Introduction This analysis was conducted to assess the prioritization of health research by governments of four countries in Sub Sahara Africa.
Methods This was a retrospective comparative analysis of secondary data on prioritization of health research and development in Kenya, Rwanda, Malawi and the Kingdom of Eswatini. Non-random sampling was adopted in the selection of the countries. Secondary data on financing of health and research; legal and policy environment; and public and private sector contribution to research between 2015 and 2019, were pooled and analysed for the sampled countries.
Results All four countries had allocations to health below 15% of the general government expenditures during the focus period. Malawi had the highest at 9.2 to 11.5%; Rwanda at 7.9 to 8.9%; Eswatini at 6 to 9.5%; and Kenya at 5.8 to 6.6%. The Gross Expenditure on Research and Development was below the recommended 2% of GDP in all the countries; 1.06% for Malawi; 0.8% for Kenya; 0.7% for Rwanda; and 0.27% for Eswatini. Most research was donor driven and funded. There were varied levels of non-financial investments in health research including laws, regulations, and institutions. Eswatini had laws on research.
Discussion Low allocations to health limit the budgetary fiscal space for health and health research. This limits government’s control of the research agenda. Anchoring research in law and critical government instruments ensures elevated prioritization and visibility of research to the policy makers. It allows for better coordination and alignment of stakeholders to the national research priorities and country beneficence. Designating public institutions to coordinate and fund research demonstrates policy prioritization of research. Increased investments (financial and nonfinancial) in research signal governments’ commitment and can attract more investments.
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