The CHEPSAA Project

The CHEPSAA project

The development of sustained African health policy and systems research and teaching capacity requires the consolidation and strengthening of relevant research and educational programmes as well as the development of stronger engagement between the policy and research communities. The Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA) will address both of these issues over the period 2011 - 2015. CHEPSAA’s goal is to extend sustainable African capacity to produce and use high quality health policy and systems research by harnessing synergies among a Consortium of African and European universities with relevant expertise. This goal will be reached through CHEPSAA’s five work packages:

assessing the capacity development needs of the African members and national policy networks;
supporting the development of African researchers and educators;
strengthening courses of relevance to health policy and systems research and analysis;
strengthening networking among the health policy and systems education, research and policy communities and strengthening the process of getting research into policy and practice;
project management and knowledge management.

The CHEPSAA project is led by Lucy Gilson (Professor: University of Cape Town & London School of Hygiene and Tropical Medicine).

PARTNERS

Health Policy & Systems Programme within the Health Economics Unit, University of Cape Town, South Africa
School of Public Health, University of the Western Cape, South Africa
Centre for Health Policy, University of the Witwatersrand, South Africa
Institute of Development Studies, University of Dar es Salaam, Tanzania
School of Public Health, University of Ghana, Legon, Ghana
Tropical Institute of Community Health, Great Lakes University of Kisumu, Kenya
College of Medicine, University of Nigeria Enugu, Nigeria
London School of Hygiene & Tropical Medicine, United Kingdom
Nuffield Centre for International Health and Development, University of Leeds, United Kingdom
Karolinska Institutet, Sweden
Swiss Tropical and Public Health Institute, University of Basel, Switzerland

CHEPSAA WEBSITE

Suggested citation

University of Nigeria College of Medicine. (2014). Report of the needs assessment feedback workshop. Enugu, Consortium for Health Policy & Systems Analysis in Africa.

/ This document is an output from a project funded by the European Commission (EC) FP7-Africa (Grant no. 265482). The views expressed are not necessarily those of the EC. /

University of Nigeria College of Medicine. (2014). Report of the needs assessment feedback workshop. Enugu, Consortium for Health Policy & Systems Analysis in Africa.
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SUMMARY

A one-day feedback workshop was conducted for the staff of the College of Medicine, University of Nigeria, Enugu campus (COMUNEC) and the policy and research networks of COMUNEC to present the findings of the study that assessed capacity needs and assets for Health Policy and Systems Research and Analysis (HPSR+A) among COMUNEC and its networks. A total of 29 people were in attendance. Presentations and group discussions were held, and suggestions for ways of building the field of HPSR+A within COMUNEC, its policy and research networks, and Nigeria as a whole, were made. The outputs of the workshop included: (i) a collective vision for HPSR+A in COMUNEC and its networks that is based on a well-defined structure; (ii) a list of potential HPSR+A research and teaching networks, including possible mechanisms for networking between researchers in COMUNEC, policymakers in the health system, other research institutes and funders of HPSR+A research; (iii) discussions around the role of networking and getting reasearch into policy and practice (GRIPP) in building the field of HPSR+A in Nigeria; and (iv) key competencies for trainers, researchers, practitioners and advocates in the field.

Workshop objectives

The purpose of the workshop was to contribute to the development of a collective vision for the future strengthening of the field of health policy and systems research and analysis (HPSR+A) in Nigeria. Specifically, the workshop aimed to:

present findings from the study that assessed COMUNEC and its network’s health policy and systems research and teaching capacity needs;
provide an opportunity for participants to reflect and comment on these findings;
enable participants to develop understandings that provide the basis for detailed planning around strengthening HPSR+A capacity in Enugu state specifically, and Nigeria as a whole.

Target participants

The target participants for this workshop were: (i) leaders of COMUNEC; (ii) COMUNEC staff involved in health policy and systems research and teaching; (iii) users of health policy and systems research and teaching; (iv) COMUNEC’s research and professional networks; and (v) key funders of health systems research.

A total of 29 people (Annex 1) participated in the workshop, some of whom were respondents during the needs assessment study.

Activities undertaken

Registration of participants

The workshop started at about 9.00am with the registration of the invited participants. This was planned to last for an hour, but was extended by 30 minutes to enable more people to be present for a wider and stronger representation of different groups of participants. This activity continued as the workshop progressed.

