The African Institute for Development Policy AFIDEP conducted a training workshop for more than 15 parliament staff from 10 African countries on evidence-informed decision-making (EIDM) on June 27-28, 2016 in Munyonyo, Uganda. The parliamentary staff included researchers and clerks who support parliamentary health committees. These staff provide committees with briefings on issues to inform their debates and decisions, and therefore play a crucial role in the ecosystem of evidence use in parliament. The workshop equipped the parliamentary researchers and clerks with knowledge and skills in: the critical place of evidence in the legislature; knowledge of where and how to effectively search for evidence, assess its quality, and synthesise and package it appropriately for use by MPs.
Monitoring equity and research policy
The Global Forum 2015 panel session dialogue entitled “From evidence to policy – thinking outside the box” was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region. The Global Forum 2015 debate attributed African Region’s low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organisations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region. The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening national health research governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of action plans for implementing research recommendations, preferably in the context of the Sustainable Development Goals; and encouragement of competition on health research strengthening and research output and uptake among the countries using a barometer or scorecard to review their performance at various regional ministerial forums and taking into account the lessons learned from the MDG period.
The need for legislative information and research, especially in developing and transition countries, is growing as policy-making processes become more complex, particularly in the context of globalisation, regional integration and decentralisation. Since the executive branch of governments generally has access to a larger pool of knowledge and expertise than the national legislature, there is a need to address the imbalance in access to knowledge between the executive, legislature and judiciary in order to promote better quality policy-making. Better access to information and research can help empower legislatures to formulate and pass effective legislation and perform effective scrutiny of government. Using the Research and Policy in Development (RAPID) framework, this study maps the links between researchers and legislators in a number of transition and developing countries; explores the role of politics in influencing researcher–legislator linkages; and comments on the type of research produced as well as the credibility of the research/researchers. Civil society organisations (CSO) particularly in Sub-Saharan Africa, perhaps because of weak political parties, play a key role in representing grassroots constituencies in legislative processes. Legislative committee hearings across all legislatures tend to be a key mechanism through which researchers’ voices can be heard in the processes of law-making and oversight. Some legislatures, particularly those in East Asia, have substantial in-house technocratic capacity, including library and research services and the capacity to commission research. In Sub-Saharan Africa, a number of (donor-funded) organisations have been set up to provide the legislature with input and capacity, particularly on management of public finances. Researcher–legislator linkages, particularly in Sub-Saharan Africa, tend to be stronger or more visible in areas that are perceived to require hard data, such as quantitative analyses. These include public financial management, particularly budgeting and budget control. In Sub-Saharan Africa, these formal mechanisms were found in the study to be externally funded and/or -inspired. Where hard data is concerned, research tends to be demand-oriented; in the softer sectors, CSOs have tended to take the initiative to engage legislators. The relationship between political context factors and researcher–legislator links was found to be complex. Legislators’ personal motivations, such as the desire for political advancement, to influence policy, for power in a legislative body and for private gain, can affect the way they view or use evidence in the policy process. The capacity provided by a legislature’s procedures, structures and support mechanisms also influences the role of research in law-making and oversight processes. They propose that researchers work harder to ensure evidence is accessible by legislators and related to legislative decisions, that fits tightly with legislative processes. Legislators emphasised the need for researchers to go beyond stating research findings to actually narrate a compelling story with practical policy recommendations. Moreover, evidence is more likely to be taken up if messages resonate with broader national policy agendas, such as economic growth. Given the pressures on their time and relatively low research literacy levels, research intended for legislators needs to be presented in short summaries, where possible illustrated by pictures and/or charts. Nevertheless, Legislators’ staff prefer formats that present more detail.
This research determined the quantity and quality of publications in biomedical research in top-producing countries in West Africa during 2005–14 as well as characteristics of journals and collaborative evidence in the area. Data was drawn from MEDLINE/PubMed and Google Scholar while the impact factors of the journals were retrieved from the SCImago Journal and Country Rank portal. Quantity of publications was measured by counting the number of publications attributable to a country while h-index was extracted to measure quality. Productivity was analysed by sorting the data according to their first named authors, journals and publication dates, and analysed using MS Excel and LOTKA®. Nigeria, Ghana, Senegal, Burkina Faso and Mali had the highest number of publications. In respect of productivity, apart from Côte d’Ivoire that had an α value less than 2 indicating a higher level of productivity, all other countries had an α value greater than 2. West African Journal of Medicine is the only journal of West African origin in the list of top ten journals where the authors from the sub-region published their papers, and it ranked tenth. Nigeria and Ghana published more of their research in local journals in comparison with other countries, but these journals have very low mean impact factors. This study reinforces the need for improved research production and collaboration between the big and small countries.
