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

Abstract

Background: Regional cooperation on health in Africa is not new. The institutional landscape of regional cooperation for health and health research, however, has seen important changes. Recent health emergencies have focussed regional bodies’ attention on supporting aspects of national health preparedness and response. The state of national health research systems is a key element of capacity to plan and respond to health needs – raising questions about the roles African regional bodies can or should play in strengthening health research systems. Methods: We mapped regional organisations involved in health research across Africa and conducted 18 interviews with informants from 15 regional organisations. We investigated the roles, challenges, and opportunities of these bodies in strengthening health research. We deductively coded interview data using themes from established pillars of health research systems – governance, creating resources, research production and use, and financing. We analysed organisations’ relevant activities in these areas, how they do this work, and where they perceive impact. Results: Regional organisations with technical foci on health or higher education (versus economic or political remits) were involved in all four areas. Most organisations reported activities in governance and research use. Involvement in governance centred mainly around agenda-setting and policy harmonisation. For organisations involved in creating resources, activities focused on strengthening human resources, but few reported developing research institutions, networks, or infrastructure. Organisations reported more involvement in disseminating than producing research. Generally, few have directly contributed to financing health research. They report gaps in research coordination, infrastructure, and advocacy at regional level. Finally, we found regional bodies’ mandates, authority, and collaborations influence their activities in supporting national health research systems. Conclusion: Continued strengthening of health research on the African continent requires strategic thinking about the roles, comparative advantages, and capability of regional organisations to facilitate capacity and growth of health research systems.

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

“…International organisations, like the WHO Regional Office for Africa (WHO AFRO), have well-documented involvement and influence on African health research agendas and capacity as evidenced by the ongoing studies by WHO AFRO using data from the African Barometer collected from health research focal points in country [32] or similar studies with the WHO Regional Office for the Eastern Mediterranean (WHO EMRO) [54,55]. Our qualitative research with informants in regional organisations confirms and elaborates on the important roles played by these two WHO regional offices [45]. However, we excluded United Nations specialised technical agencies to highlight African-initiated and owned regional institutions.…”

“…Health, science, and higher-education decision-makers in government shared that they saw opportunities for using regional organisations to include health sciences research as a domain of cooperation (where there were not already dedicated regional bodies for this such as in Western and Eastern Africa) [24]. In a more recent qualitative study, we found that regional organisations in Africa are more involved in governance and research use and dissemination, than financing or infrastructure development-with capacity strengthening activities more focused on individual human resources than institutions [45]. Some regional organisations have policies specific to health research, such as the African Union Development Agency's Health Research and Innovation Strategy for Africa (2018-2030) [46] and the WHO's Regional Office for Africa Research for Health Strategy for the African Region (2016-2025) [47].…”

“…Also, due to our focus on an African state-centric regional cooperation, relationships and collaborations with donors and external partners are not included. While this may be seen as a limitation to the analysis given the well-documented contributions of international collaborations and investment to support research capacity strengthening, the purpose of this SNA to centre state actors in collaboration builds on our findings related to the coordination and advocacy gaps identified by regional organisations for their roles in strengthening health research systems [45]. The scope of this SNA provides a picture of opportunities for inter-state regional cooperation on HSciR development using existing regional cooperation structures and not an analysis of all networks operating in the research capacity strengthening space in Africa.…”

“…Some regional organisations have policies specific to health research, such as the African Union Development Agency's Health Research and Innovation Strategy for Africa (2018-2030) [46] and the WHO's Regional Office for Africa Research for Health Strategy for the African Region (2016-2025) [47]. The mandates of regional organisations influence their involvement however, and many informants identified gaps in regional organisations' involvement in coordination, infrastructure, and advocacy for strengthening health research systems [45]. Health research regionalism could foster interdependence to harness knowledge and capacity in member states, and coordinate resources, information, and materials to benefit national health research systems more equitably.…”

“…Acknowledging this history of regional bodies on the African continent and their health programmes and policies [2,3,[48][49][50], with emerging knowledge about their roles in health research [5,39,45], there is still much unknown about the constellation of actors in regionalism for health sciences research (HSciR). Therefore, this study aims to map the state-based regional organisations in Africa involved in HSciR, characterise the network of actors, and test the hypothesis of whether regional network strength correlates with national health research indicators.…”