Where there is no research
Bihar is the third largest and one of the most resource-constrained state in India. Very little is known about the overall health research output from Bihar and its changing trend over the times.
In a new paper titled “Where there is no research: a bibliometric analysis of health research output from the resource constrained State of Bihar in India”, the authors Vikash R Keshri of The George Institute, India and Nutan S Tigga of The Centre for Health Policy, Asian Development Research Institute, Patna have analysed and presented the health research output from Bihar by undertaking bibliometrics analysis of health research papers indexed in PubMed. The results show the limited health research output from Bihar. While the public health research output is higher than the clinical research in the State, the research output on non-communicable diseases, nutrition, gender, and injuries is particularly is scarce.
The findings also corroborate that medical institutions are the largest contributors to health research, especially for basic or clinical research. Public health research is produced mainly by non-medical institutions, independent public and private research institutes, and NGOs. It was found that majority of public health research papers are led by researchers based out of Bihar and less than half of these papers had a local co-author. The result points towards two important concerns: the poor capacity to conduct large population-based research,lack of funding and/or collaborative opportunities to carry out the population-based primary health research for the local researchers based in the state.
Bihar is undergoing an epidemiological transition. As per the India State-Level Disease Burden estimates, the top 15 causes of Disability Adjusted Life Years (DALYs) in Bihar changed significantly from 1990 to 2016, with non-communicable diseases and nutritional deficiency becoming more significant. However, there is a huge gap between the disease burden estimates and the focus of health research output. Such disparity was also observed in previous evidence on research output from India and globally.
The paper also found that the ten leading research organizations dominate the health research output on Bihar and most of these leading organizations are located outside the state. Another important finding was funding by international sources being more common than funding by national sources. Getting funds from international sources is a competitive process and often highly dependent on existing capacity and demonstrated research credentials. It can be interpreted that due to limited capacity, the local research institutions get a limited opportunity for such funding. The funding by the national source was mainly by the central government funding body, the Indian council of medical research, which was mostly restricted to its constituent institutions.
The above findings reiterate the potential limitations of institutions and infrastructure, availability of funding and collaborative opportunities, and capacity of researchers in the local health research system in Bihar. The overall findings also reflect low priority and the very limited stewardship for health research in the state.
To improve the dismal health research scenario in Bihar, the state should evolve a definite health research policy. One of the ideal ways to approach reform in health research systems is to adopt and implement five action points of the WHO strategy for health research; strengthening of research culture (organization), reinforcement of research on priority health needs (priorities), provision of support to strengthen health research system within the state (capacity), promoting good practice in research (standards), and strengthening the link between policy, practice and research (translation).
Read the full research paper here.