Background
Methods
NHRS conceptual framework
Governance of research for health (R4H)
Creating and sustaining resources
Production and utilization of health research for health
Financing for R4H
Data
Governance of research for health
Creating and retaining resources
Production and utilization of health research for health
Financing for health research for health
Ethical clearance
Results and discussion
Response rate
Governance of research for health
Policy and strategic plan
Legislation
Research coordination and ethical and scientific regulation mechanisms
Variable
|
Percentage of countries in the 2014 survey (n = 47)
a
| ||
---|---|---|---|
Governance of NHRS
| |||
Valid official national health policy | 96 % (45/47) | 90.7 % (39/43) | 70 % (7/10) |
Valid strategic health plan | 94 % (44/47) | 88.1 % (37/42) | 80 % (8/10) |
Official health research policy | 49 % (23/47) | 30.2 % (13/43) | 30 % (3/10) |
Law regulating R4H | 40 % (19/47) | 16 % (7/44) | 10 % (1/10) |
National strategic health research plan | 47 % (22/47) | 20.5 % (8/39) | 20 % (2/10) |
Functional national health research system | 51 % (24/47) | 40 % (16/40) | 30 % (3/10) |
National health research focal point | 83 % (39/47) | 76.2 % (32/42) | 80 % (8/10) |
National ethical review committee | 91 % (43/47) | 75 % (33/44) | 60 % (6/10) |
Creating and sustaining R4H resources
| |||
University/colleges of health sciences conducting research | 93 % (41/44) | 30 % (3/10) | |
National health research institute or council | 55 % (26/47) | 30 % (3/10) | |
Health research programme at MoH | 51 % (24/47) | 25 % (11/44) | 20 % (2/10) |
Average number of researchers in a R4H programme | 20.9 | 7.5 | |
Non-governmental organizations conducting R4H | 65 % (30/46) | 70 % (7/10) | |
Producing and utilizing R4H
| |||
R4H programme action plan | 67 % (16/24) | (8/11) | 20 % (2/10) |
Existence of a knowledge translation platform | 33 % (15/46) | 30 % (3/10) | |
Existence of a health research management forum | 51 % (24/47) | 24.3 % (9/37) | 20 % (2/10) |
Financing R4H
| |||
Existence of a budget line in the health budget for research for health | 47 % (22/47) | 41 % (18/44) | 40 % (4/10) |
Progress towards the target of allocating 2 % of national health budget to R4H | 17.6 % (3/17) | 4.5 % (2/44) | 0 % (0/10) |
Creating and sustaining resources
Producing and utilizing research
Dissemination mechanisms
|
Count
|
Precent
|
---|---|---|
Peer-reviewed publications in journals | 18 | 69.2 |
National health research forum and international conferences and seminars | 15 | 57.7 |
Published annual progress reports of the institutions and/or Ministry of Health report | 8 | 30.8 |
Feedback meeting with study subjects (community) and district health management teams | 1 | 3.8 |
Institutional newsletters/posters/brochures in official and local languages | 2 | 7.7 |
Exhibitions by the division of health research | 3 | 11.5 |
Website (including virtual health library) | 5 | 19.2 |
Print and electronic mass media | 5 | 19.2 |
Research open day | 3 | 11.5 |
Validation workshop and seminars | 2 | 7.7 |
In-house scientific committee of researchers at the home institute | 1 | 3.8 |
Financing of research for health
Source of funding
|
Number of countries
|
Percent
|
---|---|---|
International NGOs | 16 | 45.7 |
Multilateral and bilateral donor funding | 3 | 8.6 |
Government tax revenues | 6 | 17.1 |
Private sector companies | 2 | 5.7 |
Local NGOs | 4 | 11.4 |
Other | 4 | 11.4 |
Total | 35 | 100 |
The way forward through the respondents’ eyes
Governance of R4H
Interventions by African governments
|
Number of countries
|
---|---|
Establish NHRS structures and build institutional capacity to govern, coordinate and oversee health research, including for better management of human, material and financial resources | 30 |
Develop/launch a national policy on health research | 14 |
Ensure observance of ethics and good practices, including regulation of research through the national ethics review committee and institutional ethics review committees | 9 |
Establish a national health research forum or committee to support health research | 8 |
Develop specific national legislation for health research | 8 |
Promote multisectoral and multidisciplinary health research and promote community participation in health development research | 6 |
Build networks of researchers and research centres and strengthen partnerships between research institutes and universities with faculties of health sciences | 3 |
Define a national priority research agenda for the coming 3 years to ensure that research undertaken is harmonized and addresses tangible prioritized country needs and challenges | 3 |
Support the development of standard operating procedures and guidance reference documents | 2 |
Decentralize research for health activities to the counties, including hiring research focal persons at the decentralized or devolved levels | 1 |
Establish a system for monitoring and evaluating research | 1 |
International community interventions
|
Number of countries
|
Facilitate networking of institutions for health research (for example, for undertaking multi-country studies), international cooperation and partnership; advocate for formal partnerships between universities and research institutions | 12 |
Provide technical support for the development and implementation of national health research policy and strategic plan, and ensure externally driven research is aligned with national research priorities | 10 |
Provide technical support for the development of legislation on health research | 7 |
Support the development of the national health research agenda or priority list and their alignment, and cooperate with researchers and other partners to implement and evaluate them | 6 |
Support country and intercountry research collaboration and coordination | 4 |
Provide technical support for establishment of a national committee of ethics and training of its members | 2 |
Support capacity strengthening for laboratories for their accreditation through providing equipment, infrastructure and logistics support | 2 |
