Partners’ HPSR report – 2021
Eighteen HPSR-related institutions have been identified in Uganda, with 16 of these based in the capital, Kampala. The majority are either local NGOs or independent research centres or think tanks. However, four are universities with faculties or schools offering HPSR training and research. Notably, Makerere University School of Public Health accounts for most of the funding, faculty and students focused on HPSR in the country.
HPSR supported a number of strategic planning and policy development activities in Uganda between 2018 and 2020. Examples of successful policy influence include the adoption of national anti-tobacco laws and the national Universal Health Care (UHC) roadmap, and the passage of the National Health Insurance Schemes act, as well as the Presidential commitment of US$ 10 million for indoor residual spraying for malaria control in 2018. Strategies to bridge research and policy included initiatives for policy analysis and knowledge translation, the development of advocacy strategies and the production of evidence.
HPSR is, in general, embedded in formal academic programmes at both undergraduate and postgraduate levels. Short courses are occasional and ad hoc. Funding for public health research in Uganda has increased over the past 2-3 years but it is difficult to determine the precise amount, given the fragmented financial data tracking systems, limited government funding for research, and over-reliance on donor funding.
Institutions by type
List of HPSR institutions
HPSR knowledge generation from 2018 to 2020 coincided with the need to support shifts in national and health sector priorities. During this period, the country was reviewing its Health Sector Development plan (2015-20), drafting its National Development Plan III (2020-25), as well as its Health Sector Development Plan (HSDP) II (2020-25) and a National Health Policy (2020-2030). Other issue-specific plans included the Human Resources for Health strategy (2020-2030) and National Health Insurance Bill 2019.
Efforts have been documented to align HPSR evidence generation to these national planning processes. This knowledge generation took a variety of forms, including special studies and products led or commissioned by sector stakeholders. Key products include the Universal Health Coverage (UHC) Policy Paper by the National Planning Authority; the Midterm review of the HSDP; the development of the UHC roadmap; and the revision of the National Health Insurance Bill (2019). The World Bank also commissioned 12 operational research studies on the implementation of the Global Financing Facility (GFF) and funded the Uganda Reproductive Maternal Child Services Improvement Project (URMCHIP).
The number of HPSR reports produced during this period increased from an already high 270 in 2018 to 342 in 2020.
Average number of reports produced per institution each year in Uganda and overall
Engaging policy-makers and the public
It is difficult to demonstrate tangible policy influence, given the intricate and complex relationship between evidence and policy, and both the tracking and documentation of evidence-based policy actions are limited. However, a few examples of successful policy influence from 2018 to 2020 include, as noted: the adoption of national anti-tobacco laws; the adoption of the national UHC roadmap; and the passage of the National Health Insurance Schemes act; as well as the Presidential commitment of US$ 10 million towards indoor residual spraying for malaria control in 2018.
Several strategies supported the translation of evidence into policy during this period. First, academic institutions and other think tanks conducted capacity building initiatives for policy analysis and knowledge translation. One example is the Supporting Policy Engagement for Evidence-based Decisions (SPEED) partnership under the Makerere University School of Public Health, which was a flagship initiative for policy capacity development under the European Union’s eight country Supporting Public Health Institutes Programme. Second, institutions joined coalitions and technical working groups, developed advocacy strategies, produced evidence, and presented it at several stakeholder engagement forums.
In addition, members of HPSR institutions are often commissioned as consultants to conduct special studies and evaluations to inform decision-making. Researchers are invited to develop national strategic documents, as was the case for the UHC roadmap and health sector development plan. Evidence for policy influence is packaged as scientific and popular products such as journal publications, policy briefs and newspaper articles. Such endeavours support the collation and translation of evidence into policy and systems developments.
The estimates indicate a high number of meetings with policy-makers in 2018 and 2019 (270 and 310, respectively), falling to 74 in 2020 (mostly due to COVID-19 disruptions). The number of newspaper articles identified more than doubled over this timeframe, from 65 in 2018 to 183 in 2020.
Average number of meetings held with policy-makers per institution each year in Uganda and overall
Average number of media articles published per institution each year in Uganda and overall
Academic and institutional capacity
HPSR is embedded in Uganda’s formal academic programmes at the undergraduate and postgraduate levels, with elements of HPSR taught as part of public health Master’s and medical degree programmes across the universities reviewed. Academic institutions such as Makerere University School of Public Health (MakSPH) have been at the forefront of HPSR training and research. At MakSPH, health systems was a track under the Masters in Public Health (MPH) programme until 2019 when a new curriculum was adopted. Short courses on aspects of HPSR such as vaccine economics, health policy analysis and health systems research have been offered for practitioners and managers within the health sector, but these are intermittent and remain dependent on resource availability.
Academic institutions have established partnerships to support HPSR capacity development. The CARTA consortium and Sida-funded Makerere University-Karolinska Institutet partnership, for example, have been major funders for PhD training. MakSPH is a founder member of the association of public health schools in Africa, which aims to support sustainable public health workforce development and regional research networks (MakSPH coordinates five regional research and capacity building projects in partnership with various schools of public health in Africa). Alongside academic training, there have been efforts to engage students in field placements and in research that responds to the needs of the Ministry of Health and other sector stakeholders. Examples of dissertation topics covered include health financing, workforce development, health governance, and the social and environmental determinants of health.
HPSR faculty levels remained steady from 2018 to 2019, at roughly 480. The estimates of numbers of participants in HPSR courses indicate an increase from 6000 in 2018 to 15 000 in 2019, before falling back sharply to 3000 in 2020 (possibly as a result of COVID-19 disruptions).
Total number of HPSR faculty and staff
Total number of participants in HPSR-related short courses
Funding for public health research in Uganda has increased in recent years, and the national health research budget in 2020 was nearly US$ 139 million. However, it is difficult to determine the precise amount as a result of limited government funding for research, over-reliance on donor funding and fragmented financial data tracking systems. Most institutions track full project amounts, rather than the amounts allocated specifically for HPSR. In addition, the Uganda National Research Organization is poorly resourced, which hinders the fulfilment of its mandate to oversee health research in the country.
Recent developments, however, signal positive changes in the national landscape for research funding. In 2019, under the Ministry of Science, Technology and Innovation (MoSTI), the Government of Uganda committed around US$ 135 million for the National Research and Innovation Fund to support local researchers. Also in the financial year 2019/2020, Makerere University received over US$ 8.1 million from the government under the Research and Innovations Fund (RIF) to support high impact research and innovations. The institutions have forged local and international partnerships that provide both financial and non-financial resources for research. Most academic institutions and think tanks obtain HPSR funding from donors and local partners, including the World Health Organization, the United States of America Centers for Disease Control and Prevention, European Union, The United States National Institutes of Health, USAID, the Bill and Melinda Gates Foundation, and The Global Fund, among others.
Total institutional expenditure
Credits and disclaimers
Partners’ health policy and systems research report, 2021
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