Table 3 Qualitative responses from mid-level managers regarding research priorities in Peru

"We need to convince high level authorities about the need to do research, good practical research to improve our services."

"We have to be trained to be able to talk to and convince our authorities [to undertake research], or we have to train our authorities to change."

"We need to do more evidenced-based public health activities. Research can provide us this evidence."

On the need for operations research

"I think that at this point what our country needs is - rather than general research or clinical research on individuals - research on how our health system works; that is, how it operates... operations research and how to help improve it..."

"We need more operations research, something that has been done by NGOs and international donor agencies, but it has been restricted to a few people who know how to do it and they don't even share the results. All health workers should know how to do it and should use operations research as a tool to improve their services."

"We have to learn how to develop research in teams, as part of our day-to-day work. This could become a permanent system to improve."

"I think that a priority is to learn basic epidemiology, but a much higher priority is to learn economics - cost effectiveness it is called, right? And how health systems work and can be improved."

"We should start teaching people about research methods and operations research, health services research, something that will be practical and useful."