Research funding impact and priority setting - advancing universal access and quality healthcare research in Malaysia.

BACKGROUND: Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia. METHODS: Research impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search. RESULTS: Seventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders' expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare. CONCLUSION: The concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential.

Supporting ageing well research: Findings from a research priority setting exercise.

OBJECTIVE: This paper describes a workshop process conducted to guide funding priorities for the Ageing Well National Science Challenge in New Zealand (NZ). METHODS: Based on the Checklist for Health Research Priority Setting, stakeholders networking workshops were conducted in five main cities in NZ (n = 133 attendees). Each workshop involved an introductory presentation; small group work exploring the a priori areas of: mind health, social well-being, health services and age-friendly environments; capturing key ideas on flip charts; feedback; and discussion of documented content. RESULTS: Suggested strategies to address these issues incorporated reduction in segregated "villages," delivery of integrated care and provision of age-friendly transport. Proposed examples of monitoring impact included increased tertiary participation by older people and presence of more housing options. CONCLUSION: Actively engaging older adults and community stakeholders in setting research priorities provided a unique opportunity to understand the key areas older adults think important for future research.

Stakeholder involvement in health research priority setting in low income countries: the case of Zambia.

SUMMARY: While there is increasing recognition of the importance of stakeholder involvement in health research priority setting there is a paucity of literature reporting on stakeholder involvement in health research priority setting in low income countries. This paper fills this gap by identifying and discussing the roles and legitimacy of different stakeholders (including the public and patients) involved in the health research priority setting process in Zambia; identifying the barriers to public participation and proposing improvement strategies.We interviewed 28 policy makers and practitioners who had participated in the national level health research priority setting in Zambia. Reported participants in health research priority setting included research users, researchers, research funders and the community/ public. Research funders were thought to have undue influence while the public and patients were not effectively involved. This could be due to the public's lack of education, lack of resources to facilitate public involvement and limited skills to meaningfully engage the public. Participation of people from rural areas, women and young professionals was also limited.While there is a commitment to broad stakeholder involvement in health research priority setting, there's limited public/patient involvement. Public education, availing more resources, and skills to meaningfully engage the public need to be explored. The undue influence of research funders should be mitigated and incentives availed to ensure that they align their research funding with the national priorities. These efforts would strengthen meaningful stakeholder engagement in health research prioritization within Zambia and other similar contexts. ABSTRACT: Background Stakeholder involvement in health research priority setting contributes to the legitimacy and acceptability of the priorities. Hence legitimate priority setting should involve a broad representation of stakeholders including the public. While there is a growing body of literature on health research prioritization in low income countries, there is a paucity of literature reporting on stakeholder involvement in the process. The objectives of this paper are to; 1) identify the stakeholders who were involved in the health research priority setting process in Zambia; 2) discuss the roles and perceived legitimacy of the stakeholders and analyze the degree to which patients/ public was involved; 3) To discuss some of the barriers to stakeholder participation in Zambia and similar contexts and to propose improvement strategies.Methods This was a qualitative study involving 28 in-depth interviews with stakeholders who had participated in the national level health research priority setting exercises in Zambia. An interview guide was used. Audio recorded interviews were transcribed and analyzed using INVIVO 10. Analysis of the Stakeholders' theme involved identifying the different dimensions of stakeholder involvement as discussed in the interviews.Results Identified stakeholders included; research users, researchers, research funders and the community/ public. We found that health research priority setting involved research users, researchers, research funders and the community/ public. However, research funders were thought to have undue influence while the public and patients were not effectively involved. While the respondents recognized the advantages of involving the public and patients, they were not effectively involved. This could be due to the public's limited understanding of the technicalities of priority setting, lack of resources to facilitate public involvement and limited skills to meaningfully engage the public. Participation from rural areas, women, and young professionals was also limited.Conclusions While there is a commitment to broad stakeholder involvement in health research priority setting, the public is left out. Efforts such as public education, availing more resources, and skills to meaningfully engage the public need to be explored. The undue influence of research funders should be mitigated through their direct involvement in the prioritization process and incentives to ensure that they align their research funding with the national priorities. These efforts would strengthen meaningful stakeholder engagement in health research prioritization within Zambia and other similar contexts.

Evaluating health research priority-setting in low-income countries: a case study of health research priority-setting in Zambia.

Priority-setting (PS) for health research presents an opportunity for the relevant stakeholders to identify and create a list of priorities that reflects the country's knowledge needs. Zambia has conducted several health research prioritisation exercises that have never been evaluated. Evaluation would facilitate gleaning of lessons of good practices that can be shared as well as the identification of areas of improvement. This paper describes and evaluates health research PS in Zambia from the perspectives of key stakeholders using an internationally validated evaluation framework. METHODS: This was a qualitative study based on 28 in-depth interviews with stakeholders who had participated in the PS exercises. An interview guide was employed. Data were analysed using NVIVO 10. Emerging themes were, in turn, compared to the framework parameters. RESULTS: Respondents reported that, while the Zambian political, economic, social and cultural context was conducive, there was a lack of co-ordination of funding sources, partners and research priorities. Although participatory, the process lacked community involvement, dissemination strategies and appeals mechanisms. Limited funding hampered implementation, monitoring and evaluation. Research was largely driven by the research funders. CONCLUSIONS: Although there is apparent commitment to health research in Zambia, health research PS is limited by lack of funding, and consistently used explicit and fair processes. The designated national research organisation and the availability of tools that have been validated and pilot tested within Zambia provide an opportunity for focused capacity strengthening for systematic prioritisation, monitoring and evaluation. The utility of the evaluation framework in Zambia could indicate potential usefulness in similar low-income countries.

