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Health research systems analysis in Shanghai, China

Date: Thursday 1 November 13.30–15.00
Source: Forum 11
Authors: Chen Jie, Professor, Key Laboratory of Health Technology Assessment, Fudan University, People's Republic of China

Abstract

In 2006, Fudan University embarked on a process of health research system (HRS) analysis as part of a five-country Western Pacific collaboration. China has made significant advances in health research activities, especially in Shanghai, but we do not know if the research is related to the health demand, how research is managed, how funds are allocated, or the status of the research environment.

The aims of this work were to provide evidence to describe the structure of the HRS in Shanghai and provide information that decision-makers could use to strengthen the system.

A review of approaches to research evaluation and HRS analysis informed the decision to focus on a HRS mapping exercise and an institution-level survey of research commissioners, producers and users. A range of potential indicators was assessed and those deemed most useful for the national context incorporated into the institutional questionnaires. This study built on the work of World Health Organization's Health Research Systems Analysis and the Council on Health Research for Development's (COHRED) framework on national health research systems (NHRS).

HRS analysis cannot be undertaken as a `purely technical' exercise and for the evidence to be used for sustainable impact, parallel process activities are crucial. To ensure engagement of national stakeholders, the research team invited some related government leaders, such as the directors of the Education Commission, Science and Technology Commission, and the Health Bureau of Shanghai, to constitute a steering group. A workshop was then held with participants invited in the name of the Health Bureau of Shanghai.

The HRS mapping exercise identified institutions with roles in commissioning (4 institutions), producing (20 institutions) and using (26 institutions) research. A total of 60 institutions were surveyed and 50 responded (83.3%).

Governance of the health research system is complicated. There are several funders and several government institutions involved. But there is no integrated information collection system and there is no formal ethical review system. The results of the institutional survey show that most of the resources are allocated to basic and clinical medicine. The number of projects related to national priorities is smaller than the number related to other topics. Most of the funds are allocated to high-technology medicine. Many of the results of research projects are not applicable.

Health policies need to be made according to health priorities. Similarly, research priorities need to match health needs. Resources must be allocated to research priorities, policy-makers must consider inequities, and the management of research projects must be optimized.