Strengthening health research capacity for an African evidence base
Eric Buch, Health Adviser at NEPAD, the New Partnership for Africa’s Development, discusses the organisation’s strategies on health and health research. Core issues include: how to make training more effective to build skills that Africa’s researchers can put to use today; the need to go beyond discussing ‘evidence’ and create strategies to produce it systematically, and NEPAD’s role in nurturing centers of excellence in and for Africa.
What are NEPAD’s specific strategies and activities in the area of health research?
NEPAD, the New Partnership for Africa’s Development is a programme of the African Union. It was adopted by African Heads of State as a mechanism to help accelerate the pace of development and reduction of poverty reduction for the continent.
Health is one of the NEPAD priorities and the health sector strategy has a number of goals aimed at improving health systems. The health research strategy has a specific focus on capacity building for researchers and countries’ health research systems. The underlying goal is to improve Africa’s capacity to produce high quality evidence.
These NEPAD targets include building countries’ capacity to do health research, to get health research moving in Africa; and create a situation where more African researchers are doing research for the health needs of their countries. Creating this change will create a situation where countries influence donors and global health programmes to focus research funding on each country’s top health and health care concerns.
You say that a NEPAD priority is to build capacity. What are the priorities for Africa’s health research systems?
The capacity of a large number of Africa’s researchers and students can be significantly improved, simply by on focusing on building skills that allow them to work better, for example as project managers or synthesizers of information.
We need to build capacity of staff in research institutes and health policy organisations so they can do better operational research.
The quality and effectiveness of research training programmes needs to be improved. To be useful, training needs to have a very practical focus, where people get hands-on experience – not just theory – in doing practical elements of research that they can use immediately in their work. There is also a need for more skills in proposal development and project design, including funding proposals. MPH programmes that have a strong research component are badly needed.
Another idea is to organise sessions where researchers are prepared to present their work and findings to potential users of research such as health sector policy makers and strategic planners.
I am not sure that we need more medical research in some areas – rather a mechanism to build researchers’ and research managers’ skills to research action and thereby improve implementation. And to ensure that the different elements of a country’s research system are in place and working well.
What are the health or heath research programmes of NEPAD?
NEPAD is a strategic and development advisory body, so we do not implement and run projects. We develop strategies and policies, and advocate on the priorities necessary for Africa’s development. We work with specialist partners to put in place development projects that move the strategy forward.
We are keen to establish ‘centers of excellence’ and leading knowledge institutions in Africa that can help create progress in the strategic areas defined for Africa’s development. We are also keen to encourage multi-country collaborations across Africa.
We have many international agencies and global health initiatives working in Africa. To deliver NEPAD’s vision of growing and using African capacity to address its development issues, we need organisations that are active at the national and regional level, and southern- owned organisations to be prominent.
There is a difference between a regional office of a global programme and a southern- owned organisation that is rooted in the region and countries. NEPAD invests in these kinds of partnerships.
Do you think that decision makers – national leaders and donor agency specialists – are convinced of the need for health research?
There is a lot of talk of the importance of health research. But this thinking is often in the abstract. To illustrate why research on health issues is vital for countries, we need to have concrete ideas of what needs to be done, what can be done and how research can support this.
For example: What practical steps does a country need to take to build a system for health research that meets its national needs – in terms of building skills, creation of areas of expertise, improvement or creation of specific institutions, etc.
Another example is: What are the priority health areas and problems in society where your country or region needs to focus research to improve health. And most importantly – what can you do now, with the resources and skills available today; and where should you aim to be in several years as your health research plan progresses.
Another aspect of research that can be improved for countries’ benefit is the focus of international ‘vertical’ programmes. Too often in health systems development, the individual disease specific programmes have a lot of influence, and their priorities are determined without taking the country’s wider needs or priorities into consideration. Much of this is short term ‘fixing’, not building the foundation needed for Africa to really develop.
How do you see the NEPAD-COHRED Memorandum of Understanding contributing to this need?
A particularly appealing aspect of the COHRED plan, that interested NEPAD in signing the Memorandum in 2005, is the prospect of having a center in Africa that specifically focuses on strengthening health research systems of African countries, providing advice on how they can improve and encouraging sharing of learning between countries. We are keen to see how COHRED plans to establish itself on the continent and provide support that benefits African countries directly.
In the agreement NEPAD specifies the need to request specific studies based on COHRED’s expertise. What are these?
High quality evidence provides us with a clear picture of what needs to be done to improve health – for a country, its health policy specialists and decision makers. In the health sector we continually speak of the importance of evidence and evidence-based decision making. But in most cases the evidence is lacking when decisions need to be made about improving population health.
COHRED can help us at NEPAD think through how to address problems and needs that countries face. It can provide tools and advice based on its past experience. This will inform our policy and planning work and help countries decide how they can organise themselves to produce better evidence to support their policies and national health programmes.
NEPAD wants to receive the products of this work and learning that countries are experiencing to strengthen strategies and health programmes. We expect that this information and these experiences will give a broader indication of what is needed on the African continent.
We also like the COHRED approach of building health research capacity in countries at different levels – in ministries, the NGO sector and research institutes. Also the synthesis work that COHRED can offer based on its experience of working with a large number of countries on national health research system building.
A number of organisations are working to produce health and research evidence for Africa: INCLEN looks at clinical epidemiology; the INDEPTH network provides data and analysis on surveillance activities. But none works on research system building. We feel that COHRED’s expertise will make a much needed contribution to the health research systems and policies picture.