Gaps between research and public health priorities in low income countries: evidence from a systematic literature review focused on Cambodia

Abstract

BackgroundEvidence-based public health requires that research provides policymakers with reliable and accessible information reflecting the disease threats. We described the scientific production of research in Cambodia and assessed to what extent it provides appropriate insights and implications for practice to guide health policymakers and managers and knowledge relevant for translation.MethodsWe conducted a systematic review of scientific articles published on biomedical research in Cambodia. Regression analysis assessed the trends over time and factors associated with actionable messages in the articles’ abstracts.ResultsFrom 2000 to 2012, 628 articles were published in 237 journals with a significant increase over time (from 0.6/million population to 5.9/million population, slope coefficient 7.6, 95% CI 6.5–8.7, p < 0.001). Most publications on diseases addressed communicable diseases (n = 410, 65.3%). Non-communicable diseases (NCD) were under-addressed (7.7% of all publications) considering their burden (34.5% of the disease burden). Of all articles, 67.8% reported descriptive studies and 4.3% reported studies with a high level of evidence; 27.4% of studies were led by an institution based in Cambodia. Factors associated with an actionable message (n = 73, 26.6%) were maternal health (OR 3.08, 95% CI 1.55–6.13, p = 0.001), the first author’s institution being Cambodian (OR 1.78, 95% CI 1.06–2.98, p = 0.02) and a free access to full article (OR 3.07, 95% CI 1.08–8.70, p = 0.03). Of all articles, 87% (n = 546) were accessible in full text from Cambodia.ConclusionsScientific publications do not fully match with health priorities. Gaps remain regarding NCD, implementation studies, and health system research. A health research agenda would help align research with health priorities. We recommend 1) that the health authorities create an online repository of research findings with abstracts in the local language; 2) that academics emphasize the importance of research in their university teaching; and 3) that the researcher teams involve local researchers and that they systematically provide a translation of their abstracts upon submission to a journal. We conclude that building the bridge between research and public health requires a willful, comprehensive strategy rather than relying solely only publications.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0217-1) contains supplementary material, which is available to authorized users.

Evidence and Policy in Aid-Dependent Settings

“…One interviewee further explained that mental health was another key priority in Cambodia, given the historical legacy of the genocide perpetuated in the 1970s; yet research and policy attention to mental health were said to be lacking due to dependence on donor agendas (see (Khan et al 2018) for more details). Similarly, a recent literature review found that few research reports on non-communicable diseases in Cambodia have been published, despite these accounting for the highest morbidity and mortality rates in the country (Goyet et al 2015).…”

Less research on tuberculosis than HIV and malaria when research agendas are poorly coordinated: a systematic review of research outputs from Cambodia

“…An analysis of the impact of the published research on evidence-based policy-making would also provide important insights, especially as a previous review has reported a relatively low level of actionable recommendations being made in the Cambodia health research literature. 12 In conclusion, it is well documented that the coordination and strategic planning of health sector rehabilitation and public health research is weak during periods of political transition and unprecedented aid inflow. 2 This analysis of HIV, TB, and malaria research activities during the past 15 years in Cambodia revealed that several important research areas may have been neglected; studies on TB and studies involving economic, qualitative, interventional, and genomics methods are underrepresented.…”

“…10 The distribution of donor aid to Cambodia may be influencing research conducted on TB, HIV, and malaria, as found elsewhere; 11 indeed evidence from the only systematic review to be conducted on health research in Cambodia -covering a number of conditions -indicates that there may be unequal representation of disease areas in terms of research publications. 12 The aims of this study were to compare TB research output with those for malaria and HIV and to analyse differences in research methods applied, in order to identify evidence gaps and future research needs.…”

How diverse is your reading list? Exploring issues of representation and decolonisation in the UK

“…The geographical affiliation of the author is seen to determine the nature and relevance of research, presenting 'local knowledge' tied to the communities and their needs (Connell 2018). Such knowledge is useful for generating 'actionable' inferences whether in health research (Goyet et al 2015) or climate science (Borland et al 2018). Framed in these arguments, there is some evidence to support a descriptively representative reading list, locally, on the basis of claims for substantive representation.…”