The landscape of health researches in Ilocos Region, Philippines.
In the Philippines, the health field is one important area of concern for research. In fact, a survey conducted by PCHRD among 294 institutions in the country reveals that only a little more than half (57%) of the respondents were engaged in health research during the period of 1990-1995. Furthermore, there was a lopsided distribution of health research resources in the country, as researches are usually concentrated on the National Capital Region (NCR) (PCHRD 1998 Annual Report).
Padolina (1998) reported that there were only 978 Ph.D. degree holders, in all disciplines, who were actually doing research in the country. In 1995, the health and S&T sector had 77 researchers who were holders of doctoral degrees. Of these, 66 were from UP Manila. Another survey showed that there were only 638 researchers, 502 of them work full time, and that some 70 percent of the researchers were 30 to 49 years old (Proceedings of the 5th National Health S&T Congress, 1999).
It can be seen from health research journals that in Region I, few venture into conducting health researches. The Population Commission (POPCOM) Region I 1999 Annual Report states that there were only three (3) health researches made for the year 1999. The 1994-1996 Inventory of Health Researches (PCHRD, 1997) also revealed that out of the 636 completed health and medical researches, there were only three (3) researches made by health researchers from Region I. The PCHRD Annual reports from 1998 to 2000 also showed that although there were 125 research projects funded by PCHRD, none of these research projects came from Region I.
Dumbrique (1999) conducted a study on the functional research performance of the faculty members of State Universities and Colleges (SUCs) in Region I along the natural sciences, public/development administration, and teacher education. The said study looked into the different agency's research climate, as well as the quantity and quality of the researches that were undertaken. However, health research was not included in the study.
The researchers believe that there has been a lot of health researches conducted in the region. However, these might have only been confined for publication in the newsletters and journals of certain institutions. Such researches were not published in health journals of national or regional circulation. Hence, the researchers deem it important to review health researches conducted in the region to establish a data bank for such researches leading to their proper utilization. The availability of health research materials could sustain and even spur the growth of health research in the region in order to provide global, national and regional competitive level.
For people to value health research, they have to realize how meaningful and useful health researches are. Crossing the line from the technical jargons and turning these into a language that a common person can understand is as difficult as doing the research itself. The need, therefore, to evaluate the quality of health researches is important. Findings on the quality of health researches conducted could provide baseline information for planning activities in order to improve the capability of researchers along the health field, and the delivery of health care by health providers in the region.
The findings of this study can also help determine the current health profile, as well as identify the current needs, issues, and concerns in health research. These can then help health administrators formulate policies regarding the conduct of health research in the region. Moreover, this study will increase the awareness on the importance of health research and will hopefully inspire the conduct of more researches, particularly along health.
End Users/Target Beneficiaries
The end users of this study are the present and future health researchers, the students, and even the middle and top managers of the public health system. This study can inform and educate these end users about the current health profile and research climate in Region I. Moreover, it can help them identify the current relevant health needs, issues, and concerns in health research, as well as in planning activities that will improve the capability of health researchers.
The case for action to support and improve health is strengthened by the growing recognition, in recent years, of the intimate link between health and development. Since 1993, it has become widely accepted that better health is a necessary element of development and that investments in health have become essential to economic growth policies that seek to improve the lot of poor people (World Bank, 1993; World Health Organization or WHO Ad Hoc Committee, 1996; WHO Commission, 2001). Indeed, investments in health have been demonstrated to yield higher rates of return than virtually any other investments that a government can make (WHO Commission, 2001) and they have been proven to be an indispensable component of any national strategy aiming to support poverty alleviation and reduce inequities. Health, as a core component of human development, was most clearly described by AmartyaSen in his book Development as Freedom (Sen,2000).
