• Mapping of indicators to assess and compare HSR performance across all African countries. Metrics include numbers of clinical trials conducted, publications, researchers and financial investment as a percentage of GDP.
• Analyses of factors supporting or challenging the development of HSR from in-depth case studies of national health research systems in nine African countries, based on interviews with 189 researchers, funders, and decision-makers.
• Reflections and lessons from peer-to-peer learning workshops with decision-makers from multiple policy sectors with mandates to govern HSR in nine African countries.
• Recommendations on how to strengthen national health research systems in Africa working at different levels of HSR capacity, activity, and investment.

• Indicators can be limited by data availability, and such quantified evaluations of HSR at an aggregate level do not necessarily capture the nuances of the institutional dynamics and the role of local contexts that are critical for developing a national health research system.
• Countries share common challenges related to human resources and research personnel, institutional capacity, lack of prioritisation of health research, insufficient coordination mechanisms, and inadequate domestic public funding for HSR.
• Policy and regulatory frameworks and institutional arrangements for governing health research systems vary greatly across African contexts.
• Long-term advocacy efforts by local champions, and the use of data from in-country research to identify priorities, are critical to building national health research systems.
• Processes of aligning national priorities (e.g. health, research, development, and innovation) can be hampered by the influence of foreign partners seeking to impose their own interests on the national agenda.
• External partnership and international collaboration must align with population health needs, support development of research leadership, and equitably involve local leadership in decision-making if they are to sustainably contribute to capacity strengthening.
• Health crises provide an opportunity for rapid investments to strengthen local infrastructure and capacity. Politically astute local research leaders who are well-connected in national and international networks have played important roles in seizing such opportunities.  
• Health research systems cannot be built in silos. They operate at the intersect between multiple government policy sectors, including higher education, health, and technology and innovation. More clarity of roles and improved coordination mechanisms can help reduce duplication and vacuums of responsibility in the governance of national health research systems.  

• Support national ownership and governance of health sciences research through equitable partnership agreements that promote leadership of African experts and benefit the national health research system.
• Invest in research infrastructure (institutions, ethics committees, technical platforms, laboratories, data management systems) to create a conducive regulatory environment to coordinate research activities.
• Cultivate a national culture of research, which promotes research leaders as advocates and advisors of national policies, and create pathways to attract, train, and retain skilled researchers. 

Following this work which examined strengthening health science research within national health research systems, an extension of this project adds a regional level of analysis. Findings provided justification for exploring how regional organisations are influencing health sciences research capacity on the continent. National stakeholders perceive regional organisations as actors with increasing significance within this landscape and consider regional bodies as key stakeholders for strengthening health sciences research within and between countries in Africa through advocacy and collective action.

This project will explore the role of regional cooperation in improving health sciences research by investigating what key technical, political, and economic regional organisations are doing in this area by:

• reviewing the activities, experiences, and challenges of key regional organisations related to health sciences research investment or improvement;
• analysing the barriers and facilitators in their efforts; and
• comparing approaches to health sciences research investment and improvement across regional organisations.

The project was funded by Wellcome.

Outputs for download:

Strengthening health research systems in Africa: a regional analysis (full report)

Research brief on the roles of regional organisations (in English) (en Français)

Targeted dissemination and engagement activities are being designed and carried out in collaboration with partners in Botswana, Liberia, and Madagascar to ensure that the case study results about their respective national health research systems reach relevant stakeholders from government policy sectors, universities and research institutions, research leaders, and funders. This project was developed with local partners in response to the strong demand from key informants and decision-makers in these three countries during the initial research project for engagement activities that transcend dissemination of results towards initiating a dialogue among stakeholders on the relevance, meaning, prioritisation, and possible application of the findings in light of the goals and vision for their national health research system.

Through individual and group multi-stakeholder meetings, we will engage policy-makers; decision-makers in universities, research institutions, and labs;  and researchers in these three countries  to examine the implications of the research findings for their settings and  contexts and explore the potential to contribute to policy processes or activities for strengthening health science research in their countries. Our research found that communication, collaboration, and coordination between sectors was often lacking in health research systems, with ministries and institutions operating in silos. This is why these meetings aim to facilitate networking between the health, education, and science policy sectors with officials in ministries of education and health, public health institutes, and research centres to collectively explore whether and how the results might be useful in their own plans to enhance and support health sciences research.

The project is funded by the LSE Knowledge Exchange and Impact Fund.