Research Trends and Analysis in Sri Lanka's Healthcare Sector
Dr. Dineshan Ranasinghe, a Medical Officer at Base Hospital Panadura, discusses the importance and impact of research in improving healthcare quality in Sri Lanka. Reasons for medical professionals conducting research include personal growth, salary incentives, and national healthcare advancement. The analysis of research trends reveals a focus on basic and applied research, evaluation studies, and clinical trials. The Ministry of Health's ET & R unit plays a significant role in monitoring and supporting research initiatives in the country.
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SITUATION ANALYSIS ON CURRENT RESEARCH TRENDS IN SRI LANKA Dr Dineshan Ranasinghe Medical Officer MBBS /DFM Base Hospitla Panadura
WHY MEDICAL OFFICERS/ SPECIALISTS DO RESEARCH For a Salary hike Increase the take home pay Become a Academic/ Specialist in research A must for PGIM Trainees
WHY COUNTRY NEED RESEARCH IN HEALTH CARE To evaluate the quality of health care To Improve the quality of health care Usage of quality care in a cost effective way
ULTIMATE GOAL Individual expectations Expectations of the nation DESIRED OUTCOME
REASONS OF CONDUCTING RESEARCHES BY MEDICAL PROFESSIONALS IN SRI LANKA 1. Medical officers who undergo PG training 2. Medical officers who do surveys /audits to improve the quality and increase the efficacy of the working environment eg mainly in ICUs 3. Surveys and Audits done by Ministry of Health to improve the quality of health service Funded by NCF, UNICEF, WHO
ANALYSIS OF RESEARCH TRENDS Desk review from ET & R unit of Ministry of Health PGIM
ET & R UNIT DESK REVIEW No of researches done from 2012-2015 -1076 Data Available files from ET & R 902 Files remaining in process at Ministry-174
AVAILABLE FILES TO EXTRACT DATA FROM ET & R unit 902
TYPE OF RESEARCHES DONE FROM 2012 -2015 N= 902 Basic research 90% Applied research Evaluation research Research and Development 7% Action research 1% 0% 1% Clinical trial 1%
Applied research is a form of systematic inquiry involving the practical application of science Identifying The Risk Factors For The Cellulitis of The Leg of Patients Presented to Ward 9 TH-Karapitiya During The Period of 15th March 2014 to 15th june 2014 Evaluation re-search - can be defined as a type of study that uses standard social research methods for evaluative purposes, as a specific research methodology, and as an assessment process that employs special techniques unique to the evaluation of social programs. Eg: Prevalence and associated factors of coronary atherosclerosis among young healthy adults: an analysis of autopsy findings. Action research is either research initiated to solve an immediate problem or a reflective process of progressive problem solving led by individuals working with others in teams or as part of a "community of practice" to improve the way they address issues and solve problems. Eg: A Two Year Prospective Cohort Study of St Elevation Myocardial Infarction Intervention Study
TYPE OF RESEARCHES DONE FROM 2012 -2015 Out of 902 researches Research on Research and Development 0% Clinical Trials 1% (12) Action Research -0.5 % (6) Types of researches that we should focus in the future ??
CATEGORIZATION ACCORDING TO THE GRADE Total no of researches -2702 According to the Grade seniority 30 Senior Admin 11 Junior Admin 400 Consultants 15 PG trainee 327 Grade I 1734 Grade II 147 Priliminary 38 other 0 200 400 600 800 1000 1200 1400 1600 1800 2000
No of doctors undergone the research from 2012- 2015 - 2702 20 6 282 5 No: of doctors 137 4 99 3 58 2 296 1 0 50 100 150 200 250 300 350 Number of researchers
PUBLICATIONS DONE FROM 2012-2015 N =902 68% publications done Stopped the research without publication 11% 21% Continuing the research
ONLY 21% PUBLICATIONS DONE Reasons why less publications Lack of research writing capability of Medical officers Lack of sustainability on doing a research Delay in administrative failures on paying research allowance
21% OF PUBLICATIONS FROM 2012-2015 Are we using the publications for development of Health sector Yes / No How many research outcomes used to develop the health sector? If it is not used Are there any purpose of doing researches ?? Do these research important in health sector development??