The type of research needed does not require resources on a scale comparable with that which is necessary for the development of new drugs. It does, however, require qualitative and quantitative research capacity to engage in a variety of research methods -including researches that uncover the nature and extent of underlying health problems and their root causes (including determinants in and beyond the health sector); examine the relevance and transferability of knowledge and tools developed elsewhere; experiment with adaptations to local conditions and contexts; explore the scaling-up and sustainability of interventions; monitor and evaluate the effectiveness of interventions and the degree to which they are successful; measure the efficiency and cost-effectiveness of all elements in the process; and explore social, economic, national and international obstacles to closing this gap and attempting to find solutions.
More health researchers are needed, however, the knowledge and tools available are not always adequate to tackle existing health problems and there is a constant and never-ending need to generate new information and develop improved and more effective ways to protect and promote health and reduce the occurrence of diseases. This has always generated a dilemma for policymakers: whether to support researches that may lead eventually to improved interventions and better outcomes, at the expense of diverting scarce resources from the immediate deployment of existing knowledge. Time and again, research has demonstrated its value in the longer term.
Some contemporary examples of the continuing needs for research include the following: growing microbiological resistance in, for example, diseases like tuberculosis and malaria; absence of effective treatments for diseases, such as dengue fever, in low-income countries; treatment and prevention of HIV/AIDS; preparedness for new/emerging infections; need for new knowledge about the global factors that influence health; need for new knowledge about local contexts, conditions, and health priorities; need for new knowledge about social, political, economic, and environmental determinants of health, especially in understanding how to increase health equity within and between countries; health policy and systems research how to make the health system perform better; need to understand and monitor impacts of global policies on trade and of globalization on the health of individuals, family, community, and countries; research on environmental health, the interaction between economic activity, environment, and human health, need for new knowledge about what people need to be healthy and to remain healthy; and need to understand how to best use research, not only for health improvements, but also for social and economic development--in an equitable manner.
This list is far from exhaustive. Thus, beyond the adoption, adaptation, and application of existing knowledge, there remains a substantial need for research to create new knowledge and technologies and to translate these into effective interventions that will enable people to be healthy everywhere.
OBJECTIVE OF STUDY
The general objective of this study is to analyze the health researches conducted in Ilocos Region.
Specifically, this study sought to describe the health researchers in terms of personal and professional variables and determine the quantity (subject area, authorship, cost, fund source, coverage, dissemination, and utilization) and quality (relevance and responsiveness, effectiveness, scientific, transferability, and dissemination) of health researches.
MATERIALS AND METHODS
This study used the descriptive research design. A content analysis was done on the health researches conducted in terms of quantity and quality. It also described the health researchers in terms of personal and professional factors.
This study covered the four Nursing Education Institutions and two Medical Trainings Institutions in the Ilocos Region, namely: Lyceum Northwestern University (LNU), Mariano Marcos State University (MMSU), University of Northern Philippines (UNP), VirgenMilagrosa University (VMU), Mariano Marcos Memorial Hospital & Medical Center (MMMH&MC), and Ilocos Training and Regional Medical Center (LTRMC). All the staff of the six institutions mentioned above, including the interns of the MMMH&MC and ITRMC, who had conducted health research/es from 1997 to 2005 were taken as respondents of the study. There were a total of 241 health researchers in the region and the distribution for each institution is as follows: LNU-4, MMSU-8, UNP-20, VM-7, MMMH&MC-67, and ITRMC-135.
The data gathering instrument used in the study composed of two parts. Part I gathered information on the personal and professional profile of the health researchers in the region. Part II elicited data on the quantity and quality of health researches conducted. The quantity portion of this part of the questionnaire was made by the researcher and the quality portion was adopted from Dumbrique (1999).
The primarily validated questionnaire was administered to the respondents through the help of the deans and research coordinators in the case of the academic institutions and the administrators for the hospitals. Missing data which the respondents failed to submit were culled from documents requested from the Personnel Division/Office of the respective institutions and some were culled from interviews.