Develop internationally recognized regulatory standards, policies and guidelines and foster comparable research in health | 2 |
Support evaluation of research and development | 1 |
Creating and sustaining resources
Interventions by African governments
|
Number of countries
|
---|---|
Strengthen master’s and PhD level research human resource levels through retention and motivation approaches and enhancing competencies and other capacities. For example, provide bursaries especially at postgraduate level or for young researchers, draw up career development paths for research staff (including financial management) and give priority to researchers and research teachers | 34 |
Establish a national health research institute or council | 7 |
Build or strengthen research infrastructure, such as offices and laboratories, and provide equipment, reagents and programme vehicles | 6 |
Establish/activate a national health research programme, unit or department | 9 |
Ensure official confirmation of the national focal point for health research | 2 |
Actions at the international level
|
Number of countries
|
Support strengthening of human resources for health research capacity through training and retention initiatives such as exchange programmes and scholarships for postgraduate and specialized training | 18 |
Provide technical support for the establishment of the R4H programme | 2 |
Create international research observatories for the compilation and analysis of data at the international scale | 1 |
Provide technical support for the establishment of a national health research institute | 1 |
Producing and using research
Country actions
|
No. of countries
|
---|---|
Develop a research communication and translation platform (guidance notes) to facilitate the use of research findings for policy (decision making), practice and product development | 16 |
Establish a research database to serve as a platform for information sharing amongst all stakeholders to avoid duplication of research | 2 |
Involve policymakers, partners, the private sector and diaspora community in health research | 2 |
Create individual and institutional awards for research | 1 |
Develop tools for collecting data from programmes | 1 |
Establish a national health research management forum to facilitate dialogue on and discussion of research | 1 |
International community actions
|
Number of countries
|
Facilitate science publishing, communication and knowledge translation including sharing of best practices | 7 |
Invite health research staff to regional and international conferences | 6 |
Advocate with the Ministry of Health for the establishment of a national health research forum to facilitate sharing of research findings | 6 |
Support free access to health research journals through initiatives such as HINARI | 1 |
Support government and health research institutions to link research findings to industry | 1 |
Financing of R4H
Actions for countries/national governments
|
Number of countries
|
---|---|
Create a budget line/research fund or raise its level to at least 2% of the national Ministry of Health budget, and ensure actual disbursement of the funds | 27 |
Demonstrate more commitment to health research by implementing and/or advocating for implementation of the research agreements at the Mexico, Abuja, Accra and Bamako forums | 6 |
Actions for the international community
|
Number of countries
|
Provide financial support for strengthening national health research systems to raise the support level and to align the systems with the requirements of the Algiers Declaration, and create a fund for research | 23 |
Implement the recommendation of allocating 5% of development aid project funding to health research | 10 |
Support local NGOs conducting research | 1 |
Promote public-private partnerships to fund health research | 1 |
Limitations of the study
-
The national health research focal person in each country had the responsibility of completing the questionnaire, working in consultation with government and non-governmental institutions in the country relevant to the aspect of the questionnaire. We do not know how many people were interviewed in those institutions in the process of completing the questionnaire.
-
The questionnaire did not assess the numbers of articles published in each country. Questions on research productivity were not included because we were aware that a comprehensive bibliometric study had been funded by the WHO Regional Office for Africa [33].
-
The study did not assess the availability of inputs other than information, communication and technology research inputs such as laboratories and reagents or the adequacy of office buildings. It did not adopt a broad definition on the utilisation of research findings for biomedical research and development (product, research and process innovation), and therefore it did not make any enquiries on that.
-
We did not try to establish if the funding source had any impact on knowledge translation or capacity building. However, we know from the Jones et al. [36] scoping study of donor approaches to research capacity strengthening in Africa that “Overall our findings suggest that research capacity support [by donors] is focused largely on knowledge generation within universities and research networks, but with little attention to the design of questions that resonate with national policy and development agendas, nor with support for conducting and communicating policy research”.
-
This study did not gather information on the research priority setting approaches used by countries that reported having a national health research priority list. Rudan et al.’s [37] essay on evidence-based priority setting for healthcare and research presents the available tools for priority setting that could be used by policymakers in low-resource settings. In addition, they assessed the applicability and strengths of different tools in the context of maternal and child health in sub-Saharan Africa. Their essay notwithstanding, there will be a future need for a critical analysis of the priority setting approaches applied at least by the 57 % of countries that reported, herein, that they had a national health research priority agenda.