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A forum convened by Kenya’s Ministry of Health (MoH) and AFIDEP on May 8, 2014 at the MoH headquarters in Nairobi marked the launch of the SECURE Health program’s Steering Committee. The SECURE Health (Strengthening Capacity to Use Research Evidence in Health) program is being implemented in Kenya and Malawi, with the overarching aim of strengthening individual and institutional leadership and capacity for increased utilization or consideration of research evidence in health sector decision-making, planning, and programming.
The forum was the inaugural meeting of the program’s steering committee, which comprises leading experts from the MoH and health research institutions. The forum, which was presided over the Principal Secretary, MoH, Prof. Fred H K Segor, deliberated the design of the SECURE Health program, emphasizing the value of the program to the realization of the goals of the Ministry. In his keynote address, Prof Segor said that, “the SECURE Health program is in tandem with our efforts for the realization of the Ministry’s goals because we need programs that support our use of data in enabling us to make better decisions and plans.”

By hosting this meeting, the MoH demonstrated its interest and support for the SECURE Health program, which is critical for the program’s success. Only last year, the Ministry established the Division of Health Research and Development; the DHR&D has embraced the SECURE Health program as one of its main “take-of” programs. Dr. Esther Ogara, a senior expert in the MoH’s Research Division and a member of the Steering Committee said that, “the SECURE Health program is very timely as it will strengthen the work of the research division.”

Senior Health Bureaucrats and Scientists attend the Forum

In addition to the PS and Dr. Ogara, others present at the meeting were Dr. Masasabi Wekesa, MoH’s Head of the Directorate of Planning; Dr. Patrick Amoth, MoH’s Head of Family Health division; Dr. David Soti, MoH’s Head of Informatics and M&E; Dr. James Mwitari, senior expert in the Health Research division; Dr. Maurice Siminyu, Busia County Health Executive and Chair of the Council of County Health Executives. Notable members from academia were Prof James Machoki, Deputy Director, Institute of Infectious and Tropical Diseases, the University of Nairobi; Dr. Elizabeth Bukusi, Deputy Director-Research, Kenya Medical Research Institute (KEMRI). SECURE Health program partners present included: Dr. Marsden Solomon, Programs Director, FHI 360 (Kenya Office); Dr. Eliya Zulu, AFIDEP’s Director; Dr. Samson Wasao, AFIDEP’s Director of Programs; and Mr Jones Abisi, AFIDEP’s Policy Advocacy Coordinator.

Using Research Evidence to Realize National Goals for Health

Speaking at the meeting, Dr. Zulu said that the SECURE Health program’s main purpose was to support the government’s realization of its national goals for health. As such, the program’s partnership with the MoH will ensure that its interventions focus on the Ministry’s priorities. “We want the Ministry to identify the bottlenecks that need to be addressed to enable increased use or consideration of research evidence. We also want the Ministry to tells us the priorities that the SECURE Health program should focus on,” said Dr. Zulu.

Involving KEMRI and the University of Nairobi in the SECURE Health program will strengthen the link between researchers and policymakers and contribute towards the generation of research that is required by the Ministry. For a long time, government and independent research institutions have conducted a wide array of health research initiatives. But the key question is, what is driving the research agenda for health in Kenya? Dr. Bukusi from KEMRI noted that there is a huge gap between the research conducted and the country’s health needs. “What are the research priorities for the country?” she asked. This is a critical reflection that the SECURE Health team plans to address. SECURE Health program’s national partner in Kenya, the Consortium for National Health Research (CNHR), is already leading collaborative efforts with the MoH to develop the first ever research agenda for health in Kenya.

Highlighting the usefulness of the SECURE Health program to county governments, Dr. Siminyu said that counties were in the process of developing own health policies, but the research needed to inform these policies was lacking. He noted, for instance, that the jigger menace was a big health challenge in many rural counties including Busia, but there is no clear research on how this issue can be effectively tackled.
The backbone of the SECURE Health program is to enable more policymakers to utilize research evidence in decision-making, planning and programming. Therefore, it is paramount that there’s a national research agenda as well as county-specific research agenda to ensure that the limited resources available are invested in relevant research.

Capacity, Capacity, Capacity!

Weak technical capacity to utilize research evidence came out strongly as a major gap within the MoH. This is one of the key areas the SECURE Health program seeks to strengthen. Dr. Soti pointed out that there is plenty of data and information within the MoH, but the capacity to analyze these data is lacking. Dr. Solomon of FHI 360 reiterated this point, noting that there is need to demystify research to clinicians and other health workers because they view research as “something very complex highly specialized skills”. Said he, “a clinician at a health facility in the rural areas for instance, collects a lot of data on a daily basis with patients presenting with various ailments. Training such a health worker on how to analyze these data would be very useful in guiding health development decisions at that level.” Pointing to the poor research culture in Kenya, Dr. Bukusi asked, “What kind of students are we training at our universities? Students need to learn how to ask questions and use the information available to make decisions.” She noted that the education system was not producing students who are research savvy, an issue that compounds the research-to-policy gap.

The Parliament Angle

The fact the SECURE Health Program also focuses on working with the parliament in enhancing research use was hailed at the meeting as important. Dr. Soti noted that having some interaction with the parliamentary committee on health was important for the MoH because often the committee has health concerns that the MoH can respond to. Earlier Prof. Segor had noted that research is critical in the MoH’s engagement with parliament. He cited the case of miraa (a local herb grown in Kenya), which caused heated debate over whether it miraa is a drug or not. Another topical discussion in parliament has been the prevalence of cancer in certain parts of the country (e.g. in Marsabit), which has raised concerns over what could be the probable cause(s) and how the government can address these. These were cited as examples that the MoH would be better able to respond to if officials keep abreast with existing research on issues.

A Full Plate for SECURE Health Program?

If the discussions at this forum are anything to go by, then the SECURE Health program has its work well cut out for it. The good news is that the beneficiaries of the program (i.e. senior policymakers, technocrats, and politicians) are willing to participate in the program, and the critical partners have their helping hand stretched out.

For more information on the SECURE Health program click here