Maceira Daniel, Paraje Guillermo, Aramayo Fernando, Masi Sergio Duarte, Sánchez Delia
Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.
Rev Panam Salud Publica. 2010 Jun;27(6):442-51.
Describe the public subsystems of the national health research systems (SNIS) in five Latin American countries (Argentina, Bolivia, Chile, Paraguay, and Uruguay), emphasizing the types of institutional arrangements in place in each country to promote, develop, and sustain their SNIS, as well as explicit or implicit mechanisms for prioritizing health research projects.
The bodies responsible for managing the public resources allocated to finance health research projects in the five countries studied were identified. The types of projects financed were then analyzed-using a matrix constructed by area and object of study-, certain characteristics of the principal investigators, and the sums allocated between 2002 and 2006.
Only the countries with greater resources or better developed networks of investigators have formal structures for allocating funds with regular calls for proposals and fixed rules. None of them has explicit comprehensive mechanisms for prioritizing health research. Moreover, the health research priorities in the countries vary widely. In this regard, it is significant that problems such as "nutrition and the environment" or "violence and accidents" receive little attention in most countries. The same holds true for a number of public health issues in some countries. In contrast, the research in the "hard sciences" absorbs up to one-third of the total resources for research.
Many questions arise about the ability of these countries to adapt and generate new knowledge, as well as the nearly nonexistent research on social, economic, and cultural determinants, or on health services and systems that have a high impact on groups with limited access to health care. Explicit priorities should be set with stakeholders for the health research agenda, and mechanisms should be adopted for monitoring and following up health research financing by subject and area of study.
描述五个拉丁美洲国家(阿根廷、玻利维亚、智利、巴拉圭和乌拉圭)国家卫生研究系统(SNIS)的公共子系统,重点阐述每个国家为促进、发展和维持其SNIS所采用的机构安排类型,以及确定卫生研究项目优先级的明确或隐含机制。
确定负责管理五个研究国家中分配用于资助卫生研究项目的公共资源的机构。然后使用按研究领域和对象构建的矩阵分析所资助项目的类型、主要研究人员的某些特征以及2002年至2006年期间分配的资金数额。
只有资源较为丰富或研究人员网络较为发达的国家拥有正式的资金分配结构,通过定期征集提案和固定规则来进行。这些国家均没有明确的全面机制来确定卫生研究的优先级。此外,各国的卫生研究重点差异很大。在这方面,“营养与环境”或“暴力与事故”等问题在大多数国家很少受到关注,这一点很重要。一些国家的许多公共卫生问题也是如此。相比之下,“硬科学”研究吸收了高达三分之一的研究总资源。
这些国家在适应和产生新知识的能力方面存在诸多问题,而且几乎不存在关于社会、经济和文化决定因素,或对获得医疗保健机会有限的群体有重大影响的卫生服务和系统的研究。应与利益相关者共同为卫生研究议程设定明确的优先级,并采用机制按研究主题和领域对卫生研究资金进行监测和跟踪。