CONTRIBUTORS
MARYLENE WAMUKOYA
Senior Statistician
PATRICK AMBOKA
Research Officer
A proverb from Western Kenya states that ‘That which is discussed, is rectified’ and it is to this end that the African Population and Health Research Center (APHRC) participated in the Amref International University 1st Primary Healthcare Congress (PHC) that was conducted from November 29th to December 1st, 2023. At this conference, APHRC showcased its Catalyze Impact via Africa-led Implementation Research Platforms project (Catalyze) funded by the Bill and Melinda Gates Foundation (BMGF). This project aims to create a critical mass of African researchers and institutions that generate and adopt evidence to drive impact targeted toward Africa achieving its goals.
With its diverse cultures, landscapes, and challenges, Africa stands at the forefront of the global quest for sustainable and equitable healthcare. The key to unlocking these improvements lies in advancing PHC through rigorous implementation research (IR). At the conference above, we outlined how the Catalyze is catalyzing impact in IR and how this, in turn, has the potential to transform healthcare delivery across the continent.
IR aims to promote adopting and integrating evidence-based practices, interventions, and policies into routine healthcare and public health settings. It serves as a bridge between theory and practice, aiming to identify the most effective strategies for translating research findings into tangible improvements in health outcomes. PHC is the cornerstone of a well-functioning system that can deliver these improvements to communities. It focuses on essential healthcare made universally accessible to individuals and families in the community.
Several successful initiatives have demonstrated the transformative potential of IR for catalyzing impact in advancing PHC in Africa. APHRC convened some of the institutions at the Amref PHC conference to discuss catalyzing the effects of IR towards promoting PHC in Africa. The assembled institutions include The Fenot project in Ethiopia, the Kenya Private Sector Alliance (KEPSA), and the Commission for Science and Technology (COSTECH) in Tanzania. These three institutions were represented at the conference by Prof. Tsinuel Girma Nigatu, Victor K’Ogalo, and Dr. Joseph Maziku, respectively. Dr. Julius Sindi and Ms Marylene Wamukoya of APHRC represented Catalyze.
The different institutions represented highlighted their success stories and achievements in IR for PHC in Africa. For instance, the Fenot project in Ethiopia aims to improve the country’s PHC by using locally available and context-relevant evidence to plan, monitor, make decisions, and design and analyze policies in conjunction with the Ministry of Health in Ethiopia. Their success stories underscore the importance of evidence-based, locally adapted interventions. Another example is the KEPSA, which aims to serve as a convening body for the private sector to ensure alignment in research and subsequent evidence generation within and between the private and public sectors. COSTECH in Tanzania is yet another successful example of how IR catalyzes improvements in PHC. This government agency aims to ensure that science, technology, and innovation drive evidence generation and the development of products that serve Tanzanian society. Dr. Sindi and Ms. Wamukoya of APHRC outlined the value of the Catalyze initiative for catalyzing impact via IR.
Despite all the success stories, the successful implementation of PHC faces numerous challenges in the African context, including resource constraints, infrastructural limitations, and diverse cultural landscapes. IR can address these challenges through the following means:
- Contextualizing interventions: “Africa’s healthcare landscape is diverse, with each region facing unique challenges. We can overcome these through our drive towards helping to tailor interventions to specific contexts, ensuring they are culturally sensitive and contextually relevant by partnering with different institutions across the country,” reported Mr. K’Ogalo of KEPSA.
- Optimizing resources: Limited resources demand efficient allocation, and IR identifies cost-effective strategies, ensuring that interventions are sustainable and scalable even in resource-constrained environments. “The mandate of the academic institutions in Ethiopia is to do research, but they don’t have adequate resources,” reported Prof. Tsinuel of the Fenot project.
- Building local capacity: Dr Sindi from APHRC reported that involving all stakeholders in the research process from the beginning of IR increases the buy-in. This enhances the effectiveness of interventions and fosters a sense of ownership and sustainability. “We are currently working with the governments in Kenya, Ethiopia, and Nigeria to set up research questions so that we can address the specific IR issues in the respective countries,” said Dr. Sindi of APHRC.
The panel highlighted the importance of going beyond the traditional research-to-publication model and incorporating into the research pathway the active translation of research findings into tangible policy changes and improvements in healthcare delivery. The key steps in such a research pathway would then include:
- Stakeholder engagement: Engaging policymakers, healthcare providers, and local communities from the outset ensures that the research addresses real-world needs. Collaborative partnerships foster a sense of shared responsibility for successful implementation.
- Policy advocacy: Research findings must be communicated effectively to policymakers, advocating for integrating evidence-based practices into healthcare policies. This requires effective knowledge translation strategies that bridge the gap between academia and policy formulation.
- Capacity building: Investing in training programs for healthcare professionals and researchers builds a cadre of experts capable of driving IR forward. This, in turn, ensures the sustainability of interventions beyond the scope of individual research projects.
- Monitoring and evaluation: Continuous monitoring and evaluation are essential for tracking the impact of implemented interventions. This feedback loop informs iterative improvements, enhancing the effectiveness of PHC strategies over time.
Despite these efforts, we remain mindful of persistent challenges, such as limited funding, outdated and non-supportive infrastructures, and a fragmented healthcare system. However, these challenges are not insurmountable and can be overcome by a collective effort involving researchers, policymakers, and communities to pave the way for sustainable change.
Catalyzing impact for IR is not just a theoretical concept but a call to action that requires a collective commitment to translating research findings into meaningful improvements in PHC across Africa. Through stakeholder engagement, policy advocacy, capacity building, and continuous monitoring, we can unlock the transformative potential of IR and usher in a new era of equitable and accessible healthcare for all.