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Project Topic
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TWENDE, Swahili, ‘let us go’ is developing platiform to accelerate uptake of health research innovations into policy and practice in the East African Community (EAC). Learning from the implementation of molecular diagnostics of TB, TWENDE is investigating the barriers that hinder -, and identifying opportunities to streamline - translation of research innovations into policy and practice in Uganda, Kenya and Tanzania. We aim at generating a model that could be used to accelerate uptake of health research innovations into policy and practice in the EAC and the rest of sub-Saharan Africa. The model will be informed by views from the community (patients, carers, opinion leaders etc.), healthcare practioners, academic and no-academic researchers and policy makers. In the first 12 months of existence, TWENDE has made has made great progress toward meeting her goals. The project was officially launched July 1st 2016 in Arusha, Tanzania, the heart of the East African Community with a conference that attracted researchers, civil society groups and policy makers from across East Africa. Ethical approvals were obtained from partner sites except for one where national approval wasn’t yet go by end of 2016. We have sought to understand the state of diagnosis and treatment of TB in an online survey of district health officers (DHOs). Over 50% of the survey is complelete in Kenya and Tanzania preliminary results show that over 90% TB treatment is provided by government, the microscope is the main tool for TB diagnosis whilst Xpert MTB/RIF and clinical diagnosis both stand at 50% of diagnostic coverage. The main reason given for low coverage of molecular diagnostics, Xpert MTB/RIF and Line probe assay (LPA) was under financing of healthcare budgets followed by procurement difficulties and inadequate human resource. A significant number of DHOs said they are unaware of the LPA. Completion of the survey and detailed audit of the healthcare facilities will reveal whether these factors remain the leading barrier and others such as absence of utilities (electricity & water), stigma, inaccessibility etc. become significant. Bearing in mind that translating research into policy and practice is a continuous process that will go on long after the project has ended, TWENDE has established knowledge transfer/exchange centres at four partner research institutions, Kenya Medical Research Institute, Kilimanjaro Clinical Research Institute and Makerere University. Th KTCs were equipped with computers, printers and software. These centres will carry on the responsibility of making research evidence available to the wider public and policy makers by publishing it in accessible forums such as newspapers, local magazines, radios, TVs and in a non-expert language. We have endeavoured to disseminate our work widely through print and digital media, blogs and academic peer reviewed journals: 1. Most of the TWENDE news are captured on the link: website. and on the CPAR Uganda ltd (our social science partner) website: website. TWENDE award press release: website cited in the St. andrews’ Courier (article attached). Cross referenced for Ugandan audience: website,website 2. Secured the Commonwealth PhD scholarship to Mr. Bariki Mtafya of Mbeya Medical Research Institute to evaluate the implementability of Molecular bacterial load assay (MBLA) for monitoring tuberculosis treatment response in programmatic clinical setting. Developed by the University of St. Andrews, MBLA detects and quantifies the amount of tuberculosis bacteria in the patient’s sputum in a matter of 4 hours. With funding from EDCTP, the assay was evaluated in research settings in Malawi, Mozambique and Tanzania, an now TWENDE is moving it further by evaluating it’s implementability in routine clinical practice. 3. Networked widely including the securing of the scholarships for 4 members in the TWENDE network to participate in the Winter school on Antimicrobial resistance diagnostics at the University of Edinburgh, Scotland, UK, funded by the Biotechnological and Biological Sciences Research Council (BBSRC). We have been recognised by 1) invitation to contribute to the European joint antimicrobial resistance programme discussions and 2) Invitation to host the symposium on Antimicrobial agents usage, antimicrobial resistance and policy in East Africa during the 6th East African Scientific and Health Research conference in Bujumbura, Burundi 29th – 31st of March. The impact of TWENDE is reaching far and wide, going beyond the East African Community borders. Most importantly, the integration into the East African Health Research Commission’s policy framework means that TWENDE will remain a driving force for research and advocacy for effective implementation of health research innovations. Project Website: TWENDE website
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Project Results
(after finalisation)
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•Health service delivery: Survey for district/county health officers and audit of healthcare centers in Uganda, Kenya and Uganda to determine health systems, socioeconomic and cultural barriers to implementation of TB diagnostics
•Policy (national policymaking):
•Production of policy briefs based on research findings and engagement with policy makers (MOH, parliamentarians and development partners involved in the control of TB) in Uganda, Kenya and Tanzania
•Establishment of four transfer/exchange centers at Kenya medical research Institute, Kilimanjaro Clinical Research Institute (Tanzania), NIMR-Mbeya Medical Research Centre and Makerere University College of Health Sciences (Uganda) to promote translation of research into policy and practice facilitate communication between researchers and policy makers
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