Applying knowledge management in generating and using evidence in health research priority setting (HRPS)

@#<p><strong>BACKGROUND:</strong> Current international recommendations in generating and using evidence in Health Research Priority Setting (HRPS) include the use of systematic reviews, and systematic or scientific situational analysis. In the Philippines, the Philippine National Health Research System's (PNHRS) National Guidelines for Health Research Prioritization recommends the use of either a Combined Approach Matrix (CAM) or situational analysis in generating and using evidence for HRPS. At present, there is a lack of a gold standard in generating and utilizing evidence in HRPS.</p><p><strong>OBJECTIVE: </strong>The primary objective of this paper is to document a practical yet alternative/innovative approach on how evidence was generated and utilized in the process of HRPS as observed in the development of the National Unified Health Research Agenda (NUHRA) in the Philippines. Specifically, it identifies the types of knowledge products produced and their role in the process of health research agenda setting; how evidence was used and managed in the course of NUHRA development; and, the lessons learned from the experience.</p><p><strong>METHODS:</strong> This case study is descriptive of the experience of generating and utilizing evidence for HRPS in the Philippines. The study utilized primary and secondary data. Knowledge Management (KM) was used as a lens to describe the process of generating and managing information for the NUHRA. Document analysis was used in comparing and aligning data with the integrated KM framework.</p><p><strong>RESULTS:</strong> Pre-selected data were captured and created; shared and disseminated; and subsequently acquired and applied voluntarily by stakeholders during the process of HRPS. Relevant data was presented into various information products designed with a specific stakeholder in mind. Technical papers were developed to cater to national level stakeholders and focused on broad, nationally-relevant issues. Regional situational analysis reports focused on regional and local data and were designed for regional stakeholders to use during the development of Regional Unified Health Research Agenda (RUHRA). Infographics were developed to present the findings of the technical papers creatively and concisely and the NUHRA methodology and were presented to both national and regional stakeholders. The RUHRAs and the NUHRA were the outputs of the health research prioritization activities and will be made available through local and national channels of the PNHRS.</p><p><strong>RECOMMENDATIONS:</strong> Opportunities for formalization and institutionalization of knowledge management for generating and using evidence in HRPS may be explored to address health information fragmentation across the health research system.</p>

Evaluación del proceso de priorización en salud en Colombia: perspectiva de grupos de investigación ubicados en Bogotá / Evaluating how health is prioritised in Colombia from the point of view of Bogotá-based research groups

Objetivo Evaluar el proceso de priorización de investigaciones en salud llevado a cabo en el país a partir de las metodologías internacionales y desde la perspectiva de los grupos de investigación en salud, categoría A, ubicados en Bogotá. Métodos: A partir de un enfoque cualitativo, se realizaron 14 entrevistas semies­tructuradas a líderes de los grupos seleccionados a través de una muestra propositiva. Con el programa de análisis de información cualitativa Atlas Ti se generaron categorías para comparación. Resultados Cada grupo posee diferentes experiencias en investigación en el campo de la salud. Algunos manifestaron sus propias concepciones sobre la salud y sobre la priorización a partir de sus marcos epistemológicos. Diferentes líderes de los grupos expresaron que hay una fuerte orientación biomédica en los procesos de priorización y de las metodologías utilizadas para tal fin. Un número importante de ellos ha reconocido la importancia de la participación de otros actores sociales en la definición de las prioridades para la investigación en salud, además de los mismos investigadores, dentro de un escenario de dialogo y de concertación. Por último, los líderes entrevistados plantearon algunos cuestionamientos frente a la definición de prioridades y sugirieron la importancia de fomentar un proceso más participativo e incluyente comenzando por los mismos investigadores en salud. Discusión Los hallazgos muestran la enorme heterogeneidad de posiciones frente a la temática de la priorización de investigaciones en salud y las dificultades para alcanzar consensos entre los mismos investigadores.

Objective Assessing how priorities are established in Colombia in line with international methodologies and from the perspective of Bogotá-based Category A health research groups. Methods This study used a qualitative approach; 14 leaders from groups selected via a propositive sample were given semi-structured interviews to obtain a compre­hensive interpretation of priority-setting in Colombia. ATLAS Ti software was used for organising information and producing categories from transcripts. Results Each group had a different research background and came from health research areas such as basic science, clinical science and the wide field of public health. Some talked about their own definitions of health and establishing priorities as related to their own epistemological frameworks. Other leaders stressed that a bio­medical approach still predominated in health research, priority-setting and the inter­national methodologies used for such end. Many recognised the importance of differ­ent social actors (i.e. apart from researchers) becoming involved in defining health research priorities within a scenario emphasising dialogue and coming to agreement. The leaders criticised the national health science and technology system raising questions regarding defining priorities; they stated that dialogue and involvement must be promoted. Discussion These findings revealed enormous heterogeneity regarding prioritising health research as every researcher has a different point of view due to their experi­ence and backgrounds and the difficulties in researchers' reaching consensus.