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Indian Journal of Community Medicine

Vol. 32, No. 4 (2007-10 - 2007-12)

Editorial

Editorial

ISSN No. 0970-0218

Strengthening Research in Community Medicine The potential for public health research in India is enormous due to its large disease burden. However, public health research output from the country has been inadequate. In a recent study of publications covered by PUBMED, 4896 papers with an India Affiliated first author were analysed. Only 216 (4.4%) papers were from the public health domain and only 148 of these were original research articles.1 Other reports have also highlighted the need for more public health research both in India as well as in other developing countries.2-4

Low research output in public health has a direct bearing on the health status of the population. With inadequate research on various aspects of public health problems, the true nature of the problems and ways and means to address them will continue to remain in the realm of speculation.2,3 Consequently, it would be difficult to expect any significant improvements in the health status of the population. Some practical ways of strengthening research in medical colleges/ institutes needs to be carefully planned, where it is still in infancy. “Public health rests on the moral assumption that response to the perceived needs of others is a worthy action, deserving commitment of resources and effort”.5 Research is not worth doing if it does not contribute, directly or indirectly to health of common person. Moreover, all research must be targeted to the common good and should not only be done purely from an academic perspective.

Public health research should involve medical students. There have been some serious efforts at stimulating a research interest among medical students in a number of medical colleges recently. Problem Solving for Better Health (PSBH), which is a worldwide organisation, spearheaded in India by Health Action by People6 has successfully collaborated with medical colleges in achieving this goal. PSBH works on the principle that questions arising out of interest or concern about a public health problem in the immediate surroundings could be converted into a good research question, which in turn could be developed into a research proposal forming the basis of a meaningful project. The satisfaction of having completed a research project and seeing it in print is enough motivation for a young student researcher to want to repeat the feat.

Postgraduate students of Community Medicine across the country, who are regularly engaged in field based academic activities, are constantly in touch with current and pressing health issues. This exposure invariably generates potential research projects. A keen interest in the happenings around them coupled with the burning desire to learn can stimulate the call to action. Postgraduate students can also be given responsibility to guide short-term research projects undertaken by the interns when they are posted to the department. These studies when conducted under the watchful eye of the faculty can bring forth some interesting and pertinent projects.7 This can also render valuable practical experience to postgraduates in designing, implementing, analysing, and writing up research projects. More over, this experience for postgraduates, can go a long way in preparing a quality thesis by the end of their course.

Qualitative research, which is a force by itself and holds its head high in international public health literature, is a field which has not yet received much attention. This research area needs to be further explored by researchers in Community Medicine. Training for the same needs to be included in relevant curricula. The concept of mixed methodology in public health research studies is fast gaining acceptance as it is necessary to get a holistic view of health problems.8

Community Medicine as a speciality has not yet gained desired popularity among medical students because the immense hidden potential that it has for research, service, and training has not been fully harnessed. Inviting clinicians from other specialties to participate in the community-based service delivery requires making it attractive to them by creating collaborative research opportunities. The effort however is worth it, because it significantly improves not only the quality of services but betters research opportunity9 and builds capacity and expertise of the postgraduates and the faculty. Substantial outcomes are almost always achieved when interdependence forms the basis of the collaboration.10

Not infrequently, postgraduate students do propose to carry out innovative research projects in relatively new areas for their theses. If their departments or institutions, lack the necessary expertise to guide and support such students, then they must be allowed to seek help from outside the department/institution. The concerned student must be helped to locate the resources from the literature or from the experts or key scientists working in the area of his/her research interest. Once these persons are identified, the student should be encouraged to contact them, and if possible a short term placement may be arranged so that direct learning from them is possible. This is a worthwhile exercise not merely because it helps to improve the quality of research but it also builds capacity of the department in newer areas.

