Kapiriri Lydia
Department of Health and Aging, McMaster University, 1280 Main Street West, Hamilton, ON Canada.
Res Involv Engagem. 2018 Nov 5;4:41. doi: 10.1186/s40900-018-0121-3. eCollection 2018.
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.
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. 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. 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. 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.
虽然人们越来越认识到利益相关者参与卫生研究重点确定的重要性，但关于低收入国家利益相关者参与卫生研究重点确定的文献却很少。本文通过识别和讨论参与赞比亚卫生研究重点确定过程的不同利益相关者（包括公众和患者）的角色与合法性，找出公众参与的障碍并提出改进策略，填补了这一空白。我们采访了28位参与赞比亚国家级卫生研究重点确定工作的政策制定者和从业者。据报告，参与卫生研究重点确定的人员包括研究使用者、研究人员、研究资助者以及社区/公众。研究资助者被认为具有不当影响，而公众和患者并未得到有效参与。这可能是由于公众缺乏教育、缺乏促进公众参与的资源以及缺乏有意义地让公众参与的技能。农村地区的人群、女性和年轻专业人员的参与也很有限。虽然致力于让广泛的利益相关者参与卫生研究重点确定，但公众/患者的参与有限。需要探索公众教育、提供更多资源以及有意义地让公众参与的技能等方面的措施。应减轻研究资助者的不当影响，并提供激励措施，以确保他们使研究资金与国家优先事项保持一致。这些努力将加强赞比亚及其他类似背景下利益相关者在卫生研究优先排序方面的有意义参与。
利益相关者参与卫生研究重点确定有助于重点的合法性和可接受性。因此，合理的重点确定应包括包括公众在内的广泛利益相关者代表。虽然关于低收入国家卫生研究优先排序的文献越来越多，但关于利益相关者参与这一过程的文献却很少。本文的目的是：1）识别参与赞比亚卫生研究重点确定过程的利益相关者；2）讨论利益相关者的角色和感知到的合法性，分析患者/公众的参与程度；3）讨论赞比亚及类似背景下利益相关者参与的一些障碍并提出改进策略。这是一项定性研究，对28位参与赞比亚国家级卫生研究重点确定工作的利益相关者进行了深入访谈。使用了访谈指南。对录音访谈进行转录，并使用INVIVO 10进行分析。对利益相关者主题的分析包括识别访谈中讨论的利益相关者参与的不同维度。识别出的利益相关者包括：研究使用者、研究人员、研究资助者以及社区/公众。我们发现卫生研究重点确定涉及研究使用者、研究人员、研究资助者以及社区/公众。然而，研究资助者被认为具有不当影响，而公众和患者并未得到有效参与。虽然受访者认识到让公众和患者参与的好处，但他们并未得到有效参与。这可能是由于公众对重点确定技术细节的理解有限、缺乏促进公众参与的资源以及缺乏有意义地让公众参与的技能。农村地区、女性和年轻专业人员的参与也很有限。虽然致力于让广泛的利益相关者参与卫生研究重点确定，但公众却被排除在外。需要探索公众教育、提供更多资源以及有意义地让公众参与的技能等方面的措施。应通过让研究资助者直接参与优先排序过程并提供激励措施来减轻其不当影响，以确保他们使研究资金与国家优先事项保持一致。这些努力将加强赞比亚及其他类似背景下利益相关者在卫生研究优先排序方面的有意义参与。
