The role of research on health equity in Sub-Saharan Africa – the need for a paradigm shift

There is a great need and urgency in achieving Millennium Development Goals in Sub-Sahara Africa . Most of what needs to be done to achieve the health MDGs is already known. The challenge is implementing at scale what is already known. This will entail adoption of new technologies, new ways of implementing interventions as well as tracking progress to answer critical questions of whether we are making progress and achieving the desired impact. For these to happen they need to be accompanied by changes in policies and practices to provide an enabling environment.

An assessment of current research efforts indicates that traditional research methods, capacities and mechanisms are inadequate in meeting the needs for implementation research in the developing world where the need is most. Existing global research networks and interest groups are not set up to provide optimal support for implementation research. This paper explores the availability and use of population based data (mainly Demographic Health Surveys and Multiple Indicator Cluster Surveys) and their potential uses.  Our hypothesis is that there is ample data to support advocacy campaigns generated by the current systems but is not being optimally utilized.  The set up of existing research institutions is too detached from communities to undertake practical implementation research.

We propose a paradigm shift in the organization of operations research networks and roles in order to conduct and ensure the use of implementation research by empowering and making greater use of Civil Society Organizations in the developing world and particularly Africa. We use the work of the African Medical Research Foundation as a case study.