Objective: To identify key data sources of health information and describe their availability in countries of the World Health Organization (WHO) African Region. Methods: An analytical review on the availability and quality of health information data sources in countries; from experience, observations, literature and contributions from countries. Setting: Forty-six Member States of the WHO African Region. Participants: No participants. Main outcome measures: The state of data sources, including censuses, surveys, vital registration and health care facility-based sources. Results: In almost all countries of the Region, there is a heavy reliance on household surveys for most indicators, with more than 121 household surveys having been conducted in the Region since 2000. Few countries have civil registration systems that permit adequate and regular tracking of mortality and causes of death. Demographic surveillance sites function in several countries, but the data generated are not integrated into the national health information system because of concerns about representativeness. Health management information systems generate considerable data, but the information is rarely used because of concerns about bias, quality and timeliness. To date, 43 countries in the Region have initiated Integrated Disease Surveillance and Response. Conclusions: A multitude of data sources are used to track progress towards health-related goals in the Region, with heavy reliance on household surveys for most indicators. Countries need to develop comprehensive national plans for health information that address the full range of data needs and data sources and that include provision for building national capacities for data generation, analysis, dissemination and use.

Objective: To assess the state of national health research systems of countries in the World Health Organization (WHO) African Region. Design: A questionnaire-based survey Methods: Structured questionnaires were used to solicit health research systems' relevant information from key informants in each country. Setting: Forty-six Member States of the WHO African Region. Participants: Key informants from the ministry of health in each country, with the support of WHO Country Offices. Main outcome measures: Presence of national health research policy or strategy, priority setting and ethical review of research. Results: Of the 44 responding countries, 39 (89%) reportedly had an official national health policy and 37 (84%) had a strategic health plan. A total of 16 (36%) countries reportedly had a functional national health research governance mechanism, nine of which had clear terms of reference; nine (20%) countries had a functional national health research management forum. Functional ethical review committees were reported in 33 countries (75%). Conclusions: National health research systems were weak in the countries assessed. Significantly more resources should be allocated to strengthening these systems.

Objective: To describe the current status of institutional facilities and the supporting research infrastructure of surveyed health research institutions in Africa, including information on communication technologies and connectivity, library resources, and laboratory operations and resources. Design: A structured questionnaire was used to solicit information on institutional facilities at health research institutions. Setting: Health research institutions in 42 sub-Saharan African countries. Participants: Key informants from 847 health research institutions. Main outcome measures: The availability of laboratory, information and communication, and library facilities in health research institutions. Results: Less than half of the respondent health research institutions had computer laboratories (49%), network computers (50%) and information technology support (38%). More than two-thirds (67%) had a library. Electronic subscriptions to international journals were observed to be very low, with an average of three subscriptions per institution. Almost two-thirds of the surveyed institutions (69%) reported having laboratories, about half of which (55%) were accredited nationally. Linkages and research collaborations were generally weak, particularly those with other laboratories in the Region. Challenges included financial and human resource constraints and the inability to communicate effectively with partners. Conclusions: Health research institutions in the Region have insufficient access to essential facilities such as laboratories, libraries, computers and the Internet to generate, access and share information.

Objective: To describe in detail the methods followed in each of the qualitative and quantitative surveys of national health information, research and knowledge systems and research institutions. Design: Cross-sectional surveys. Setting: National health information and research systems, and 847 health research institutions in 42 countries in the World Health Organization (WHO) African Region. Participants: Key informants from health research institutions, ministries of health and statistical offices. Main outcome measures: Stewardship, financing, ethics, human and material resources and output of health information and research systems. Results: Key informants were used to collect data to assess national research systems in 44 countries in the Region. The same method was followed in assessing national information systems in 17 countries and knowledge systems for health in 44 countries. These assessments included a detailed review of the state of data sources in the Region and their effect on measuring progress on the healthrelated Millennium Development Goals. A concurrent survey employed a structured questionnaire (the WHO Health Research Systems Analysis Questionnaire) to assess the capacity of 847 health research institutions in 42 countries. Stewardship, financing, ethics, human and material resources and research output were assessed. Conclusions: The logistics and resources involved in surveying the knowledge landscape in the 42 countries were substantial. However, the investment was worthwhile as the results of the surveys can be used to inform policymaking and decision-making, as well as to establish a regional database of national health information, research and knowledge systems.Keywords health research systems, health research institutions, health knowledge management, health knowledge systems

Objective: To describe the state of research ethics policies and practices in health research institutions in sub-Saharan African countries. Design: A structured questionnaire was used to solicit information on research ethics from health research institutions. Setting: Forty-two sub-Saharan African countries. Participants: Key informants from the health research institutions. Main outcome measures: Existence of institutional ethics review policies and mechanisms. Results: About half (51%) of respondent institutions reported having policies on research ethics and 58% had written policies requiring that researchers obtain informed consent of research participants. About one-third of respondent institutions (34%) had established ethics review committees, 42% required that studies went through ethics review committees and 46% had linkages with national or regional ethics organisations. Regarding operating procedures for ethics review committees, 53% had adopted standard operating procedures. Less than one-quarter of respondent institutions reported having policies in place to monitor ongoing research. Of the institutions that monitored ongoing research, 34% did an annual ethical review and 74% required a periodic written report. Only 36% provided any type of ethics training for staff, including those conducting health research and those who were not members of the ethics review committee. Conclusions: There are substantial gaps in the capacity of health research institutions in the WHO African Region to undertake ethical review of studies before, during and after studies conducted. There is a need to strengthen such capacity in order to ensure the wellbeing of individuals enrolled in studies and that of communities that host these studies.