Governance of health research in four eastern and southern African countries

Joelle Sobngwi-Tambekou,Tiny Masupe,Clare Wenham,Justin Parkhurst,Namuunda Mtombo,Rhona Mijumbi-Deve,Godfrey Biemba,Pamela A Juma,Catherine M Jones

doi:10.1186/s12961-021-00781-3

Abstract

BackgroundHealth 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.MethodsWe 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.ResultsAll 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.ConclusionBuilding 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.

Highlights

Health research governance is an essential function of national health research systems
We coded the data structurally to categorize the interview content wherein informants discussed these concepts [31]. To comparatively analyse this data, we looked for what researchers, funders and decision-makers in the four countries saw as key elements of health research governance at the national level according to their perspectives, and we questioned why and how these were seen to be important as governance functions to strengthen the national health research system (NHRS)
We first present a mapping of key policies and institutions for health research governance identified in our case study countries—from documents reviewed and including when these were identified by key informants

Summary

Introduction

Health research governance is an essential function of national health research systems. Past initiatives to improve NHRS in African countries have generally focused on strengthening governance mechanisms, capacity-building and funding [5,6,7,8] These are frequently short-term initiatives, lacking sustained engagement and support. Robust and high-performing NHRS have typically integrated governance elements such as national research policies and regulations, institutional structures and systems to guide and support researchers, and funding mechanisms [11]. Many low- and middle-income countries have historically faced challenges in the development of research governance and management of these elements [9] This has been attributed to several factors, such as models of research capacity-building that focus primarily on developing individual skills without the necessary national and institutional structures and systems to support the trained individuals, or inadequate funding for research systems strengthening [12, 13]

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