I NDEPTH Network — leading research in Africa and Asia

There is no doubt that public health decision-making is critically dependent on the availability of sound data. One cannot but agree with the physicist Niels

Bohr when he stated in 1930 that "Nothing exists until it is measured".

It is indeed an undeniable fact that information is needed for effectively assessing the extent to which health services are meeting the needs and demands of individuals and communities.

Similarly health information is needed for strategic policy-making and resource allocation. Vital health information can only be obtained through adequate relevant data obtained from carrying out quality research.

Unfortunately research is not a priority for most developing countries as they hardly make any budgetary allocation for population and health research. It is not surprising that developing countries continue to be over-burdened

by diseases often preventable with proven and effective technologies.

One international NGO working hard to bring reliable health information to bear on policy and planning in resource-constrained countries is the INDEPTH Network.

Since 2000, INDEPTH Network, with a Secretariat based in Accra, has been

making systematic efforts to harness and make widely available data from various health and demographic surveillance systems (HDSS) sites to fill the existing void in vital health information needed for planning.

Demographic surveillance looks at risk and corresponding dynamics in rates of birth, deaths, and migration in a population over time. Surveillance systems are often set up around specific intervention studies and later converted into standing HDSS sites that can form a platform for further studies.

INDEPTH aims to develop into a network that builds key scientific blocks in poverty-related diseases such as malaria, HIV/AIDS and tuberculosis.

INDEPTH Network currently consists of 38 HDSS field sites in 19 countries that collectively monitor 2,200,000 people at a household-level. In Ghana the sites are located in Dodowa, Kintampo and Navrongo.

"Each site operates in geographically defined populations and conducts longitudinal, demographic monitoring, with timely production of data on all births, deaths, causes of death and migration" explained Dr Ayaga Bawah, the Senior Research Associate of

INDEPTH Network.

According to him the collection of data in a well-defined area is done on a continuous basis and this helps to provide timely information for planning and service provision to communities.

INDEPTH Network’s research work is well guided in the cost effective use of tools, interventions and systems to ensure and monitor progress towards national and international goals.

For instance, research generated from some of the INDEPTH sites in Ghana have resulted in the formulation of some national health policies. An example, Dr Bawah said is the Community-based Health and Planning Services (CHIPS), which is now the government's policy for delivering health services to the people of Ghana.

Dr Bawa h explained that the CHIPS approach had its origins from groundbreaking research carried out at the Navrongo Health Research Centre in northern Ghana.

Another example is the use of insecticide treated bed nets whose pioneering research was also done in Navrongo.

Again, the Dodowa district is being used to evaluate the National Health Insurance Scheme (NHIS).

Further more, among the scientific and policy findings that have been developed, tested and demonstrated by HDSS sites are the effectiveness of Insecticide Treated Nets (ITNs) in reducing the incidence of malaria mortality; the impact of expanding the health care workers on health outcomes in a community and the first real model life tables for sub-Saharan Africa, which had previously relied on estimates based on non-African populations.

One major boost of INDEPTH Network's projects of which Ghana is at the forefront is the establishment of the Malaria Clinical Trials Alliance (MCTA) in 2006 with a $17 million grant from the Bill and Melinda Gates Foundation to the INDEPTH Network. The main goal of MCTA is to facilitate site preparation for the effective conduct of clinical trials for life-saving malaria interventions such as

vaccines and drugs.

MCTA is also supporting sites to develop tools to assess the disease profiles of countries while encouraging the wise use of resources in resource-constrained countries in Africa.

Currently there are 16 trial sites in 10 African countries ( Burkina Faso, Gabon, Ghana, Kenya, Nigeria, Malawi, Mozambique, Senegal, Tanzania and The Gambia) on the

MCTA platform.

An international Management Board headed by former Prime Minister of Mozambique, Dr Pascaol Mocumbi was constituted.

Dr Osman Sankoh, the new Executive Director of INDEPTH Network says prevention and control of malaria are critical steps for reducing the burden of malaria, and is happy that Ghana is playing a leading role through the work of MCTA. The Kintampo site, for instance, is giving the country a lot of visibility.

Another issue of concern to Dr Sanko h is the effect of the rollout of antiretrovirals (ARTs) in Africa.

"ARTs are being rolled out in many countries, but we still do not have concrete evidence about the effects of this rollout on individuals, populations and the health systems", he noted. Dr Sankoh says that the INDEPTH Network intends to carry out a research to evaluate these effects.

Dr Sankoh who took over the position of executive director in October 2007, said his vision was to make INDEPTH Network the reference point for policy makers when looking for empirical evidence for policy planning.

Another area, Dr Sankoh is passionate about is for INDEPTH to be seen as an efficient and effective organisation that can be counted on as a credible partner that is based right here in Africa and headed by an African. He was optimistic that maintaining and establishing partnerships with funders and donors groups is essential to realising I NDEPTH 's vision and mission.

According to Dr Sankoh, scientists have a crucial role to play in the development of Africa and the rest of the developing world. It is for this reason that INDEPTH Network is supporting young scientists from Africa and Asia to undertake further training to help accelerate the development of our countries.

The INDEPTH Network boss thinks it is important for our governments to recognise and understand the role research centres such as Navrongo, Kintampo and Dodowa play in contributing to health policies through the generation of knowledge.

"Policies must be based on evidence and since research work provides evidence, it is important governments support it," he stressed.

Source: Research (feat)