The respondents were requested to submit a copy of their research abstracts and a full copy of their best research (in cases where there were two or more researches conducted). The researcher also requested a copy of the research publication of each of the institutions. This was used as a reference for the research manuscripts and/or abstracts not submitted by the respondents.
The quality of the best research conducted was evaluated by the researchers themselves, making use of the quality portion on part two of the questionnaire. Two research experts were also requested to evaluate the same researches. The pooled assessments from the researchers and from the experts were the final data on research quality that were considered in the study.
Data gathered in the study were analyzed through the use of the following statistical tools: frequency count and percentage, and weighted mean.
RESULTS AND DISCUSSION
Profile of the Health Researchers
There were 241 health researchers in Ilocos Region from 1997 to 2005. Most (105 or 43.6%) of them were 31-40 years old, an indication that they were in their middle age. This is particularly true for the respondents from the hospitals. Most of those from the academic institutions were already in their early adulthood.
Majority (156 or 64.7%) of the researchers were female. This was true in all six the institutions. Majority (201 or 83.4%) of the health researchers were medical doctors. This was due to the great number of respondents from the hospitals (MMMH&MC and ITRMC). Few respondents were from the academic institutions and there were more who had finished master's degrees compared to those who finished doctoral degrees.
Majority (84.8 percent) of the total number of respondents were medical professionals. The others were in the teaching profession and others were support staff, such as the psychologists who worked in the hospital and medical technologists who had minimum teaching loads. About one third (68 or 28.2%) of the health researchers had been in their medical and teaching professions for 6-10 years. While more than half of the researchers had been in their profession for more than 10 years. Most of the health researchers received PhP10,001-PhP15,000 as basic monthly salary. There were, however, 93 (38.6%) who received monthly salaries of Php15,001-20,000, and few received more than PhP 20,000.
Most of the respondents had attended health-related trainings/ conferences at the regional level. There were also some who had attended trainings at the national level. It is also noteworthy that there were 17 respondents who had attended international health-related trainings. It should further be noted that most of the national trainings attended by the respondents are annual conferences related to their specific fields. Very few had attended health research-related trainings.
Almost all the health researchers were members of professional organizations like the Philippine Medical Association, Philippine Nurses Association, and other health-related associations. In addition, majority of them were also members of civic organizations like the medical-related societies, research-related associations, and other organizations.
A great majority (233 or 96.7%) of the health researchers had never been granted scholarship or fellowship. Very few had received scholarship grants, such as those from Ford Foundation and DOH Scholarship Grants. Some health researchers had received awards at the local to national levels. Most of these awards were given to medical doctor researchers in recognition for their outstanding performance in their case presentations.
Quantity of Health Researches
There were 248 reported health researches conducted in Region 1 from 1997-2005.
As shown in table 1, the majority of the health researches were conducted in hospitals, particularly the MMMH&MC and ITRMC. Only a limited number (less than 20%) of the health researches came from the academic institutions. The health researches conducted in the hospitals were mostly clinical research papers, around three-fourths of which were requirements of the researchers' residency in the hospitals. It is also worth noting that around one-fourth of the medical doctors who were taken as respondents for this study conducted clinical researches voluntarily. On the other hand, around 70 percent of the researches conducted in the academic institutions were requirements for the researchers' doctorate or master's degrees.
Research Area. As gleaned from Table 2, majority (33.9%) of the health researches conducted focused on clinical studies. About a fourth (22.9%) were on epidemiological studies. The rest were on evaluation, socio-behavior intervention, biomedical feasibility and others (60.4%).
The clinical studies focused on medical and surgical cases which commonly prevail in the region. Epidemiological studies focused on pulmonary diseases, environment-related diseases and malignancies. Evaluation researches accounted for 49 or 19.6% of the health researches conducted. Others dwelt on performance of health providers, technology effectiveness, screening program, program impact, and health status. The few (24 or 9.6%) researches along socio-behavioral studies concentrated on risk factors of a certain condition; health knowledge, attitude, practices, beliefs, lifestyle modification; and compliance behavior on certain treatment regimen. The least researched areas were Operation Research (1 or 0.4%), Health Economics (1 or 0.4%), and Health Policy Research (1 or 0.4%).
