The Use of Research for Health Systems Policy Development and Implementation in Mozambique: A Descriptive Study

Post-independence health research productivity in Portuguese-speaking African countries: A bibliometric analysis of 43 years of research and higher education in Mozambique

Background

Africa has a high double burden of infectious and non-communicable diseases underscoring the critical need for robust scientific research. However, it is also associated with low scientific research productivity. Mozambique, which gained independence in 1975, serves as a poignant example. However, there remains a notable scarcity of evidence evaluating the country's trajectory in scientific and academic development. This study aims to evaluate 43 years of health-related scientific knowledge production through bibliometric analysis, focusing on key indicators. Additionally, it seeks to characterize the higher education institutions within the country.

Methods

The data was retrieved from the Web of Science Core Collection using an advanced search tool with Boolean research strategies, covering the period from 1976 to 2022 for all PALOP and 1976 to 2019 for Mozambique. To map Mozambican higher institutions, information was sourced from the Ministry of Science Technology and Higher Education database. Descriptive statistics were employed to summarize the findings, while the VOSviewer program version 1.6.19 was utilized to visualize distance-based bibliometric networks, focusing on co-authorship among institutions and keyword co-occurrence.

Results

Portuguese-speaking African countries (PALOP) contribute 2.5 % (10,933 out of 442,309) to Africa's total scientific output, with Mozambique leading at 63.6 % (6,951 publications) followed by Angola at 16.6 % (1,811 publications). All PALOP countries experienced decreased scientific productivity during the third year of the COVID-19 pandemic. In Mozambique, over 70 % (1,710 out of 2,380) of health-related publications from 2011 to 2019 were concentrated in this period. Key journals for health sciences include PLOS ONE, Malaria Journal, and Tropical Medicine & International Health, focusing on HIV, malaria, and tuberculosis. Higher education institutions in Mozambique show regional disparities, with 67.9 % in the South and only 8.9 % in the North, indicating significant inequality in their distribution across the country.

Conclusion

This study highlights Mozambique's significant progress in health research productivity over 43 years, establishing it as a leader among PALOP countries. The substantial increase in publications, particularly after 2008, underscores the nation's growing research capacity and commitment to addressing critical health challenges such as HIV, malaria, and tuberculosis. However, regional disparities in higher education access and limited research contributions from private universities remain high in Mozambique.

Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review

BACKGROUND

An estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review.

METHODS

The scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question.

RESULTS

A total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms.

CONCLUSION

Important barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

The compilation of lessons in this supplement on the Doris Duke Charitable Foundation’s African Health Initiative’s work in the application of implementation research in primary health care in sub-Saharan Africa reflects the evolution of the discipline that is now increasingly recognized as integral to health systems strengthening.