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Bridging the leadership gap

Mentorship and capacity development initiatives will help Africa bridge its leadership gap in health policy and systems research, writes Nonhlanhla Nxumalo.

Health policy and systems research is an emerging multi-disciplinary field, which is essential for improving public health. It blends economics, sociology, anthropology, political sciences, public health and epidemiology to build health research capacity, to use research in policymaking and to evaluate health policies.

It requires a critical mass of skills to ensure that both the public and private health sectors are adequately capacitated to effectively deliver quality care. However, Africa’s health policy and systems research capacity is limited.

The Ebola outbreak has not only highlighted the importance of HPSR to understand the complexity of health systems but also the limits in its capacity in Africa due to a range of factors, primary of which is insufficient resources and initiatives to develop future HPSR leaders.

Several capacity development initiatives exist. An example is the Consortium for Health Policy and Systems Analysis in Africa, which involves African and European universities. Its primary purpose is to enable Africa to produce and use high quality health policy and systems research and analysis.

Efforts to develop leadership in the field have not been without challenges. These challenges may not be unique to Africa but they continue to create barriers to nurturing professionals who are able to develop relationships with researchers and stakeholders from different backgrounds. Yet Africa needs to use knowledge from different disciplines to apply richer research methods that address multi-faceted public health challenges.

In South Africa, for example, the challenge of developing leadership in HPSR lies in the nature of the pathway for entering the profession. The field often requires high level qualifications such as a masters or a PhD. Following that academic trajectory requires sustained financial support in a continent where lack of funding remains a major constraint facing higher education. The implications are, therefore, that research institutions have a limited pool of highly skilled senior researchers to draw from to build a critical mass of future leaders.

Another common challenge in Africa is the ratio between senior and emerging researchers in research institutions. Some institutions have fewer senior researchers who are often the ones with the skills to write successful grant proposals to generate funding. Senior researchers are, therefore, faced with the dilemma of investing more time in generating funds and managing organisations versus finding more time to offer sustained mentorship to emerging researchers.

More systematic mechanisms for mentorship are needed to create opportunities for leadership development. There is need, for instance, to establish a system of shared leadership, where an emerging researcher is matched with a senior researcher, to create opportunities to share leadership roles within a project or an activity. Allowing emerging researchers to participate in projects led by senior researchers also creates opportunities for the young researchers to learn from the leaders in HPSR through observations and modelling.

Public health research needs to incorporate multi-disciplinary perspectives and methods to address public health challenges in Africa. It is only through capacity development and mentorship initiatives that Africa can build a mass of researchers with the leadership skills that respond to its health challenges.

Nonhlanhla Nxumalo is a health policy and systems researcher at the University of the Witwatersrand School of Public Health’s Centre for Health Policy in South Africa.