understood the labels, and many of those who said they understood did not always follow the instructions. About a quarter of the smokers said they smoked while using pesticides; about a sixth of the survey subjects said they ate food while using pesticides; and over 60 percent said they never wore protective clothing

La lucha contra el SIDA en el Caribe: Un enfoque subregional coordinado / Combatting AIDS in the Caribbean: A coordinated subregional approach

Combatting AIDS in the Caribbean: A coordinated subregional approach