In Beira, the Ministry of Health (MOH) with support from Health Alliance International recently opened the country’s first operations research center for the Central Region. The Operations Research (OR) Center was founded to increase the capacity of the health system to carry out applied research and use the outcomes to better inform health policy-decision making in the Central Region. The center will have the capacity to house a number of research studies at any given time, and provide Mozambican researchers with valuable links to external researchers and thus foster cooperation and strong site-initiated research questions. Human resources required to carry out a study will also be available at the center, and facilitate operations research in the Central Region of Mozambique.
It is well-known that health service delivery is weak in many of Mozambique’s basic health programs. Although economics play a role in the adequate delivery of primary health care, many programs function poorly for other reasons. Often it is not known whether programs function well or what could be changed to improve them. Information on the quality and functioning of health services for HIV/AIDS, for example, is now critical to assure that the national care and treatment program rolls out as quickly as possible, while ensuring a high level of care.
Health care managers need information on what is working and what needs to be changed to develop strategies for improvement, for areas such as:
Finally, assessing community-based services, including community health workers and health committees, is necessary to gauge the effectiveness of these programs as well as their integration into the formal health sector. Looking at how these programs work can be important guides for the development of more appropriate, cost-effective strategies to maximize limited health resources.
At this site, the training of Mozambicans in basic research design, data collection, management and analysis, will also be a priority. There is a strong desire by both the Ministry of Health and international donors to support Mozambican initiated research. In the past limited numbers of individuals with these skills has been a major barrier outside of the capital, Maputo.
Sofala and Manica Provinces have been leaders in the development of capacity for health systems research. Manica Province presented 15 assessments/studies at the December 1994 National Health Conference (Journadas de Saude) and both Manica and Sofala Province presented 8 assessments in 1996 and 11 in 2000 and 23 in 2005. Most of the presentations were related to health systems research. (Abstracts are available on request). The issues and problems encountered in these provinces are similar to those encountered in other areas of the country, and information from these assessments has been useful in developing policies and strategies nationwide.
Health Alliance International (HAI) has long been a major supporter of these health systems research projects in Manica and Sofala Provinces. HAI’s strong link with the University of Washington School of Public Health and Community Medicine provides strong support from faculty with substantial experience in health systems research in Mozambique. Research currently being carried out at the Beira center includes a Ministry of Health and University of Washington collaboration on Nevirapine resistance, and sexual networking.
Funding for the Operations Research Center is being provided by MOH and the World Bank (Treatment Acceleration Program).