Operational research (OR) in public health investigates strategies, interventions, tools and knowledge that can enhance the quality, coverage, effectiveness or performance of health systems and programmes.1 It encompasses a range of applied research activities, including historical reviews of programmatic data and prospective studies of interventions.
Since 2009, the Structured Operational Research and Training Initiative (SORT IT) has been running courses to improve the capacity of health care workers in low- and middle-income countries to design, conduct and apply the findings of OR. SORT IT is a global partnership led by the Special Programme for Research and Training in Tropical Diseases, in collaboration with the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF).2 These courses comprise three to four 1-week modules of classroom-based work to develop a research protocol and ethics application, undertake training in data management and analysis, design a data analysis plan, write a paper for the peer-reviewed scientific literature and, in some cases, write a policy brief or a presentation for stakeholders.2 Over the course of 1 year, OR course participants carry out a research project, using national data. This edition of Public Health Action showcases the results of the Papua New Guinea (PNG) OR course, highlighting important operational challenges and successes in the prevention and control of tuberculosis (TB), in a setting where TB (and its drug-resistant forms) is highly prevalent.3
The PNG OR course is the seventh course to be run in the Pacific region. In 2011, the Union/MSF OR course was introduced into the Pacific region, with some context-specific adaptations.4 A total of 102 participants from 14 of the 22 countries and territories in the Pacific region have been trained in OR methods since 2011, with the majority completing the course and publishing their work. The PNG OR course focused on the national public health emergency of drug-resistant TB. It is featured here as it was a standalone course and not part of previous OR courses in the Pacific region, partly due to the fact that PNG has a relatively large population compared to other Pacific Islands (and could therefore sustain a national OR course) and due to unique challenges related to communication, transport, geography and a decentralised health care system, as well as drug-resistant TB hot spots, when compared to smaller countries in the region.
The critical mass of OR-trained health care workers is now primed to improve health care service provision and patient outcomes in the Pacific region, using local evidence to determine priority actions. It will be important to monitor how the Pacific OR projects impact policy and practice5 and how OR capacity is sustained and expanded. In addition, sustainability of the OR course itself is an issue for serious consideration among stakeholders. As Aia et al. describe in their paper in this issue of Public Health Action, ongoing initiatives are needed to sustain the considerable investments in OR and improve the health of populations in the Pacific region. Embedding research into the National TB Control Program and improving the capacity of the work-force to conduct OR through the local Field Epidemiology Training Program and other initiatives are ways in which sustainable research capacity can be addressed.
References
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