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Project Topic
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The recent unprecedented Ebola Virus Disease (EVD) outbreak in West Africa highlighted the fragility of the health system and its lack of capacity to respond rapidly to the crisis. Capacity to undertake research – from basic descriptive epidemiological studies to interventional trials of new medicinal products or diagnostic devices – is an integral component of a resilient and responsive health system. The King’s Sierra Leone Partnership (KSLP) is a long-term capacity building partnership formed in 2011 between King’s Heath Partners in London and key partner institutions in Sierra Leone. KSLP aims to help strengthen Sierra Leone’s health system by improving training, clinical services, policy and research. During the Ebola Virus Disease (EVD) outbreak, KSLP played a critical role in the response in Sierra Leone with the establishment and supervision of Holding Units, training of Health Care Workers and contributing in the Case Management pillar at the National Ebola Response Centre (NERC). As Sierra Leone moves in to the recovery phase, KSLP is helping support clinical research capacity development in Sierra Leone in collaboration with key partner institutions: • The College of Medicine & Allied Health Sciences (COMAHS) – the only medical and pharmacy school in Sierra Leone • Connaught Hospital – the main government tertiary referral hospital • 34 Military Hospital – the referral hospital for the military • The Ministry of Health & Sanitation (MOHS) – particularly the Sierra Leone Ethics & Scientific Review Committee, the Pharmacy Board of Sierra Leone and infectious disease focused technical working groups. ID-Clinical Capacity project has supported KSLP’s infectious disease research capacity development across three platforms: • Human resource development • Infrastructure development • Enabling environment Human Resources Undergraduates Final year student research project guidelines were developed to ensure faculty consensus and help students better understand expectations. A bank of taught and self-directed training research resources for teachers and students were developed for current and future cohorts. KSLP also assisted COMAHS faculty in developing the research methods block objectives and timetable in collaboration with other partners (CDC, Harvard) and delivered nine sessions during the research methods blocks over two academic years. In collaboration with the RECAP-SL EDCTP funded COMAHS project, KSLP supported extracurricular research training with the Sierra Leone Medical Students Association advocated for. Several students were also mentored through research projects, with a focus on data collection, analysis, interpretation and presentation of findings. Postgraduates Scoping meetings with clinicians at 34 Military and Connaught Hospital revealed that many junior clinicians were interested in research. Some had worked on research projects during the outbreak, but many of them felt that the focus had been on data collection and they were keen to develop their ability to conduct clinical research from concept to dissemination. An introductory research methods workshop was followed by small group seminars, Good Clinical Practice training and certification and a data analysis workshop. Individual clinicians at both sites also received one-to-one mentorship through infectious disease research projects identified by Connaught and 34 Military clinicians: one has been completed and accepted for publication, three further projects completed and manuscripts are being drafted and two further ongoing. Infrastructure Development KSLP supported Connaught Hospital to transition from the Holding Unit to an Infectious Diseases Unit, capable of isolating and treating patients with a diverse range of clinical syndromes. Admission criteria, protocols for patient and staff flow, diagnosis and treatment guidelines, standardised admission forms and structured clinical observations were developed and an electronic data capture system to facilitate patient management and clinical research were introduced. The medical records system in Connaught Hospital, previously entirely paper-based, was also developed with introduction of Unique ID codes for all patients and an electronic database that has subsequently been used to facilitate research and quality improvement projects in the hospital. Enabling Environment Clinicians and academics can more easily develop protocols if guidelines, and procedures are in place and the national research agenda is strengthened. KSLP has supported the development of guidelines and templates for clinical research and contributed to various MOHS infectious disease related technical working groups to integrate research priorities into strategic plans. In the sub-regional context, KSLP has also contributed to the development of the research agenda during the strategy session of the third West African Consortium Regional Conference. KSLP worked with the SLESRC and Pharmacy Board of Sierra Leone (the main regulatory authority) to develop a concept note for larger funding to support ethics and regulatory capacity development and will continue to seek opportunities to support the further development of policy, training, infrastructure and administration of these key agencies. For more information on King’s Sierra Leone Partnership and research capacity building, visit: website.
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Project Results
(after finalisation)
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•Capacity development (Human resources):
Provision of support to undergraduate medical students: Development of student research project guidelines, development of research methods teaching module, mentorship of several students on data collection, analysis, interpretation and presentation of findings.
Provision of support to postgraduate medical students: Delivery of research methods workshop as well as Good Clinical Practice and data analysis workshop.
•Capacity development (Systems and infrastructure): Support to Connaught Hospital in transition from the Holding Unit to an Infectious Diseases Unit: development of admission criteria, protocols for patient and staff flow, diagnosis and treatment guidelines, standardised admission forms, introduction of an electronic data capture system to facilitate patient management and clinical research.
•Policy (national policymaking): Input to Ministry of Health infectious disease-related technical working groups with a view to integrating research priorities into strategic plans. Input the development of the research agenda during the strategy session of the 3rd West African Consortium Regional Conference.
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