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