Kirigia Joses Muthuri, Kathyola Damson D, Muula Adamson S, Ota Martin Matthew Okechukwu
Research, Publications and Library Services Programme, Health Systems and Services Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo.
Ministry of Health, Department of Research, Lilongwe, Malawi.
BMC Health Serv Res. 2015 Mar 31;15:126. doi: 10.1186/s12913-015-0796-1.
Several instruments at both the global and regional levels to which countries in the WHO African Region are party call for action by governments to strengthen national health research systems (NHRS). This paper debates the extent to which Malawi has fulfilled this commitment.
Some research literature has characterized African research - and by implication NHRS - as moribund. In our view, the Malawi government, with partner support, has made effort to strengthen the capacities of individuals and institutions that generate scientific knowledge. This is reflected in the Malawi national NHRS index (MNSR4HI) of 51%, which is within the 50%-69% range, and thus, it should be characterized as tepid with significant potential to flourish. Governance of research for health (R4H) has improved with the promulgation of the Malawi Science and Technology Act in 2003. However, lack of an explicit R4H policy, a strategic plan and a national R4H management forum undermines the government's effectiveness in overseeing the operation of the NHRS. The mean index of 'governance of R4H' sub-functions was 67%, implying that research governance is tepid. Malawi has a national health research focal point, an R4H program, and four public and 11 private universities. The average index of 'creating and sustaining resources' sub-functions was 48.6%, meaning that R4H human and infrastructural resources can be considered to be in a moribund state. The average index of 'producing and using research' sub-functions of 50.4% implies that production and utilization of research findings in policy development and public health practice can best be described as tepid. Efforts need to be intensified to boost national research productivity. Over the five financial years 2011-2016 the government plans to spend 0.26% of its total health budget on R4H. The mean index of 'financing' sub-functions of 23.6% is within the range of 1-49%, which is considered moribund. A functional NHRS is a prerequisite for the achievement of the health system goal of universal health coverage. Malawi, like majority of African countries, needs to invest more in strengthening R4H governance, developing and sustaining R4H resources, and producing and using research findings.
世卫组织非洲区域各国加入的全球和区域层面的多项文书呼吁各国政府采取行动加强国家卫生研究系统（NHRS）。本文探讨了马拉维在多大程度上履行了这一承诺。
一些研究文献将非洲的研究——以及由此推断的国家卫生研究系统——描述为停滞不前。我们认为，在合作伙伴的支持下，马拉维政府已努力加强产生科学知识的个人和机构的能力。这反映在马拉维国家卫生研究系统指数（MNSR4HI）为51%，处于50%-69%的范围内，因此，应将其描述为发展缓慢但有显著的蓬勃发展潜力。随着2003年《马拉维科学与技术法》的颁布，卫生研究（R4H）的治理有所改善。然而，缺乏明确的卫生研究政策、战略计划和国家卫生研究管理论坛，削弱了政府监督国家卫生研究系统运作的有效性。“卫生研究治理”子功能的平均指数为67%，这意味着研究治理发展缓慢。马拉维有一个国家卫生研究协调中心、一个卫生研究项目，以及四所公立大学和11所私立大学。“创造和维持资源”子功能的平均指数为48.6%，这意味着卫生研究的人力和基础设施资源可被视为处于停滞状态。“产生和利用研究”子功能的平均指数为50.4%，这意味着在政策制定和公共卫生实践中研究成果的产生和利用充其量只能说是发展缓慢。需要加大力度提高国家研究生产力。在2011-2016年的五个财政年度里，政府计划将其卫生预算总额的0.26%用于卫生研究。“融资”子功能的平均指数为23.6%，处于1%-49%的范围内，被视为停滞不前。一个运转良好的国家卫生研究系统是实现全民健康覆盖这一卫生系统目标的先决条件。与大多数非洲国家一样，马拉维需要在加强卫生研究治理、开发和维持卫生研究资源以及产生和利用研究成果方面加大投资。
