Abstract
IntroductionPoor funding for Health Policy and Systems Research (HPSR) is a major constraint to the development, generation and uptake of HPSR evidence in Low and Middle-Income countries. The study assessed the status of HPSR domestic funding and advocacy strategies for improving HPSR funding in Nigeria. It equally explored the knowledge and perception of the domestic funding status of HPSR and the effect of capacity building on the knowledge of domestic funding for HPSR in Nigeria.MethodsThis was a sub-national study involving policymakers and researchers from Enugu and Ebonyi States in Southeast Nigeria who participated in the sub-national Health Systems Global convening for the African region. A before-after study design (workshop) was utilized. Data collection employed semi-structured questionnaires, group and panel discussions. The workshop facilitated knowledge of HPSR, funding processes, and advocacy strategies for increased domestic funding for HPSR. Pre and immediate post-workshop knowledge assessments were done. Data were analyzed using SPSS version 25 and thematic analysis.ResultsTwenty-six participants were involved in the study. Half were females (50.0%) and 46.2% were aged 35–44 years. Policymakers constituted 23.1% of the participants. Domestic funding for HPSR in Nigeria was adjudged to be grossly inadequate. Identified barriers to domestic funding of HPSR included bureaucratic bottlenecks, political and policy transitions, and corruption. Potential opportunities centered on existing policy documents and emerging private sector willingness to fund health research. Multi-stakeholder advocacy coalitions, continuous advocacy and researcher skill-building on advocacy with active private sector involvement were the strategies proffered by the participants. Pre-workshop, understanding of the meaning of HPSR had the highest mean ratings while knowledge of budgeting processes and use of legal action to enable opportunities for budget advocacy for HPSR funding had the lowest mean ratings. Following the capacity-building workshop, all knowledge and understanding parameters markedly improved (percentage increase of 12.5%–71.0%).ConclusionThis study found that there was paucity of domestic funding for HPSR in Nigeria alongside poor knowledge of budgeting and advocacy strategies among both policymakers and researchers. We recommend the deployment of these identified strategies and wider national and regional stakeholder engagement towards prioritizing and improving domestic funding for HPSR.
Highlights
Poor funding for Health Policy and Systems Research (HPSR) is a major constraint to the development, generation and uptake of HPSR evidence in Low and Middle-Income countries
This study found that there was paucity of domestic funding for HPSR in Nigeria alongside poor knowl‐ edge of budgeting and advocacy strategies among both policymakers and researchers
The purpose of this study was to assess the status of HPSR domestic funding and advocacy strategies for improving HPSR funding in Nigeria. It explored the knowledge and perception of HPSR domestic funding status and the effect of capacity building on the knowledge of domestic funding for HPSR in Nigeria
Summary
Poor funding for Health Policy and Systems Research (HPSR) is a major constraint to the development, generation and uptake of HPSR evidence in Low and Middle-Income countries. Failure to prioritize local research has resulted in a poor understanding of the determinants of poor health in Africa, and the unharnessed discovery of sound and contextualized interventions for addressing them These social determinants are at the root of ill-health, health inequalities, and inequities [2, 3]. Health systems including health research in sub-Saharan Africa have benefited massively from foreign aid [4,5,6] While this has resulted in the improved health status of the populace, it has been associated with increased dependence on external funding, pressure to meet the technical and administrative requirements of the funders, and most importantly the attendant focus on the priorities of funders rather than on national priorities. The absence of core funding for Health Policy and Systems Research (HPSR) has been recognized as a major constraint to the development of the field, generation, and uptake of evidence in Low and Middle-Income countries (LMICs) [7, 8]
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