Research has to change the lives of end users, experts say

As calls grow louder for Africa to produce a critical mass of PhDs to help find local solutions to the challenges affecting the continent, there should also be a sharper focus on how the research and innovations produced by scientists get to the end users and improve their lives.

This is according to experts drawn from academia, governments and the private sector, who, at a conference on 14-15 September in Johannesburg, South Africa, said the call on Africa to produce more PhDs – the World Bank suggested 10,000 PhDs annually – will not help to address the challenges affecting the continent, especially in the health, access to water and climate change sectors, if policy-makers are not using research evidence to make decisions and the research produced remains inaccessible to the public.

Speaking at a gathering of the University of the Witwatersrand’s School of Public Health and the Consortium for Advanced Research Training in Africa (CARTA), the experts decried the low research uptake in Africa, despite mounting pressure on universities and research institutions to train more PhDs and produce more research evidence.

The conference, organised by the Nairobi-based African Population and Health Research Center (APHRC), in collaboration with the University of the Witwatersrand (Wits), also included CARTA PhD fellows and alumni, who presented published and unpublished research papers on public health issues across Africa.

Translating research into practice

Professor Nicholas Crisp, a deputy director general in South Africa’s national Department of Health, said there is an abundance of “really good” research that is available in Africa but that it “doesn’t translate into anything”.

“The question is really how we bring research, research findings, publications, qualifications, and so on, [to change practice],” Crisp said, reiterating that it was not enough to discuss how to get thousands of PhDs without also interrogating how the research produced can make a difference to end users, such as the people who use health services.

“Not having the evidence of what we do is also not helping us to provide better health care. [But] even very practical, implementable work that is researched and published often [also] doesn’t translate into changes in practice.

“That, then, means the patients fail to receive the best possible treatments and the best care available and health organisations and society miss out on the potential value of all this research. So the challenge lies in translating this clinical knowledge,” said Crisp.

He warned that, if evidence-based knowledge is not transferred to the practitioners, it implies that Africa is still using old technologies that may not yield the desired results today.

He called on researchers and academics to facilitate the interplay between individuals, the new knowledge and the actual context in which new evidence is being operationalised and used in daily practice so that it gets to the end user by also ensuring that the applicability of the research results is locally evaluated.

However, Crisp said, much of the change needed to get research to practice is anchored on leadership and getting all stakeholders to assimilate the new factors.

“Otherwise, it just remains something that somebody researched and [got a PhD for] … So we need to find systematic ways of making sure the research findings that show the evidence for the change and the improvement of [what] we do find their way into practice,” said Crisp.

Connecting with communities

Associate professor Lindelani Mnguni, the assistant dean at the University of the Witwatersrand’s faculty of health sciences, said that, as the call for the production of PhDs heightens, there’s a need to critically question the function of academia in the context of the challenges facing Africa.

“It’s great to publish and produce PhDs … but how are we addressing the challenges facing communities – like matters related to education and environmental health?” Mnguni challenged the delegates.

He said that universities and the research community tend to be alienated from the communities around them yet they are supposed to be involved in the process of research. He reiterated that academia needs to increase efforts of awareness about research so as to heighten the value of research and also attract commercial interests in research.

Arguing that academia may not be doing enough to solve the problems of the continent, like strengthening healthcare systems to effectively manage disease outbreaks, Mnguni urged the delegates to leverage knowledge generated from research, data science and machine learning to help strengthen Africa’s health systems and improve livelihoods.

More work needed on health systems

Other academics also highlighted the importance of doing multidisciplinary research that is focused on benefiting end-users.

Said Dr Catherine Kyobutungi, executive director of APHRC and co-director of CARTA: “We need to solve complex problems in society … we need to learn, unlearn and look at the world from different perspectives … that [is] why we call for multidisciplinary research.”

Professor Salome Maswime, the University of Cape Town’s head of global surgery, urged for a shift from offering services research to improvement of systems to secure the future of research in Africa.

“We only know how to treat sick people. But who heals a sick health system?” said Maswime.

As the interventions to produce more PhDs pick up momentum, Maswime urged for the setting of a research agenda that is driven by local stakeholders and also funded locally through public funds.

“We need to design research interventions that are systems-oriented … People need to benefit from the advancement of science and, so, bridging the gap between health services and health systems is the future of public health research in Africa,” she said.