Governance of health research in four eastern and southern African countries

Abstract

Background Health research governance is an essential function of national health research systems. Yet many African countries have not developed strong health research governance structures and processes. This paper presents a comparative analysis of national health research governance in Botswana, Kenya, Uganda and Zambia, where health sciences research production is well established relative to some others in the region and continues to grow. The paper aims to examine progress made and challenges faced in strengthening health research governance in these countries. Methods We collected data through document review and key informant interviews with a total of 80 participants including decision-makers, researchers and funders across stakeholder institutions in the four countries. Data on health research governance were thematically coded for policies, legislation, regulation and institutions and analysed comparatively across the four national health research systems. Results All countries were found to be moving from using a research governance framework set by national science, technology and innovation policies to one that is more anchored in health research structures and policies within the health sectors. Kenya and Zambia have adopted health research legislation and policies, while Botswana and Uganda are in the process of developing the same. National-level health research coordination and regulation is hampered by inadequate financial and human resource capacities, which present challenges for building strong health research governance institutions. Conclusion Building health research governance as a key pillar of national health research systems involves developing stronger governance institutions, strengthening health research legislation, increasing financing for governance processes and improving human resource capacity in health research governance and management.

The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives

“…18 Yet, developing statutory institutions for HSciR with regulatory and coordinating mandates (eg, national health research authorities) support an enabling environment, especially to integrate coordination between government authorities and research institutions. 18,45 Relatedly, while many national decision-makers and researchers see the development of a national health research law as the gold standard for formalising the national health research systems 45 , none of the regional organisations in our study reported working with countries to support the development of a legal framework for HSciR.…”

What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study

“…At the same time, leadership is also a matter of future human resources management from different aspects [ 25 , 42 – 44 ]. Establishing a focal point to institute the NHRS governance/management is recommended in dealing with such challenges [ 12 , 45 – 47 ] so that defining a comprehensive perspective and following strategic plans make sense and work [ 24 , 48 ].…”

“…Stewardship is an initial function of a health system that allows for meeting the objectives [ 8 ]. Stewardship and governance are used interchangeably in HRS frameworks as the primary function of an HRS with mostly the same sub-functions [ 9 – 11 ], as follows: (1) setting vision; (2) developing a national strategic health plan; (3) performance monitoring; (4) setting relations, partnerships, processes, regulations and rules; (5) intelligence generation; (6) ensuring accountability and (7) priority-setting [ 2 , 5 , 12 – 15 ].…”

Mapping regional cooperation of state actors for health research systems in Africa: A social network analysis

“…This is an important asset to national health research systems, as, theoretically, lessons learned in one locality could easily be shared throughout the network either in continental forums or in more specialised regional discussions. One key challenge to this is that regional organisations tend to be organised by policy sector [45], while health research systems are multi-sectoral [24,59,60]. This means that the health, science and innovation, and higher education sectors need to coordinate at the national level to incorporate such information coming through state representatives via respective ministries or departments to various regional organisations [24,33].…”