Minjung Cho
Netherlands
Assistant Professor
University of Leiden, Netherlands
2017
Social Scientist
B Pharm, RPh, MPH
Official Development Assistance(ODA) Project Manager - Public Health Specialist, Korea International Cooperation Agency, Tashkent, Uzbekistan
Temporary Consultant, The World Bank, Washington, DC.
Program Coordinator, MediPeace International NGO
Researcher- Health Insurance Provision Policy Department, Korea National Health Insurance Corporation, Seoul, Korea.
Assistant Manager- Pharmaceutical Pricing and Policy Department, Korea National Health Insurance Corporation, Seoul, Korea.
doctoral work
2017
Forthcoming
and Downloads
- Environmental and climate change
- Biodiversity
- Development Politics
- Politics & Democracy
- Uzbekistan
B Pharm, RPh, MPH
Public Health, Policy and Management, Pharmaceutical policy, International Health
Research and its governance in the health research system of Uzbekistan
At the country level, the Health Research System (HRS) is essential for producing and capturing health-related knowledge to improve the population’s health. Uzbekistan has been reforming its research system by developing new financing opportunities, promoting science and technology activities and initiating human capital training to ultimately improve competitiveness. While these reforms help to strengthen the Uzbekistan HRS, aligning this system’s efforts with the population’s health needs has remained a significant challenge. For example, despite the reforms from early 2000’s, Uzbekistan has been addressed as one of the countries with fewest publications of health research all over the world adjusting for population per capita (McKee et al. 2012). When it comes to understanding HRS, much of the studies focus on monitoring and evaluation approaches assessing on how much impact research capacity strengthening efforts have been made and its outputs such as the number of graduates or the number of research publications. There is a lack of analysis in understanding the research system governance in the framework of institutions and health system actors in a developing country context which affects knowledge production and research performance in the HRS.
The main objective of the thesis is therefore to investigate the current status of health research system and to understand the institutional dynamic of health research governance in Uzbekistan through historical institutionalism perspective. In order to answer this objective, this thesis takes Londono & Frenk's (1997) definition of ‘research governance’ as “the organized institutional social response to generate resources relating to knowledge production to deal with health conditions in health care systems and public health management”. Given this concept, research governance arises from various components such as health research driven by national and international demands and the numbers of institutions that produce health research. The main aspects of research governance examined were: (i) hierarchical centralized policy, formal and informal rules and practices, power relations, duplication of research efforts within health research system and (ii) influence of path dependencies on the development of a health research system that limit institutional change and subsequent performance. Path dependence in this context means persistent institutional forms and practices from the past influencing current activities and trajectories (Blanchet 2015; Schreyogg et al. 2011; Zukowski 2004).
The research used a mixed method case study design methodology guided by Yin (2011, 2013). The quantitative analysis included a bibliometric analysis examining research production and activities in the health sector of Uzbekistan from 1991-2015. The qualitative analysis employed the analytical narrative method to describe and analyze the actors, institutions, ideas and history behind the HRS in Uzbekistan. The preliminary results from both quantitative and qualitative analysis revealed that the gradual, albeit, slow progress in any institutional change in the health sector was due to path dependent traits dating back to more than 60 years of Soviet science management. Moreover, the organizational structure, funding mechanism, post graduate education, and research communication showed varying aspects of path dependencies. The study also finds that formal and informal institutions matter in the performance of a research system. These institutions have legacies, which facilitate or hinder change. Even though the funding scheme in science system has changed overall to innovative funding, much of its criteria and priorities need to be streamlined and improved to attract diversity in research endeavors. Basic incentive structures or forced regulatory reforms, which reinforce path-dependent behavior, often fail to create significant change in Uzbek health research performance and subsequently the systems that they are governed under. It is unlikely that the new research governance mechanism that has been instilled will in itself lead to changes in scientific relationships and practices in the presence of strong path dependencies. Further analysis reveals that causes of (under)performance in Uzbek health research system are complex and deeply rooted, reaching beyond the current circumstances and resources.
doctoral work
