Table 1 Summary of priority setting process, success, challenges and recommendations
From: Health research priority setting in Zambia: a stock taking of approaches conducted from 1998 to 2015
Title | Process | Success | List of identified priority areas | Challenges | Recommendations |
|---|---|---|---|---|---|
Ministry of Health (MoH) 2008, Country Report Alignment and Harmonization in Health Research | − Tracking what research had been done − Small group brainstorming sessions − A National Health Research meeting that brought together different stakeholders (200 to 300 people involved) − Synthesis of key research findings by a team of experts | − Integration of the various processes into a coordinated system − Development of processes through which research outcomes could be continually fed into policymaking and programme implementation − Identification of a process for updating the priorities | − Malaria − Child health − Nutrition − Diarrhoeal diseases − Reproductive health − Sexually transmitted diseases/HIV/AIDS/tuberculosis/leprosy − Water and sanitation | − The process was disease focused, which affects priority research − Process was not a very representative or inclusive − The influence of donors was also cited as a problem that skews health research priorities − Current donor interest in certain conditions influences the availability of research funds | − Formalised process be established for participatory health research − Priority setting and review with a clear listing of all relevant stakeholders to be involved |
August 2010 to March 2011, Zambia Forum for Health Research | − Worksheets for summarising the approach for prioritising topics for policy briefs were given to participants − The participants were then divided into working groups − The scope of the priority-setting process was limited to the topic of sexual and reproductive health | − All stakeholder groups (those that would be affected by the outcome of the policy) were represented at the workshop and all participated in the process; this enabled a wide range of reproductive health priority topics to be identified − The method used was transparent − Participants had an opportunity to take an active part in compiling the list of priority topics | − Promoting the use of misoprostol in labour specifically to prevent haemorrhage after delivery at home − Ensuring that all maternal deaths are notifiable − Encouraging research at the district level − Fostering the involvement of traditional leaders in reproductive health programmes | − The input of some participants was overshadowed by those who were more outspoken; some vital contributions may have been missed as a result − Some important topics, including the reasons for the drastic decline in facility-based births; tackling abuse at facility-based births emerged only after the workshop; these topics were provided by individuals who were unable to attend the workshop | − Adopt a standard national priority-setting tool − Financing of priorities for research |
2011, MoH Program Managers | Using the Medium-Term Expenditure Framework approach | - Had a comprehensive list of priority setting lists for the all country | − Child health − Cancer diseases hospital − Reproductive health − Health education − Oral health − Pharmacy − Non-communicable diseases − Virology laboratory − Malaria − Antiretroviral therapy − Nutrition − Tuberculosis − Mental health and substance abuse | − Period to get consensus from all stakeholders was short − Not all stakeholders were involved in the process, especially the community − Implementation was affected by lack of resources to carry out the priority setting research | − Adopt a standard national priority-setting tool − Allocate resources to implement the priority areas identified − Enforce the National Health Research Act No 2 of 2013 |
October 2011, Maternal, Neonatal and Child Health Priority Setting Case, Zambia | Child Health and Nutrition Research Initiative method | − It was short, focused − It was responding to a specific program area − It was easy to identify stakeholders − It was transparent | − How can community-based neonatal care be strengthened to reduce mortality and morbidity in Zambia? − How can strategies to reduce adolescent/teenage pregnancies be strengthened in Zambia? − How can we improve the proportion of institutional deliveries? − How can child immunisation coverage be improved? − What is the effectiveness of different models to attract and retain doctors, nurses, and technicians in rural and hard to reach areas? − What incentives can be used to improve attendance for postnatal care in Zambia? − How can we improve early ANC attendance in the first trimester? | − It was externally driven − The was no post evaluation of the process or follow-up | − Priority-setting activities should be locally driven and standardised − Global partner should buy into national priorities as is being recommended by WHO ESSENCE |
2007 to date (Annually) National Science and Technology Council Strategic Research Fund | Receiving priority areas from all sectors | − Multi-sectoral and funds are allocated to fund research − It is transparent − There is standard call for proposals − Standard proposal evaluation − The funding is predictable − It is efficient and locally driven | − Communicable diseases − Non-communicable diseases − Maternal diseases − Nutritional diseases | − Process for selecting the priority areas in each sector is not standardised though guided by the Five-Year National Strategic Development Plans | Standardised intra-sector priority setting |