Introductory session

This session, which lasted for 30 minutes, comprised of: (i) the introduction of participants; (ii) discussions on the purpose, objectives and structure of the workshop; and (iii) a brief overview of CHEPSAA’s objectives, work packages, partner institutions, etc. These sessions were co-facilitated by Professor Obi Onwujekwe, Chinyere Mbachu and Enyi Etiaba.

Presentations

Two presentations were made during the workshop. The first was a 30 minute presentation by Prof ObiOnwujekwe on “The Nigerian health system: historical perspectives and the place of health policy and systems research”. The Nigerian health system was said to have evolved through 3 distinct, but naturally overlapping, periods of rapidly changing socio-political and economic environments, and with the need to follow and fulfil global trends being the most important driver of efforts at improving the system. A participant noted that health policy and systems research does not appear to be visible in the evolution of the Nigerian health system and is also not clearly seen in the current health system.

The next presentation lasted for about an hour. The findings from the needs assessment study was presented by ChinyereMbachu. It was highlighted that within COMUNEC and its policy and research networks:

Identity - the identity of HPSR+A is unclear;
Priority for health policy and systems research – priorityis low,mostly driven by available international funding;
Quality assurance of research – attention is paid more to the proposal stage and less to the research process and output stages;
Demand - low levels of demand for health policy and systems research and teaching; research outputs are criticized by policy makers as lacking in operationalization of findings/recommendations; students appear not to have a good grasp of HPSR+A, stating that they have late and limited exposure to research in general and HPSR+A specifically;
Communication, networking and GRIPP – these are not effectively done at an institutional level;
Succession planning - there is no formal structure for succession planning;
Resources - the constraint of inadequate/insufficient expertise in HPSR+A constitutes the most significant resource influence in health policy and systems work in the institution.

These findings generated some discussions around: (i) how early and how much exposure to HPSR+A do students need to enable better understanding of the field, development of interest and increased participation; (ii) ways to institutionalize HPSR+A in the College of Medicine; (iii) opportunities for collaborations within and between groups of actors in HPSR+A; and (iv) ways of harnessing available expertise to overcome resource challenges.

Some action points that were noted for taking forward are:

The need to build partnerships and networks between different groups of researchers in the institution.
It was agreed that the place to start in building the field of HPSR+A is to identify the small groups of researchers and research units in the institution, and then to create avenues for them to meet, exchange ideas, build interests and collaborate in research.

The need for the stronger presence of and greater visibility of the directorate for research and publication. It was noted that the directorate, which is a formal structure for coordinating research activities in COMUNEC, is not making enough impact because there is no framework in place for coordination of research activities. It was therefore agreed that:
A framework for the coordination of research activities needs to be developed, with significant inputs from the Health Policy Research Group within COMUNEC;
A database of all groups involved in research needs to be set up by the directorate;
A functional, accessible online library must be set up and a desk officer employed to manage it, and scope for and advertise calls for research proposals. It is hoped that this will attract researchers working in small groups to network and collaborate, to produce better quality responses to calls and higher quality research outputs.
The need for building researcher-policymaker networks with the state ministry of health (SMOH).
The need to strengthen the capacity of policymakers in the state ministry of health to use research evidence for decision making, and also capacity to contribute to the evidence generation process. To achieve this, it was agreed that:
The ministry of health needs to develop a research policy framework and implementation guidelines to enable proper research coordination, networking and machinery for sustainability.

Group reflections

Two small group reflections were held. Participants were groupedinto: (i) leaders of COMUNEC; (ii) researchers in COMUNEC and other networks; (iii) bureaucrats from the state ministry of health and politicians involved in policy formulation; (iv) health policy and systems teachersin COMUNEC; (v) development partners and funders of HPSR+A; and (vi) students in HPSR+A-related fields.

The first group reflections were on the findings of the study. Participants were asked to consider in what ways the findings have reflected or not reflected the true picture. There was a consensus that the true picture was captured by the study and that given that HPSR+A is a relatively new field, biomedical research still gets more attention from researchers and funders; and research uptake for decision making is generally poor in the state with poor networks and no structure for GRIPP.

The next group reflections were on building the field of HPSR+A in COMUNEC and its policy and research networks in Nigeria. Participants were asked to think about: (i) what they would want the HPSR+A field to look like in COMUNEC, Enugu state and Nigeria, and what contributions they would make to achieving the vision; (ii) who should be part of the field, who they would want to network with, and what role the networks would play in GRIPP and building the field of HPSR+A; (iii) what key competencies would be needed by people in the field – trainers, researchers, practitioners, policymakers, advocates etc. The outputsare presented in Table 1 below.