A functional national health research system (NHRS) is crucial in strengthening a country’s health system to promote, restore and maintain the health status of its population. Progress towards the goal of universal health coverage in the post-2015 sustainable development agenda will be difficult for African countries without strengthening of their NHRS to yield the required evidence for decision-making. This study developed a barometer to facilitate monitoring of the development and performance of NHRSs in WHOs African Region. The African national health research systems barometer algorithm was developed in response to a recommendation of the African Advisory Committee for Health Research and Development of WHO. Survey data collected from all the 47 Member States in the WHO African Region using a questionnaire were entered into an Excel spreadsheet and analysed. The barometer scores for each country were calculated and the performance interpreted according to a set of values ranging from 0% to 100%. The overall NHRS barometer score for the African Region was 42%, which is below the average of 50%. Among the 47 countries, the average NHRS performance was less than 20% in 10 countries, 20–40% in 11 countries, 41–60% in 16 countries, 61–80% in nine countries, and over 80% in one country. The performance of NHRSs in 30 (64%) countries was below 50%. An African NHRS barometer with four functions and 17 sub-functions was developed to identify the gaps in and facilitate monitoring of NHRS development and performance. The NHRS scores for the individual sub-functions can guide policymakers to locate sources of poor performance and to design interventions to address them.
The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role—serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, the authors administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks and identified academic KBs using social network analysis (SNA). Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, they identified 7 KBs in 4 of the 6 SPHs. KBs were also situated in a wide range along a 'connector/betweenness’ measure. The authors propose that SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies.
This paper draws on the African publishing industry initiative to determine ‘Africa’s 100 Best Books of the 20th Century’, to discuss writing, scholarship and publishing in and on Africa. It argues that it is not enough to publish or read about Africa, just as it is not enough to pass for an African writer or scholar. There is need to problematise what is published and read on Africa, and how sympathetic to Africa culturally, morally and scientifically authors and publications are. The author argues that it is not enough to simply assume Africanness from the fact that a publication is produced by an African, or that 'non-Africans’ cannot competently and positively articulate African causes in ways relevant to ordinary Africans, and poses challenge as one of how to promote commitment to African humanity and creativity without producing a simplistic reductionism or the inflation of belonging in Africa. The paper pursues these considerations, by focusing on how ‘Africans’ and ‘non-Africans’ alike have tended to represent Africa in publications. The author states "Often missing have been perspectives of the silent majorities deprived of the opportunity to tell their own stories their own ways or even to enrich defective accounts by
others of their own life experiences. Correcting this entails paying more attention to the popular epistemologies from which ordinary people draw on a daily basis".... "It also means encouraging ‘a meaningful dialogue’ between these epistemologies and ‘modern science’, both in its old and new forms, as a way of enhancing rather than simply trampling and crushing the past with modern creativity. For publishers to play a part in this rehabilitation, a deliberate effort must be made to privilege people over profit, and to do more than reproduce the rhetoric of equality of humanity and the celebration of creative diversity. So far, publishing Africa for most is much less an
ideological commitment than a commercial option...".
The regime of publication pervades contemporary academic life across countries. The obligation that academic staff must publish is invariably presented as a virtuous thing. It is right and proper for academics to expand and extend the boundaries of their respective disciplines by publishing in outlets, as approved by their peers. Moreover, a public that is often sceptical of the usefulness of universities is often told that academics publish in “the public good”. But, the authors ask, if academic publishing is so significant in the profession, why is it that the young and talented in the academy increasingly resist it, calling it formulaic, at best, and, at worst, a sweatshop? And they ask, why is it that old academic hands are simply no longer interested in contributing to the peer-review system that is at the heart of the system and without which the standing of the entire industry will falter? For one thing, the authors argue, there is a dark side in the ceaseless pressure to publish. Funding agencies use publication records to distribute money or rank scholars and academic managers use the publication record as a means to manage people. For another, the current system privileges the journal over the book, which is argued to be damaging to the humanities. They argue for the need to recognise that “slow scholarship” is as important as it is necessary, and that deep research – especially, but not exclusively in the humanities – requires what strategic theorist Albert Wohlstetter once called a high thought to publication ratio. Research and publishing is the oxygen of academic life, but the authors suggest that the regimes of control that surround contemporary approaches to publishing are choking creativity and, with it, the profession itself.
Hosted by COHRED, the Research Fairness Initiative aims to create a reporting system that encourages governments, business, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. The RFI prioritises its application in global health because there are so many urgent health-related issues, but it can be applied to other settings as well. By providing a guide to high quality reporting on measures and conditions that promote fair research partnerships, the RFI encourages all stakeholders in research and innovation for health to describe what is done within their organisation to promote fair partnerships. Through an extensive global consultative process, the RFI have identified 17 key areas of relevance to effective and lasting partnerships. The RFI acknowledges that successful partnerships often start at personal level but are then continued at institutional or national levels. While mutual admiration, respect and friendship are essential to create the foundation of effective partnerships – it is the institutional and national dimensions of research collaboration that define how, ultimately, benefits are shared.
Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organised and comprehensive response to NCDs. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardisation of patient and program monitoring tools. In this cross-sectional qualitative study the authors assessed existing monitoring and evaluation tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, they explored the tools being used in the program and analysed how they might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. The authors findings indicate the apparent lack of information systems for NCD services, including the absence of standardised patient and program monitoring tools to support the services. They identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardised tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardising patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.