Abstract

BackgroundPriority setting in health research is an emerging field. In Zambia, like many other African countries, various priority setting activities have been undertaken with a view to identify research activities to which the available resources can be targeted while at the same time maximising the health impact for resource allocation to support evidence-based decision-making. The aim of this paper is to document the key elements of the various priority setting activities that have been conducted since 1998, identifying the key lessons and providing recommendations to improve the process.MethodsA comprehensive review of the previous priority setting activities and processes in Zambia was conducted. Both published and unpublished reports were reviewed in order to identify any research priority setting processes that have been undertaken in Zambia. We developed a framework, based on the priority setting literature, to guide our abstraction and synthesis of the literature.ResultThe earliest record of priority setting was conducted in 1998. Various priority setting approaches have been implemented in Zambia; ranging from externally driven, once-off activities to locally (in country) initiated comprehensive processes. However, there has been no systematic national process for priority setting. These priority setting processes in Zambia were characterised by limited stakeholder buy-in of the resulting national research or programmatic research agenda. Most striking was the lack of linkages between the different initiatives. There seems to have been no conscious recognition and building on previous priority-setting experiences of previous initiatives.ConclusionThere were gaps in the priority setting processes, stakeholder engagement and application of a defined criterion. There is a need for a priority setting framework coupled with local capacity developed across a range of stakeholders.

Highlights

  • Priority setting in health research is an emerging field

  • There is a need for a priority setting framework coupled with local capacity developed across a range of stakeholders

  • Our review revealed that, to date, five health research priority setting initiatives have been undertaken in Zambia, namely (1) the National Health Research Advisory Committee (NHRAC) of the Ministry of Health (MoH) initiative; (2) priority setting for health research as part of the general priority setting for health driven by the National Health Strategic Plan 2006–2011; (3) priority setting by the National Science and Technology Council (NSTC); (4) priority setting by The Zambia Forum for Health Research (ZAMFOHR), a comprehensive priority setting process for MoH programs; and (5) priority setting by the MoH in partnership with the World Health Organization Implementation Research Leverage Fund (WHO-IRLF) on Maternal, Neonatal and Child Health (MNCH); we discuss each in detail (Table 1)

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Summary

Introduction

In Zambia, like many other African countries, various priority setting activities have been undertaken with a view to identify research activities to which the available resources can be targeted while at the same time maximising the health impact for resource allocation to support evidence-based decision-making. Priority setting is important because it guides investments in healthcare, health research and respects resource constraints [3]. A 1990 report by the Commission on Health Research for Development created momentum for researchers and policymakers to become interested in priority setting both at country and international levels [6]. A number of low- and middle-income countries, such as Zambia, began to experiment with setting priorities for health research to guide various stakeholders from the health and non-health sectors [7]

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