Table 1.

Summary of priority setting process, success, challenges and recommendations

Title	Process	Success	List of identified priority areas	Challenges	Recommendations
Ministry of Health (MoH) 2008, Country Report Alignment and Harmonization in Health Research	− Tracking what research had been done − Small group brainstorming sessions − A National Health Research meeting that brought together different stakeholders (200 to 300 people involved) − Synthesis of key research findings by a team of experts	− Integration of the various processes into a coordinated system − Development of processes through which research outcomes could be continually fed into policymaking and programme implementation − Identification of a process for updating the priorities	− Malaria − Child health − Nutrition − Diarrhoeal diseases − Reproductive health − Sexually transmitted diseases/HIV/AIDS/tuberculosis/leprosy − Water and sanitation	− The process was disease focused, which affects priority research − Process was not a very representative or inclusive − The influence of donors was also cited as a problem that skews health research priorities − Current donor interest in certain conditions influences the availability of research funds	− Formalised process be established for participatory health research − Priority setting and review with a clear listing of all relevant stakeholders to be involved
August 2010 to March 2011, Zambia Forum for Health Research	− Worksheets for summarising the approach for prioritising topics for policy briefs were given to participants − The participants were then divided into working groups − The scope of the priority-setting process was limited to the topic of sexual and reproductive health	− All stakeholder groups (those that would be affected by the outcome of the policy) were represented at the workshop and all participated in the process; this enabled a wide range of reproductive health priority topics to be identified − The method used was transparent − Participants had an opportunity to take an active part in compiling the list of priority topics	− Promoting the use of misoprostol in labour specifically to prevent haemorrhage after delivery at home − Ensuring that all maternal deaths are notifiable − Encouraging research at the district level − Fostering the involvement of traditional leaders in reproductive health programmes	− The input of some participants was overshadowed by those who were more outspoken; some vital contributions may have been missed as a result − Some important topics, including the reasons for the drastic decline in facility-based births; tackling abuse at facility-based births emerged only after the workshop; these topics were provided by individuals who were unable to attend the workshop	− Adopt a standard national priority-setting tool − Financing of priorities for research
2011, MoH Program Managers	Using the Medium-Term Expenditure Framework approach	- Had a comprehensive list of priority setting lists for the all country	− Child health − Cancer diseases hospital − Reproductive health − Health education − Oral health − Pharmacy − Non-communicable diseases − Virology laboratory − Malaria − Antiretroviral therapy − Nutrition − Tuberculosis − Mental health and substance abuse	− Period to get consensus from all stakeholders was short − Not all stakeholders were involved in the process, especially the community − Implementation was affected by lack of resources to carry out the priority setting research	− Adopt a standard national priority-setting tool − Allocate resources to implement the priority areas identified − Enforce the National Health Research Act No 2 of 2013
October 2011, Maternal, Neonatal and Child Health Priority Setting Case, Zambia	Child Health and Nutrition Research Initiative method	− It was short, focused − It was responding to a specific program area − It was easy to identify stakeholders − It was transparent	− How can community-based neonatal care be strengthened to reduce mortality and morbidity in Zambia? − How can strategies to reduce adolescent/teenage pregnancies be strengthened in Zambia? − How can we improve the proportion of institutional deliveries? − How can child immunisation coverage be improved? − What is the effectiveness of different models to attract and retain doctors, nurses, and technicians in rural and hard to reach areas? − What incentives can be used to improve attendance for postnatal care in Zambia? − How can we improve early ANC attendance in the first trimester?	− It was externally driven − The was no post evaluation of the process or follow-up	− Priority-setting activities should be locally driven and standardised − Global partner should buy into national priorities as is being recommended by WHO ESSENCE
2007 to date (Annually) National Science and Technology Council Strategic Research Fund	Receiving priority areas from all sectors	− Multi-sectoral and funds are allocated to fund research − It is transparent − There is standard call for proposals − Standard proposal evaluation − The funding is predictable − It is efficient and locally driven	− Communicable diseases − Non-communicable diseases − Maternal diseases − Nutritional diseases	− Process for selecting the priority areas in each sector is not standardised though guided by the Five-Year National Strategic Development Plans	Standardised intra-sector priority setting