Majority (64.9%) of the health researches were conducted by individual authors. More than one-third of the researches were coauthored and were conducted by a group with two to four members. Rarely were the researches conducted by a group of five or more members.
The researcher was not successful in determining the cost of the researches. Around (49.2%) one-half of the researchers failed to indicate the cost of their research. This is particularly true in the MMMH&MC and ITRMC. Among the researchers who reported a research cost, 59 (23.8%) claimed to have expenditures amounting to PhP10,000-PhP 20,000. There were four (1.6%) which cost more than PhP 50,000.
Regarding the sources of the funds used in the researches, majority (96.0%) of the researches were personally funded by the researchers. Four (4) (1.6%) researches were funded by the respective institutions where the researchers belong, five (5) (2.0%) were funded by the PCHRD, and two (2) (0.4%) by the DOH. The five PCHRD grants were given to Lyceum (with two grants), UNP (with two grants) and MMMH&MC (with one grant). On the other hand, the sole DOH research assistance was granted to UNP.
The most common area of coverage of the health researches that were conducted in Region I is the institutional or local level, (81.9%). There were only few researches which covered the provincial (5.2%) and regional (11.3%) levels. It is worth noting, however, that four researches (1.6%) focused on national health concerns.
More than one-half (58.1%) of the researches reviewed were published in research and scientific journals of the institutions. Some were published at the national research proceedings while 41.9% were unpublished. None were published in International peer-reviewed journals.
Majority (78.2%) of the researches were claimed by the researchers to have been disseminated through fora, conferences, research displays/ exhibits, and research utilization seminars at the local, regional, and national levels while a fifth (21.8%) have not been disseminated.
Out of the 248 researches reviewed, only 30% percent revealed whether the researches were actually utilized or not. It was found out that only seven (2.8%) researches were actually utilized. The researcher could not determine whether the majority of the researches (69.8%) were utilized or not. This calls for a need to publish in electronic journal and to monitor citation tally which can provide indication of the impact of the researches conducted.
The health researches in the region were likewise assessed based on quality. Each health researcher was requested to submit one research publication that he/she conducted. Those who conducted more than one research were asked to submit their best research. The researchers were also requested to evaluate their research based on the following criteria: relevance and responsiveness, effectiveness, scientific, quality, transferability, and dissemination. The assessment tools were provided to them in questionnaire form. To validate the evaluation made by the researchers, two experts were requested to evaluate the same researches using the same instrument. The pooled evaluations of the experts and the researchers are presented in Table 5.
As shown in Table 5, the health researches conducted in the region were generally assessed to have a moderately high degree of relevance and responsiveness. This means that the researches conducted and reviewed were not very much in line with the medium or long term development thrusts and priorities of the country, as well as the recognized development plans of the National Economic Development Authority (NEDA) and the local government, and even with the research objectives of the institutions. Furthermore, the researches were assessed to be only fairly responsive to immediate/current social needs.
The researches conducted were claimed by the researchers and the experts to have high level of effectiveness. The research findings were said to have contributed to additional knowledge and innovative ideas for the improvement of research and extension activities, and health services delivery. However, the researches were only assessed as moderately effective in their contribution to productivity and, in general, to national development.
The researches were adjudged to have high scientific quality. The researchers have followed the standard format of research writing, the research design had captured the objective of the study, and the data were properly presented and substantially analyzed using appropriate statistical tools. However, on the representativeness of the sample, validation and pre-testing of the data-gathering instruments these were found inadequately and explained.
