Abstract
BackgroundThe importance of a health research system (HRS), namely an instrument for developing and enabling health systems, is increasing, particularly in developing countries. Assessing the perceptions of system performers is a necessary part of system analysis, which seeks to recognize a system’s strengths and limitations aiming towards improvement. This study assesses the perceptions of policy-makers, academicians and experts regarding the HRS concept and its importance to generate insights for system strengthening. In Palestine, HRS is just emerging, helping to address the many public health-related challenges faced by the country.MethodsThe study was implemented from January until July 2016, targeting three sectors, namely relevant government institutions, schools of public health, and major local and international health agencies. Data was collected through 52 in-depth interviews and six focus group discussions (FGDs) with policy-makers, academics, directors and experts. Participants and institutions were selected based on stated criteria and peer review. Data were translated, transcribed, checked and then imported to a software program (MAXQDA 12) for thematic and content analysis.ResultsA total of 104 experts participated, wherein 52 were interviewed and 52 participated in the six FGDs. The HRS concept, as defined by WHO, was conceptualized differently among participants with unclear delineations between various components. Inconsistencies appeared when participants attempted to conceptualize HRS in broader contexts, though HRS goals and functions were sufficiently delineated. The majority of participants agreed that HRS correlates with notions of ‘improvement’ and recognized HRS ‘as a significant gain’. Neglect of HRS was perceived as a big loss.ConclusionsThe study revealed that the level of understanding of HRS among health experts in Palestine is inadequate and not sufficiently conceptualized for its application. Findings also underlined the need to establish a central governance coordination body that promotes HRS understanding, awareness and culture as an enabler for HRS strengthening.
Highlights
The importance of a health research system (HRS), namely an instrument for developing and enabling health systems, is increasing, in developing countries
As a logical first step, this study provides an overview of the perceptions of health policymakers, academics and experts involved in HRS with regards to their understanding of the HRS concept
The study contained two relevant sub-themes, namely (1) the overall understanding of the definition of HRS, where interviewees and focus group discussions (FGDs) participants were asked to delineate the concept and describe how they realised its goals and functions; and (2) the thoughts evoked by the mention of HRS, and the perceived gains and losses associated with its application or disuse
Summary
Design Descriptive situation analysis was developed based on data collected through qualitative methods, in-depth interviews (IDIs) and focus group discussions (FGDs) to inductively investigate the perceptions of HRS stakeholders in Palestine. For both IDIs and FGDs, open-ended questions were drawn up, assembled and adapted according to the principles laid out in the relevant literature [1, 3, 9, 14, 18, 27], and can be found in Additional file 1: Supplement 4 (4a for IDIs and 4b for FGDs) Both instruments focused on five themes, namely (1) HRS conceptualisation and its importance (the focus this study); (2) stakeholder satisfaction with HRS performance; (3) governance, policy and finance; (4) stakeholder analysis, HRS capacities and research priorities in Palestine; and (5) HRS challenges and insights for strengthening. Selected data were reviewed and discussed carefully with the team to identify patterns
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