SITUATION ANALYSIS ON CURRENT RESEARCH TRENDS IN

SRI LANKA

Dr Dineshan RanasingheMedical Officer

MBBS /DFMBase Hospitla Panadura

WHY MEDICAL OFFICERS/ SPECIALISTS DO RESEARCH

For a Salary hikeIncrease 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

DESIRED OUTCOME

Individual expectations

Expectations of the nation

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

4. Medical officers with the intention of claiming research allowance

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

90%1%

7%

1%

2%

Chart Title

Basic research

Applied research

Evaluation research

Research and Development

Action research

Clinical trial

N= 902

• 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

other

Priliminary

Grade II

Grade I

PG trainee

Consultants

Junior Admin

Senior Admin

0 200 400 600 800 1000 1200 1400 1600 1800 2000

38

147

1734

327

15

400

11

30

According to the Grade seniority

• No of doctors undergone the research from 2012-2015 - 2702

Number of Doctors involved in research

No: of doctors

Number of researchers

1

2

3

4

5

6

0 50 100 150 200 250 300 350

296

58

99

137

282

20

Chart Title

PUBLICATIONS DONE FROM 2012-2015

21%

68%

11%

Chart Title

publications doneStopped the research without publicationContinuing the research

N =902

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

Continuing

Published

Stopped within 1st 6 months

Stopped in 2nd 6 months

Defaulted after 1 yr

within 2nd year

within 3rd year

0 50 100 150 200 250 300 350 400 450

97

191

81

119

409

1

4

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

Dip in Disaster Management Dip in Health Sector Disaster Management

Diploma in Medical MicrobiologyDiploma in Reproductive Health

MD ( Clinical Oncology)MD ( Medical Virology)

MD (Medical Microbiology)MD (Microbiology)

MD, (Medical Administration)MD. (Community Dentistry)MD. (Community Medicine)

MD. (Family Medicine)MD. (Opthalmology)

MD. (psychiatry) MD. (psychiatry) MD.(Obs & Gyn)

MSc (Community Medicine)MSc Biomedical Informatics

MSc. ( Medical Administration )MSc. (Community Dentistry)

MSc. (Molecular Medicine)PhD. (Philosophy)

(blank)

0 10 20 30 40 50 60

18

39

124

171

31

382

81

86

5425

419

121

NATIONAL RESEARCH COUNCIL SRILANKASri 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

• After the introduction of research allowance rapid increase in performing research among medical officers

RESEARCH ALLOWANCE FOR MEDICAL OFFICERS

RESEARCH ALLOWANCE FOR MEDICAL OFFICERS

Total No of Researches - 902

867; 96%

35; 4%

Chart Title

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}

• Still 80 % not claiming the allowance

• WHY

Reasons why Medical officers arenot interested in research

allowance

STATISTICS ON RESEARCH ALLOWANCES

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

12%

54%

28%

6% Chart Title

Grade I Medical of-ficer

Grade II Medical of-ficer

Priliminary Grade MO

Consultant

N=325

10; 3%

315; 97%

Chart Title

Not aware

MEDICAL OFFICERS AWARENESS REGARDING RESEARCH ALLOWANCE

97 % Doctors aware about the research allowance

PERCEPTION OF CONDUCTING A RESEARCH

14; 22%

3; 5%

48; 74%

Chart Title

Not attemptedNo ideaAttempted

74% of Doctors thought of doing a research

40; 12%

285; 88%

Are you applied for research allowance

YesNo

NO: OF DOCTORS APPLIED FOR RESEARCH ALLOWANCE

Only 12 % of Doctors applied for research allowance

PROBLEMS OF WRITING METHADOLOGY

19%

25%

25%

32%

Chart Title

No difficulty at allLittle bit DifficultDifficultVery Much Dif-ficult

Perception of writing a methodology

81% stated that writing a methodology is difficult

6; 9%

16; 25%

43; 66%

Chart Title

No no need at allYesYes very much needed

Asistance and guidance to write a methodology

91% stated that they need an assistance to write a methodology

GUIDANCE OF WRITING METHADOLOGY

DIFFICULTY IN OBTAINING ETHICAL CLEARANCE

8; 19%

8; 19%

16; 38%

10; 24%

Chart Title

No difficulty at alllittle bit difficultdifficultvery much difficult

Applying and obtaining ethical clearance

81% informed they went through a difficult period to obtain ethical clearance

PROBLEMS ENCOUNTERED IN OBTAINING ETHICAL CLEARANCE

Difficulty in finding documents to submit for ethical clearance

Do not know the procedure of getting ethical clearance

it takes a long time to prepare with all documents

Lack of technical support to fill out the form

lengthy procedure

0 50 100 150 200 250

25

195

5

60

5Chart Title

17%

20%

26%

18%

18%

Chart Title

Don’t knowNot satisfied at allNot satisfiedSomewhat satisfiedSatisfied

N =325

37% satisfied regarding current allowance procedure

LEVEL OF SATISFACTION REGARNDING CURRENT RESEARCH

ALLOWANCE PROCEDURE

REASONS FOR NON SATISFACTION REGARDING CURRENT RESEARCH

ALLOWANCE PROEDURE

41%

39%

14%

7%

Chart Title

Guidance for applying research allowance is not available

It is a lengthy procedure

It is not online

Have to come to colombo to get the payment

N =220 (one person can fill more than one reason)

DURATION FROM ETHICAL APPROVAL TO PAYMENT

40157%

8111%

436%

254%

507%

7310%

203%

71%

71%

1 month

2 months

3months

4 months

6months

1yr

2yrs

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

ISSUES

NEED TO BE ADDRESSED

SOCIETY FOR HEALTH RESEARCH & INNOVATION