STRENGTHENING RESEARCH CAPACITY Research Capacity Strengthening among young

STRENGTHENING RESEARCH CAPACITY Research Capacity Strengthening among young African Scientists : from GMP to MCDC Dr. Evelyn Korkor Ansah (Ghana) w: www. mcdconsortium. org Supported by

Academic progression Fellow of the Ghana College of Physicians Qualified in Medicine in Ghana MPH Ph. D award GMP in 2002 Re-entry Grant GMP in 2006 Additional Funds from ACT Consortium Senior Fellowship Award - MCDC in 2010

Currently STRENGTHENING RESEARCH CAPACITY § Deputy Director, Research & Development Division of GHS since 2011 § Adjunct Lecturer in Epidemiology, MSc Clinical Trials Course at SPH, University of Ghana § Adjunct Lecturer at the Ghana Institute of Management and Public Administration § Member of Steering Committee, ACT Consortium, LSHTM § Chairperson of the Institutional Review Board (IRB) of the Dodowa Health Research Centre, Ghana § MCDC Investigator § Currently supervising two Ph. D and an MSc student, advisor to another Ph. D student

Role of GMP/MCDC in my progression • A twelve-year period of linkage with GMP/MCDC including: q. Capacity strengthening (Ph. D) q. Support for research q. Support for Personal Development Programme (PDP) q. Mentoring and q. Leadership Development Programme (LDP)

Passing on the legacy of RCS • Setting up a new department in the Research Division of GHS with a mandate that includes providing RCS for health staff at all levels • Developing a Handbook for Operational Research for use by Regional/District health teams in Ghana • Providing short courses on OR (Research Ethics, Data Management using EPI Data, Scientific Writing, Dissemination of research findings) – accepted for CPD of Doctors • Awarded WHO/TDR short term grant for RCS to train 5 teams • Adjunct lecturer in OR and Epidemiology in two Institutions

RCS among different categories of health teams

Research Work: A compendium of studies each filling an information niche (diagnostics) An individually randomized controlled trial of RDTs in two types of Health Facility settings in rural Ghana The impact of introducing m. RDTs for the management of fever in the private retail sector in Ghana: a cluster RCT PATIENT Clinician and patients percept- ions of the use of m. RDTs for diagnosis of malaria The cost-effectiveness of malaria diagnostics in public health facilities in rural Ghana

Impact of work on Local Policy • Member of the Task Team on Malaria Laboratory Policy • Contributed to the development of National Guidelines for Laboratory Diagnosis of Malaria • • Malaria Rapid Diagnostic Tests introduced into health facilities with great input from results of study

Current Research Question • Can we trust chemical sellers in drug retail shops to safely and effectively carry out rapid diagnostic testing for malaria prior to dispensing antimalarials in order to reduce the abuse and overuse of ACTs and subsequent development of resistance?

The Intervention q 2 trial arms • Intervention arm carried out a test using RDT prior to dispensing medication • The control arm dispensed medication to clients without testing as was standard practice • RDTs were provided by the study team on a monthly basis free of charge to chemical sellers and clients • Chemical sellers in the 2 trial arms received separate 3 -dy/4 dy training MCDC_ASTMH 2014

Preparatory Activities and formative research

Filming followed by community sensitization 13

Supporting logistics • Bin for disposal of sharps • Bin for disposal of other waste • Storage box for test items i. e gloves, test kits etc (adapted from the TACT study, Tanzania) • Posters on treatment schedule for first line ACTs for adults and children • Training certificate for display • Job Aids

Summary • RDTs to guide dispensing practice of chemical sellers has a significant impact on the dispensing of AMs and also ACTs in this setting • There was no change in prescribing ACTs to true malaria cases, but a significant reduction in AMs of all types and ACTs to non malaria cases observed • A more rapid change in behavior observed among shopkeepers than that found when RDTs were first introduced to health staff in the same setting • No safety concerns were identified as a result of introducing RDTs • RDTs were acceptable to both clients and chemical sellers • A number of operational issues need to be considered

In conclusion • My training has maximized my potential as a scientist and enabled me to contribute both locally and internationally to capacity building of other scientists and evidence-based decision making for health

Acknowledgements • Prof. Brian Greenwood who believed that building capacity in young African scientists will yield great dividends • Prof. Chris Whitty, my Ph. D Supervisor and mentor • Director and Secretariat, Gates Malaria Partnership, LSHTM • Director and Secretariat, Malaria Capacity Development Consortium, LSHTM • Director and Secretariat, ACT Consortium, LSHTM • My very supportive husband children • Co-Investigators and colleagues

Thanks for listening