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      A need to accelerate health research productivity in an African University: the case of Makerere University College of Health Sciences

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          Abstract

          Background

          In the last decade, Makerere University College of Health Sciences (MakCHS) has taken strides in research and training to improve healthcare through collaborative training and research programs. However, there is limited data on the trends of MakCHS faculty contributions to research and on faculty growth to take leading roles in health research. This paper reviews MakCHS faculty research publications over 15.5 years and outlines possible strategies to enhance faculty research outputs.

          Methods

          We used a mixed methods approach. A systematic review of research publications by faculty at MakCHS (PubMed and Google Scholar from January 1, 2000, to June 30, 2015) to quantify the number of research articles, areas researched, authorship contribution by MakCHS faculty, source of funding, as well as affiliated local and international collaborations. Graphs were used to shown trends in publications and leadership of authorship by faculty. Annual individual faculty research productivity was presented as publication per capita. Qualitative data on high priority needs to improve research outputs was collected through focus group discussions (FGDs) with faculty members, and analysed manually into emerging themes.

          Results

          Of 298 faculty at MakCHS at 2015, 89 (30%) were female and 229 (77%) were junior and mid-level faculty (senior lecturer and below). The PubMed and Google Scholar searches yielded 6927 published articles, of which 3399 (49%) full-text articles were downloaded for analysis, 426/3825 (11%) available as titles/abstracts only, and 598/4423 (14%) were excluded. Only 614 articles were published in 2014, giving a publication per capita of 2.1 for any authorship, and 0.3 for first and last authorship positions. MakCHS faculty increasingly contributed as first, second, third, and last authors. Up to 57% of research was in infectious diseases, followed by non-communicable diseases (20%) and non-communicable maternal child health (11%). Priority needs to improve research outputs, as expressed by faculty, were (1) an institutionally led faculty career development program, (2) skills building in research methods and scientific writing, (3) protected time for research related activities, (4) opportunities for collaborative research, and (5) use of individual development plans.

          Conclusion

          Faculty research productivity was low and dominated by infectious diseases and non-communicable disease research. There is a need for structured institutional support to optimise faculty research outputs. Only with increased research productivity will MakCHS and other academic institutions be able to make a significant contribution in addressing national health challenges.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12961-017-0196-6) contains supplementary material, which is available to authorized users.

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          Most cited references25

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          The anatomy of medical research: US and international comparisons.

          Medical research is a prerequisite of clinical advances, while health service research supports improved delivery, access, and cost. Few previous analyses have compared the United States with other developed countries.
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            Hypertension awareness, treatment and control in Africa: a systematic review

            Background Inadequate diagnosis and suboptimal control of hypertension is a major driver of cardiovascular morbidity and mortality in Africa. Understanding the levels of awareness, treatment and control of hypertension and the associated factors has important implications for hypertension control efforts. Methods The PubMed database was searched for original articles related to awareness, treatment and control of hypertension in Africa published between 1993 and 2013. The key search terms were: Africa, awareness, treatment, control, and hypertension. Exploration of bibliographies cited in the identified articles was done to provide further studies. Full texts of the articles were obtained from various internet sources and individual authors. A data extraction sheet was used to collect this information. Results Thirty eight studies drawn from 23 African countries from all regions of the continent met the inclusion criteria. The levels of awareness, treatment and control varied widely from country to country. Rural populations had lower levels of awareness than urban areas. North African countries had the highest levels of treatment in the continent. There was generally poor control of hypertension across the region even among subjects that were aware of their status and those that were treated. On the whole, the women had a better control status than the men. Conclusion There are low levels of awareness and treatment of hypertension and even lower levels of control. Tailored research is required to uncover specific reasons behind these low levels of awareness and treatment, and especially control, in order to inform policy formulation for the improvement of outcomes of hypertensive patients in Africa.
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              The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain

              Background The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. Methods We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. Results More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64%) in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools. Conclusions Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
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                Author and article information

                Contributors
                +256772411273 , dnakanjako@gmail.com , dnakanjako@idi.co.ug
                akenadickens@yahoo.co.uk
                dankkaye@yahoo.com
                kabaleimc@gmail.com
                elialilia@yahoo.co.uk
                annettee.nakimuli@gmail.com
                akambugu@idi.co.ug
                hazel.mccullough@lshtm.ac.uk
                hmk@chs.mak.ac.ug
                mkamya@infocom.co.ug
                sewankam@infocom.co.ug
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                21 April 2017
                21 April 2017
                2017
                : 15
                : 33
                Affiliations
                [1 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Internal Medicine, , Makerere University College of Health Sciences, ; P.O. Box 7072, Kampala, Uganda
                [2 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Psychiatry, , Makerere University College of Health Sciences, ; Kampala, Uganda
                [3 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Obstetrics and Gynaecology, , Makerere University College of Health Sciences, ; Kampala, Uganda
                [4 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Department of Paediatrics, , Makerere University College of Health Sciences, ; Kampala, Uganda
                [5 ]ISNI 0000 0004 0620 0548, GRID grid.11194.3c, Infectious Diseases Institute, , Makerere University College of Health Sciences, ; Kampala, Uganda
                [6 ]ISNI 0000 0004 0425 469X, GRID grid.8991.9, , London School of Hygiene and Tropical Medicine, ; London, United Kingdom
                Author information
                http://orcid.org/0000-0002-0935-2112
                Article
                196
                10.1186/s12961-017-0196-6
                5399829
                28431554
                d0b5cada-628c-4f70-b1d5-19ce39f8496e
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 February 2017
                : 6 April 2017
                Funding
                Funded by: Malaria Capacity Development Consortium (MCDC)
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: 1D43TW010132-01
                Award ID: R25TW009343, subaward 7186SC
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                Health & Social care

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