Sexual and Reproductive Health Research and Research Capacity Strengthening in Africa: Perspectives from the region

Developing the capacity to effectively carry out public health research is an integral
part of health systems at both the national and global levels and strengthening research
capacity is recognized as an approach to better health and development in low- and
middle-income countries (LMICs).1] The process of embedding research within health systems requires competent, locally-based
scientists and a strong supportive and enabling environment that will allow research
communities to grow and deliver research that contribute to the health of their communities.2] Especially fields such as sexual and reproductive health (SRH) would require inter-disciplinary
teams of researchers equipped with a range of methodologies to achieve this.

The UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and
Research Training in Human Reproduction (HRP) has been leading large multi-country
research studies as well as research capacity strengthening efforts in low- and middle-income
countries (LMICs) since its inception more than 40 years ago.3] In November 2013, as part of the International Family Planning Conference in Addis
Ababa, Ethiopia, a group of African researchers came together to discuss the gaps
and strategies to improve SRH research and research capacity strengthening in Africa.
The day-long discussions and proposed solutions have focused around the following
three broad areas: Addressing research gaps that are most relevant to policies and
programmes, carrying out high quality and collaborative research, and translating
research findings into policies and programmes. Even though the focus of the discussions
was Africa, the issues and proposed solutions can also be applied to other regions
with limited resources facing a high burden of disease.

Addressing research gaps that are most relevant to policies and programmes in SRH

Currently, in practice, international organizations and networks tend to decide on
SRH research priorities for Africa, based on their areas of focus and mandate. Some
of the research questions they identify are extremely relevant, others are less so.
Sometimes, African policy makers, programme managers (within the government and non-government
sectors) and researchers are closely involved in defining research priorities. More
often, their participation is token or non-existent.

To address this problem, funders and government officials should identify SRH priorities
at the continental and national levels through a credible and consultative process.
This will ensure that external funding as well as the funds from African governments
and non-governmental organizations are used to address research gaps that are most
relevant to continental, regional and country-specific SRH policies and programmes.
Moreover, they can insist on the central role of African policy makers, programme
managers, health workers and researchers in setting these priorities.

Carrying out high quality and collaborative SRH research

Another problem identified related to the fact that African research institutions
and African researchers often play an ancillary role in major SRH research projects
carried out in the continent. Much of the research is led by research institutions
and researchers from high-income countries. Therefore, empowering existing researchers
and institutions, while building the next generation of African researchers will be
paramount.

(i) Empowering existing African researchers and research institutions and drawing
from their expertise

There are a number of actions which can be taken by different stakeholders. Staff
in research institutions should receive refresher training in areas of emerging interest,
for example implementation research and costing studies are two major areas of focus
in which few African research institutions have expertise. Meanwhile, funders and
government officials should insist on the central role of African institutions and
African researchers in research on SRH in the continent. Furthermore, they can promote
mechanisms for information exchange – research institutions and researchers are not
always aware of research that is under way in their countries or of new opportunities.
County-level information sharing platforms could address this important gap. E-platforms
could play a useful role here. Similarly information sharing could be valuable at
the sub-continental and continental levels through organizations such as Association
of Schools of Public Health in Africa.4]

(ii) Building the next generation of African researchers in Africa:

Investment in training more researchers is crucial. There are some well-staffed and
well-funded universities carrying out high quality research in Africa. These universities
train researchers and provide them with opportunities to contribute to and learn from
research projects that are under way. But such universities are few and far between.
To quicken the pace and expand the number of trained researchers across the continent,
more training and more learning-by-doing opportunities must be created. An integral
part of the institutional support must be directed at supporting senior staff to devote
time and effort to identify, train and mentor promising young researchers. This support
must also be coupled by creating funding opportunities for young researchers such
as earmarked funding created for junior researchers to compete for research funds.

Translating research findings into SRH policies and programmes

The findings of many research studies conducted in Africa are presented in international
meetings and published in international journals, but they are not communicated to
the same extent (or received with the same interest) within the continent. Research
institutions and researchers may think that working to take research findings to practice
is not their responsibility; even if they do, they may not have the capacity nor the
incentives to do this.

Therefore, it is important that research institutions include it in their mandate
to train researchers in communicating the findings of their research to decision makers
(policy makers, programme managers and funders), to civil society bodies and the population,
as consumers of healthcare and target of any research, at large. They can also create
incentives for researchers to reach out to stakeholders who could contribute to translating
research findings into practice.

Institutional changes alone will not be sufficient. Researchers also will need to
engage with the leaders and members of the communities where they carry out their
research. They can use their privileged position as respected community members to
share research findings with influential individuals and organizations to ensure that
laws, policies and strategies are evidence-based, and research findings are effectively
used to address communities’ sexual and reproductive health related priorities. Funders
and government officials support this exchange by creating opportunities for researchers
and programmers to get together periodically to share and discuss research findings
as well as viewpoints and experiences.