The Indian Association of Preventive and Social Medicine (IAPSM) will do well, after consultations with the concerned government agencies, to publish the priority areas for research. In addition, IAPSM could increase competitive scholarships for young scientists pursuing research in these priority areas. Developing research societies in medical colleges which provide small research grants to researchers on a competitive basis will also help encourage students and faculty to take up research projects. A prize can be instituted for the best thesis every year. Applications for the prize can be restricted to only published work to reduce the number of entries making evaluation easier and ensuring that only quality articles enter the competition. This will provide an impetus to publish research. If the project was worth doing, it is well worth publishing. Generally, research not done well will not get published. The competition could follow a multi stage process, and can be coordinated under the auspices of the IAPSM. There are not many motivators like competition.

Departments of Community Medicine may not always have the luxury of a competent statistician4 and loads of data can go unpublished for want of reasonable statistical expertise. Statistical literature in standard textbooks of community medicine is more useful to answer questions in examinations rather than to explain practical methods of handling raw data for the purpose of analysis. The Indian Journal of Community Medicine can consider publishing a series on developing research proposals, analysis of both qualitative and quantitative data, and writing manuscripts for publication. High impact general medical journals like the BMJ have made attempts at publishing similar series to nurture and further an interest in research among its readers.11-13

In conclusion, if every postgraduate resident student in Community medicine, with support from their faculty were to earnestly take up the responsibility of contributing to the betterment of the health of the Indian people not only through service and training but also through high quality research, then it will only be a matter of time before results begin to show.

Acknowledgement

The author acknowledges with gratitude the contribution of his teachers at the department of Community Health at St. John’s Medical College, Bangalore. Most of the content of this article has been influenced by experiences gained while working there.

References

  1. Dandona L, Sivan YS, Jyothi MN, Udaya Bhaskar VS, Dandona R. The lack of public health research output from India. BMC Public Health 2004;4:55. [Cited on 2007 Aug 25]. Available from: http://www.biomedcentral.com/1471-2458/4/55
  2. Dandona L. Conceptualizing health policy. Natl Med J India 2002;15:226-31.
  3. Dandona L. Academic medicine: time for reinvention: Public health sciences need strengthening in developing countries. BMJ 2004;328:47.
  4. Saldana R, D’Souza C, Hyder AA, Chowdhury AM. Importance of health research in South Asia. BMJ 2004;328:826-30.
  5. Hann RA. Anthropology in public health. Oxford University Press: New York; 1999.
  6. Health Action by People, [Internet]. Thiruvananthapuram, India; 2002 [cited on 2007 Oct 10]. Available from: http://www.hapindia.org/?q=node/3.
  7. Padmashree S, Anton N. Isaacs. Expectations of primary care patients in rural Karnataka. Pak J Med Sci 2007;23:534-7. Available from: http://www.pjms.com.pk/issues/julsep07/pdf/patients_care.pdf.
  8. Mishra TN. Interdisciplinary Collaboration in Epidemiological Research The way forward for public Health in the Next Millennium. Indian J Community Med 2004;29:77-9.
  9. Isaacs AN, Neerakkal I, Srinivasan K, Jayaram G. Initiating a Community Mental Health Programme in Rural Karnataka. Indian J Community Med 2006;31:86-7.
  10. Covey SR. Seven habits of highly effective people. Simon and Schuster: New York; 1989.
  11. Pope C, Mays N. Qualitative Research: Reaching the parts other methods cannot reach: An introduction to qualitative methods in health and health services research. BMJ 1995;311:42-5.
  12. Pope C, Mays N. Qualitative research: Observational methods in health care settings. BMJ 1995;311:182-4.
  13. Britten N. Qualitative research: Qualitative interviews in medical research. BMJ 1995;311:251-3.

Anton N Isaacs
Monash University, Department of Rural and Indigenous Health, PO Box 973, Moe Victoria 3825, Australia.
E-mail: antonisaacs(at)yahoo.co.in
Received: 04.09.2007
Accecpted: 07.11.2007

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