The work of the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA) over the last four years to build the field of health policy and systems research and analysis (HPSR+A) has impressed a range of external stakeholders invited to attend the consortium’s recent networking meeting. The meeting, CHEPSAA's final formal project meeting, took place in Johannesburg from 27–29 January 2015 and was aimed at showcasing CHEPSAA's work and starting conversations about common interests and future areas of work with colleagues from Africa and beyond.

In particular, the external stakeholders praised CHEPSAA’s open access materials which were a significant demonstration of the work done, its principles of generosity and the Emerging Leaders Programme. CHEPSAA was described as a very important and solid group for influencing health policy and systems in Africa, and its organizational strengths had contributed to its impressive outputs. One delegate ascribed CHEPSAA’s impressive outputs to its organizational strengths, while another believed the networking and engagement had contributed to its great progress.

“An excellent output was how people enjoyed engaging, which fostered a great commitment to reinforce health policy and systems research,” said Dr Chokri Afra from the University of Carthage in the Middle East and North Africa Region (MENA).

Dr Mabel Nangami of Moi University in Kenya and the Africa Hub agreed that CHEPSAA’s broader, continental appeal would make it easier for similar programmes to scale up in the future. The Africa Hub is a consortium of seven schools of public health in six East and Central African countries.

Building the field

According to Dr Nangami, without knowing about CHEPSAA’s initiative, the Africa Hub had planned to address capacity gaps identified by its needs assessment by developing a curriculum in health systems and policy research. “CHEPSAA’s open access materials will make our new train-the-trainers activity much easier and I am looking forward to building on and sharing what CHEPSAA has done,” she said.

Dr Mabel Nangami	Dr Sabina Rashid

In West Africa, Prof. Jean-Pierre Olivier de Sardan of the Lasdel Institute in Niger remarked that the field of health policy and systems research (HPSR) still had to be built in Francophone West Africa, which had a strong epidemiological approach. “This is not a good starting point for HPSR. There are virtually no French publications on implementation of public policies in Africa, not only in health but almost any other field. The divide between Anglophone and Francophone Africa is a huge challenge. Most of our students cannot read English, and nearly all the research is in English. We have to break this divide. I hope the CHEPSAA courses can be translated and adapted for use in Francophone West Africa.”

He suggested that links with policy makers should not only be institutional but also for reformers inside the health system. This meant being more sensitive to those inside the health system who are willing to strengthen health systems by reforming from the inside as well as the outside.

Contextual differences and similarities

From the MENA region, Dr Raghad Hadidi from the National Health Council in Jordan explained that her country was at the needs assessment stage, and HPSR faced many challenges such as the availability of research and access to research for formulating policies. “Policy makers are not aware of the importance of HPSR in formulating health policies and are unaware of policy tools like policy briefs. Policy formulation is ‘haphazard’, with a high turnover of policy makers. We must do a needs assessment of research policy topics for policy makers, and raise awareness of the importance of research for formulating policies and strategies. We have to have an effective monitoring and evaluation system for any process to be successful,” she said.

She plans to negotiate the idea of a well-designed short training course for policy makers with the help of CHEPSAA to improve the policy formulation process in Jordan.

Prof. Laksono Trisnantoro of the Faculty of Medicine at Universitas Gadja Mada in Indonesia, said his country had 150 universities training in health policy. “What I have learnt from CHEPSAA is that it embraces many disciplines - including social and political scientists - which we still have to do. I hope to convince political scientists to become involved in the field.”

According to Dr Sabina Rashid, Dean of the James P Grant School of Public Health in Bangladesh, the meeting was a great opportunity to learn in an environment where contexts and challenges were in some ways similar, for example around governance and application of competencies.

Sustainability for the future

Exposure to CHEPSAA made several external stakeholders think innovatively about sustainability. Dr Rashid said: “CHEPSAA’s open access courses will endure long after the project closes. We are currently developing online courses, and I am exploring partnerships with individuals in the consortium, particularly around curriculum review. I liked the informality of the approach, dealing with people who have a real desire to share and give support.”

Africa Hub’s Dr Chrispus Mayora of Makarere University in Uganda said the meeting had made him think about his programme’s own exit strategy. “This is an opportunity for both the Africa Hub and CHEPSAA to work together to escalate the initiatives to even broader levels. CHEPSAA has been a big player in the region, and I know that if we collaborate, people will listen more easily if you bring along the ‘gurus in the field’. I think CHEPSAA is a tiger you need to ride on as you look forward to new things.”

Dr Mabel Nangami agreed: “We now know there are networks and many like-minded people in institutions beyond East Africa. We have met new potential partners here, also for facilitating our train-the-trainer activities. We were hard-pressed to source appropriate persons, now we know where to get them!”