END RESULT OF THE RESEARCHES FROM 2012-2015 4 within 3rd year 1 within 2nd year 409 Defaulted after 1 yr 119 Stopped in 2nd 6 months 81 Stopped within 1st 6 months 191 Published 97 Continuing 0 50 100 150 200 250 300 350 400 450
REASONS FOR DROP OUTS Only interested on research allowance for stipulated period of time (1st Year) Administrative support is not adequate to carry out the research Difficulty of publishing in a journal How to reduce the drop outs
POST GRADUATE INSTITUTE OF MEDICINE N= 264 (blank) PhD. (Philosophy) 1 MSc. (Molecular Medicine) 12 MSc. (Community Dentistry) 9 MSc. ( Medical Administration ) 41 MSc Biomedical Informatics 25 MSc (Community Medicine) 54 MD.(Obs & Gyn) 6 MD. (psychiatry) 8 MD. (psychiatry) 1 MD. (Opthalmology) 8 MD. (Family Medicine) 2 MD. (Community Medicine) 38 MD. (Community Dentistry) 1 MD, (Medical Administration) 3 MD (Microbiology) 1 MD (Medical Microbiology) 17 MD ( Medical Virology) 4 MD ( Clinical Oncology) 12 Diploma in Reproductive Health 9 Diploma in Medical Microbiology 3 Dip in Health Sector Disaster 8 Dip in Disaster Management 1 0 10 20 30 40 50 60
NATIONAL RESEARCH COUNCIL SRILANKA Sri lankan scientists publication in indexed journals
NATIONAL RESEARCH COUNCIL SRILANKA Research grants funded on Health Food and Nutrition and other fields
RESEARCH ALLOWANCE FOR MEDICAL OFFICERS
RESEARCH ALLOWANCE FOR MEDICAL OFFICERS After the introduction of research allowance rapid increase in performing research among medical officers
RESEARCH ALLOWANCE FOR MEDICAL OFFICERS Total No of Researches - 902 35, 4% 867, 96% Research allowance claimed
STATISTICS ON RESEARCH ALLOWANCES No: of doctors undergone the research from 2012- 2015 - 3304 No: of doctors claiming research allowance - 2650 No: of doctors awaiting for research allowance (Still files are processing at MOH)-522 Percentage entitled for research Allowance - 19.8% { (2650+522) / 16000 x 100}
STATISTICS ON RESEARCH ALLOWANCES Still 80 % not claiming the allowance WHY No - for 35% basic salary hike per month
PERCEPTION OF MEDICAL OFFICERS REGARDING RESEARCH SURVEY ON WHY MEDICAL OFFICERS ARE RELUCTANT TO CARRY OUT RESEARCH
Categorization of Medical officer participated in the research N=325 6% 12% Grade I Medical officer Grade II Medical officer Priliminary Grade MO Consultant 28% 54%
MEDICAL OFFICERS AWARENESS REGARDING RESEARCH ALLOWANCE 315, 97% Not aware Aware 10, 3% 97 % Doctors aware about the research allowance
PERCEPTION OF CONDUCTING A RESEARCH 14; 21% Not attempted 3; 5% No idea Attempted 48; 74% 74% of Doctors thought of doing a research
NO: OF DOCTORS APPLIED FOR RESEARCH ALLOWANCE Are you applied for research allowance 40, 12% Yes No 285, 88% Only 12 % of Doctors applied for research allowance
PROBLEMS OF WRITING METHADOLOGY Perception of writing a methodology No difficulty at all 19% 32% Little bit Difficult Difficult 24% 25% Very Much Difficult 81% stated that writing a methodology is difficult
GUIDANCE OF WRITING METHADOLOGY Asistance and guidance to write a methodology 6, 9% 16, 25% No no need at all Yes 43, 66% Yes very much needed 91% stated that they need an assistance to write a methodology
DIFFICULTY IN OBTAINING ETHICAL CLEARANCE Applying and obtaining ethical clearance No difficulty at all little bit difficult 8, 19% difficult 10, 24% very much difficult 8, 19% 16, 38% 81% informed they went through a difficult period to obtain ethical clearance
PROBLEMS ENCOUNTERED IN OBTAINING ETHICAL CLEARANCE 5 lengthy procedure 60 Lack of technical support to fill out the form 5 it takes a long time to prepare with all documents 195 Do not know the procedure of getting ethical clearance 25 Difficulty in finding documents to submit for ethical clearance 0 50 100 150 200 250
LEVEL OF SATISFACTION REGARNDING CURRENT RESEARCH ALLOWANCE PROCEDURE N =325 17% 18% Don t know Not satisfied at all Not satisfied 20% Somewhat satisfied 19% Satisfied 26% 37% satisfied regarding current allowance procedure
REASONS FOR NON SATISFACTION REGARDING CURRENT RESEARCH ALLOWANCE PROEDURE N =220 (one person can fill more than one reason) Guidance for applying research allowance is not available It is a lengthy procedure 41% 38% It is not online 14% 7% Have to come to colombo to get the payment
DURATION FROM ETHICAL APPROVAL TO PAYMENT 7 7 20 3% 1% 1% 73 10% 1 month 2 months 50 7% 3months 25 4% 4 months 6months 43 6% 401 57% 1yr 2yrs 81 11% 3yrs 4yrs Average time is around 3 4 months
REASONS ON WHY RELUCTANT TO DO RESEARCH Difficulty in writing a methodology No assistance on writing methodology Lack of expertise on applying for ethical clearance Lack of accredited journals to publish the surveys Dissatisfaction regarding current allowance procedure Delay in payment of research allowance allowances
TO DEVELOP RESEARCH CULTURE AMONG MEDICAL OFFICERS Difficulty in writing a methodology No assistance on writing methodology Lack of expertise on applying for ethical clearance Dissatisfaction regarding current allowance procedure Lack of accredited journals to publish the surveys Administrative issues in research allowance Delay in payment of research allowance allowances NEED TO BE ADDRESSED ISSUES SOCIETY FOR HEALTH RESEARCH & INNOVATION