Evaluating health research priority-setting in low-income countries: a case study of health research priority-setting in Zambia

Lydia Kapiriri,Pascalina Chanda-Kapata,Corinne Schuster-Wallace

doi:10.1186/s12961-018-0384-z

Lydia Kapiriri, Pascalina Chanda-Kapata + Show 1 more

Open Access

https://doi.org/10.1186/s12961-018-0384-z

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Abstract

Priority-setting (PS) for health research presents an opportunity for the relevant stakeholders to identify and create a list of priorities that reflects the country’s knowledge needs. Zambia has conducted several health research prioritisation exercises that have never been evaluated. Evaluation would facilitate gleaning of lessons of good practices that can be shared as well as the identification of areas of improvement. This paper describes and evaluates health research PS in Zambia from the perspectives of key stakeholders using an internationally validated evaluation framework.MethodsThis was a qualitative study based on 28 in-depth interviews with stakeholders who had participated in the PS exercises. An interview guide was employed. Data were analysed using NVIVO 10. Emerging themes were, in turn, compared to the framework parameters.ResultsRespondents reported that, while the Zambian political, economic, social and cultural context was conducive, there was a lack of co-ordination of funding sources, partners and research priorities. Although participatory, the process lacked community involvement, dissemination strategies and appeals mechanisms. Limited funding hampered implementation, monitoring and evaluation. Research was largely driven by the research funders.ConclusionsAlthough there is apparent commitment to health research in Zambia, health research PS is limited by lack of funding, and consistently used explicit and fair processes. The designated national research organisation and the availability of tools that have been validated and pilot tested within Zambia provide an opportunity for focused capacity strengthening for systematic prioritisation, monitoring and evaluation. The utility of the evaluation framework in Zambia could indicate potential usefulness in similar low-income countries.

Highlights

Several international organisations have responded to the call to bridge the existing inequities in health research funding whereby less than 10% of global funding for research is spent on diseases that afflict more than 90% of the world’s population by increasing their funding for global health research [1]
Conclusions: there is apparent commitment to health research in Zambia, health research PS is limited by lack of funding, and consistently used explicit and fair processes
The designated national research organisation and the availability of tools that have been validated and pilot tested within Zambia provide an opportunity for focused capacity strengthening for systematic prioritisation, monitoring and evaluation

Summary

Introduction

Several international organisations have responded to the call to bridge the existing inequities in health research funding whereby less than 10% of global funding for research is spent on diseases that afflict more than 90% of the world’s population (i.e. the 10/90 gap) by increasing their funding for global health research [1]. PS is the first, and often missing, step in connecting research with policy and practice needs, reducing research waste (by ensuring that the research that is conducted is well aligned with the policy and practice needs). There is an increasing body of literature on the tools that can be used to guide PS [3,4,5,6,7,8,9,10,11,12] Approaches such as the Child Health and Nutrition Research Initiative method, the James Lind Alliance method, the Combined Approach Matrix method and the Essential National Health Research method have been developed and used to guide health research prioritisation in different contexts [13]. The literature on studies evaluating PS processes in low- and middle-income countries is limited

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