The West African Health Organization’s experience in improving the health research environment in the ECOWAS region

Abstract

BackgroundThe West African Health Organization (WAHO) implemented a research development program in West Africa during 2009–2013 using the Knowledge for Better Health Research Capacity Development Framework, developed by Pang et al. (Bull World Health Organ 81(11):815–820, 2003), on strategies used to improve the research environment. The framework has the following components: stewardship, financing, sustainable resourcing and research utilization. This paper describes how WAHO implemented this research development program in the West African region to help improve the research environment and lessons learnt.MethodsThis is a retrospective review of the regional research development program using a triangulation of activity reports, an independent evaluation and the authors’ experiences with stakeholders. This program was designed to address gaps along the components of the framework and to improve partnership. The activities, results and challenges are summarised for each component of the framework. The independent evaluation was conducted using over 180 semi-structured interviews of key stakeholders in the West African region and activity reports. WAHO and major stakeholders validated these findings during a regional meeting.ResultsAll 15 ECOWAS countries benefited from this regional research development program. WAHO provided technical and financial support to eight countries to develop their policies, priorities and plans for research development to improve their research governance. WAHO, along with other technical and financial partners, organised many capacity-strengthening trainings in health systems research methodology, resource mobilization, ethical oversight and on HRWeb, a research information management platform. WAHO helped launch a regional network of health research institutions to improve collaboration between regional participating institutions. Further, WAHO developed strategic research partnerships and mobilised additional funding to support the program. The program supported 24 health research projects. High staff turnover, weak institutional capacities and ineffective collaboration were some of the challenges encountered during program activity implementation.ConclusionThe regional collaborative approach to health research development using this framework was effective given the challenges in the West African region. The achievements particularly with improved research partnerships and funding helped strengthen local health research environments. This highlights WAHO’s role and the common experiences in the West African region in improving health research.

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“…17 Health researchers in developing countries are poorly paid, 18 and young researchers are often demotivated by the lack of career opportunities. 19 Health worker migration contributes to the poor research output from developing countries and perpetuates the cycle of inequality in both health research and clinical medical care. 12,18,20 Unless the importance of research on the continent is emphasised and supported by governments and other funders, research capacity is unlikely to escalate.…”

“…22 However, essential research tools such as computers, printers, and notably internet access are not commonplace in many centres across the continent, with manual record keeping, poor archiving, and inaccessible data exacerbating research difficulties. 19,23 The average internet penetration in Africa is 28.3%, but is <10% in many countries. 10 In this environment any form of research, especially large-scale collaborative research such as ASOS, is exceptionally challenging.…”

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“…Since then, more attention has been paid to national health research systems (NHRS) in developing countries [2–18], and several initiatives to strengthen these systems have taken place in Africa [10, 13–15]. A national research system is an important element of a modern health system that defines the environment in which research is encouraged and carried out.…”

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“…Overall, the main strengths of member states and the region for that matter include: in country capacity to test; strong political support; the existence of incident management systems (IMS) and rapid response teams (RRTs) that are on alert for activation, the availability of three tiers of skilled eld epidemiology workforce, the availability of experienced public health practitioners able to adopt existing and new preparedness and response protocols to country-speci c contexts; and their readiness to collaborate on cross-border surveillance and response. These strengths represent modest gains in health system resilience of the ECOWAS region as envisaged by WAHO and development partners following some investments in region (16)(17)(18).…”