Abstract
BackgroundThe need for locally-driven, locally-generated evidence to guide health policy and systems decision-making and implementation in West Africa remains urgent. Thus, health policy and systems research (HPSR) is a field with great potential for addressing many of the sub-region’s intransigent health challenges. This paper presents an analysis of trends and patterns of peer-reviewed HPSR publications across the Economic Community of West African States (ECOWAS), to help understand trends and patterns of HPSR publication and the degree of involvement of West African researchers in HPSR evidence generation in the sub-region. Our goal was to use the findings to inform the development of a sub-regional strategy to strengthen HPSR and its use to inform development and improvement of health outcomes.MethodsA scoping review was conducted over a 25-year period from January 1990 to September 2015. Literature searches were conducted in English and French using Google Scholar, PubMed Central and Cairn.info.ResultsA total of 258 articles were retrieved. Of these, 246 were statistically analysed, with 54% having West African lead authors. Two thirds of the papers originated from three out of the 15 countries of the ECOWAS, specifically Nigeria (28.86%), Burkina Faso (21.54%) and Ghana (17.07%). Most authors were based in academic institutions and participation of authors from ministries of health, hospitals and non-governmental organisations was limited. English was the predominant language for publication even for papers originating from Francophone West African countries. There has been a progressive increase in publications over the studied period.ConclusionDespite progressive improvements over time, West Africa remains a weak sub-region in terms of peer-reviewed HPSR publications. Within the overall weakness, there is country-to-country variation. The fact that only a handful of countries accounted for nearly 70% of the total volume of publications in West Africa attests to the great disparities in individual, institutional and contextual capacities for HPSR evidence generation. Bridging the gap between lead institutions (universities and research centres) and the practice community (ministries, hospitals, non-governmental organisations) is indispensable for ensuring the practical use of HPSR evidence. There remains a major need for investments in HPSR capacity building in West Africa.
Highlights
The need for locally-driven, locally-generated evidence to guide health policy and systems decisionmaking and implementation in West Africa remains urgent
Apart from Burkina Faso, which stands out considerably, the five Anglophone West African countries seemed to be publishing more than the majority of Francophone West African countries
The study covered a period of 25 years and author institutional affiliations may have changed over this period. This first health policy and systems research (HPSR) situational analysis in West Africa examined the general publication trends and sought to identify individuals and institutions involved in HPSR
Summary
The need for locally-driven, locally-generated evidence to guide health policy and systems decisionmaking and implementation in West Africa remains urgent. Health systems have been described as complex adaptive systems, given the fact that they are constantly adjusting in dynamic and unpredictable ways to changes within the system itself and/or in the broader context within which they operate [4] This dynamism underscores the fact that pre-defined health system strengthening blueprints risk becoming ineffective beyond a certain time, and calls for regular production of evidence to inform national and local health systems development. Several studies have accentuated the fact that evidence emanating from research can improve health policy development in terms of identifying issues for the policy agenda, informing policy decision and evaluating policy outcomes, and orienting efforts at strengthening health systems [5,6,7,8]. Health systems strengthening has been globally recognised as being critical to improving health outcomes, but the knowledge-base to support this effort in low- and middle-income countries (LMICs) has been rather weak
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