A high quality of the researches was found in terms of transferability. The evaluators claimed that the research findings can be highly applied in other areas and the skills, knowledge, and technology used can be highly adopted under normal conditions. The evaluators also averred that the skills, knowledge or technology generated from the research are highly economically viable and socially acceptable.
The quality of the researches in terms of dissemination was slightly low on the translation of the researches in the vernacular, publication of the researches in newspapers of local and national circulation, and displaying of research findings. Although majority of the researches were disseminated they were low in translational research.
The health researches conducted in Ilocos Region, Philippines and reviewed in this study are moderately of high quality. The researches are moderately relevant and responsive, highly effective, highly scientific, highly transferable, but slightly disseminated. In view of their limited dissemination, the researches conducted in the region are of low impact and with minimal effect on the quality of health care and the global, national and regional competitive level.
Dumbrique, J. S. 1999 Determinants of functional research performance of the faculty members of SUCs in Region I. Doctoral dissertation, University of Northern Philippines, Vigan City, Ilocos Sur.
PCHRD 1998 Annual Report.
PCHRD 1999 Annual Report.
Proceedings of the 5th National Health S&T Congress, 1999.
EDELYN A. CADORNA
ERWIN F. CADORNA
University of Northern Philippines,
UNESCO World Heritage City of Vigan
Table 1. Distribution of the researches in the nursing education and medical training institutions in Ilocos Region, Philippines Institutions No. % Lyceum University (LU) 6 2.4 Mariano Marcos State University (MMSU) 8 3.2 University of Northern Philippines (UNP) 24 9.7 Virgen Milagrosa University (VMU) 7 2.8 Mariano Marcos Memorial Hospital & Medical Center 59 23.8 (MMMH & MC) Ilocos Training Regional Medical Center (ITRMC) 144 58.1 TOTAL 248 100.0 Table 2. Quantity of health researches in Ilocos Region, Philippines Quantity Indicators f % Research Area Biomedical Research 5 2.0 Socio-Behavioral Studies 24 9.7 Clinical Studies 84 33.9 Epidemiological Studies 57 22.9 Health System Research or Operational Research 1 0.4 Intervention Studies 23 9.3 Evaluation Research 49 19.8 Feasibility Studies 3 1.2 Health Economics 1 0.4 Health Policy Research 1 0.4 Total 248 100.0 Authorship Co-author 87 35.1 Single-Author 161 64.9 Total 248 100.0 Research Cost More than PhP50,000 4 1.6 PhP 40,001-50,000 13 5.2 PhP 30,001-40,000 1 0.4 PhP 20,001-30,000 15 6.0 PhP 10,001-20,000 59 23.8 Less than PhP 10,000 35 14.1 No Response 122 49.2 Total 248 100.0 Funding Source PCHRD 5 2.0 DOH 1 .4 Institution 4 1.6 Personal 238 96.0 Total 248 100.0 Coverage National 4 1.6 Regional 28 11.3 Provincial 13 5.2 Local 203 81.9 Total 248 100.0 Publication Published 144 58.1 Unpublished 104 41.9 Total 248 100.0 Dissemination Disseminated 194 78.2 Not Disseminated 54 21.8 Total 248 100.0 Utilization Utilized 7 2.8 Not Utilized 68 27.4 No Response 173 69.8 Total 248 100.0 Table 5. Quality of the health researches conducted in Ilocos Region, Philippines Quality Indicators [bar.x] Level A. Relevance and Responsiveness 3.22 MH B. Effectiveness 3.50 H C. Scientific 3.57 H D. Transferability 3.66 H E. Dissemination 2.37 SL Overall 3.27 MH Norm: 4.50-5.00 Very High (VH) 3.50-4.49 High (H) 2.50-3.49 Moderately High (MH) 1.50-2.49 Slightly Low (SL) 1.00-1.49 Low (L)
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|Author:||Cadorna, Edelyn A.; Cadorna, Erwin F.|
|Publication:||Asian Journal of Health|
|Date:||Jan 1, 2012|
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