Table 1: Group reflections on building the field of HPSR+A in COMUNEC and its policy and research networks in Nigeria

Group of participants / Vision for HPSR+A and contribution to the vision / Who should be part of the field; possible networks and benefits / Key competencies needed
Researchers / Improved visibility; more representation and involvement of different fields; harmonization of stakeholders to ensure uptake of research findings; a formalized structure for HPSR+A; get all stakeholders involved in setting priority needs.
Health policy and systems researchers will drive the vision and setting up of the policy and strategic plan; share experiences of networking; be involved in training of other researchers and policymakers. / Everybody is a part of the network – university staff, staff in SMOH, other health staff, researchers from other institutes, donor agencies, beneficiaries, people from other fields with different expertise.
This will bring in different perspectives; improve ownership and community participation; make for better adoption and priority setting and uptake. / Advocacy and communication skills (workshop, publications etc); research methodology skills; GRIPP skills; management skills; teaching/training skills.
Leaders in COMUNEC / A well-defined structure with a clear policy document. Establish an office that will have a full-time employed research administrator (clearly defined roles – scouting for calls; publicizing calls etc.); and budget for running the office must be available/provided by the college. Harmonization of different research groups. / Entire research team; networking with other research groups within and outside the institution and country -
Important for capacity building / Expertise in the field; research interest/orientation; mentorship; computer literacy; workshop facilitation and training.
Health policy and systems teachers / Well-articulated HPSR+A structure with identification of areas of need in HPSR+A. A clear budget line for research within the institution that is managed by the directorate for R&P. / Whoever is willing and interested
Networks with the university; development partners (e.g. WHO); donor agencies; professional groups (NiHEA, AfHEA, iHEA etc.).
There is a need to sensitize policymakers on the need to use evidence for policy, and through dissemination of research findings.
Bureaucrats and other policymakers / Contribute by developing research policy, implementation plan and budget, proper coordination and framework.
Ensure active participation; establish a researcher-policymaker network and machinery for sustainability.
Facilitate funding; carry out research gap analysis. / SMOH, SHCOH, HPRG, Universities, development partners, private research organizations and private health practitioners; all tiers of government. / Research design, proposal writing and dissemination; data mgt packages; sourcing interpretation and utilization of research findings.
Development partners and funders / A robust evidence-based research network that can generate and communicate research findings and ideas to provide evidence for planning, decision making, M&E of health system interventions.
Develop a research engine, i.e. a coordinating body to champion HPSR+A. With lobby groups that will cut across all groups of people and a robust research network that goes beyond COMUNEC. / Development partners; ministry of health (all tiers); university community/researchers; private sector; civil society organizations; faith-based organizations; media.
Networks should be developed to

build a synergy among like groups;
implement knowledge management;
do resource mobilization and sharing;
build capacity and confidence;
provide a robust and accessible database.

/ Analytical skills for policy analysis; negotiation skills; ICT skills; communication skills - presentation; training; technical skills.

Outputs

The outputs of the workshop, which are expected to contribute to building the field of HPSR+A in COMUNEC and its networks are:

A collective vision for HPSR+A in COMUNEC and its networks;
A list of potential HPSR+A research and teaching networks; possible mechanisms for networking between researchers in COMUNEC, policymakers in the health system, other research institutes and funders of HPSR+A;
A list of mechanisms for GRIPP, how they would work, and what roles GRIPP would play in building the field of HPSR+A in Nigeria; and
A list of key competencies for trainers, researchers, practitioners and advocates in the field.

Action points

The action points for the two main categories of actors involved in HPSR+A – researchers and policymakers – which emanated from the workshop are presented in Table 2 below.

Table 2: Action points for building the field of HPSR+A in COMUNEC and its policy networks in Nigeria

COMUNEC (Directorate for R&P) / Bureaucrats in the SMOH and other policymakers

Identify small groups of researchers and research units in the institution
Set up a database of the groups
Create avenues for them to meet, exchange ideas, build interests and collaborate in research
Develop a framework for coordination of research activities
Set up an online research library to be managed by a desk officer
Build research network with the state ministry of health

Develop a research policy framework and implementation guidelines for proper:

. research coordination
. networking
. sustainability of machinery

Build research network with research institutes, including COMUNEC
Participate actively in the evidence generation process (funding, research priority setting etc.)