My daily interactions with patients in my medical practice revealed the many challenges which impact on health in Ghana. These ranged from inadequacies in health provision at the community level through to state and health policy barriers, which often resulted in a recurring pattern of my patients presenting to clinic with preventable illnesses. These experiences largely influenced my decision to enrol in a postgraduate degree programme with a global health research focus and have enabled me to explore the wider determinants of health.
I have since gained insights into the complexities of governance, policy development, implementation and research in this field. Importantly, I appreciate the progress made on global initiatives aimed at promoting fairness in research, especially as pertains to Africa and low-resourced countries.
However, much more remains to be done in the global health research space as evidenced by the repeated calls for decolonizing research which highlight inequities at the various stages of the research cycle: from research conception and initiation to publication and dissemination of findings and, importantly, the effective translation of research into policy and practice without which research for development fails to achieve its goals.
Decades after African countries attained independence the discourse on colonialism and its ramifications often provokes strong divergent opinions and emotions, and there is hardly ever a consensus on the negative and positive impacts of colonial rule. Contemporary society has undoubtedly been shaped by past events which often propagated racial discrimination thus, the vestiges of colonialism have lingered, finding expression in subtle ways in all sectors including research.
The enduring perception of inferiority of African research, evident in their portrayal in reports, articles and in dialogue, the undervaluing of the role of African researchers in research governance and practice and the disregard for contextual and participant perspectives are key barriers to achieving equity in research.
A complete transformation of this deep-rooted perception driven by a willingness to embrace change and concerted efforts of researchers, research participants, funders, African country governments and policy makers will be crucial in overcoming these challenges. Research itself can be a tool for exploring the intricacies of these challenges, identifying bottlenecks and devising feasible solutions aimed at advancing fairness in research practice.
“Engagement” and “collaboration”, which are at the core of existing policies to advance equitable research, have become common place jargon in the international development field, only stated to satisfy research requirements without being explicitly elaborated on in practice. Here, funders can play a vital role as gate keepers by requiring grantees to demonstrate a full uptake of these principles in research practice as with other tenets of good research such as data sharing. A modification of research conduct can also be encouraged such that ethnographies are embedded in research proposals for development programming allowing for in-depth exploration of contexts and culminating in the practical solutions to developmental challenges in Africa. African governments and policy makers must also prioritise research for development in national agenda and institute sustainable strategies for building research expertise and capacity in partnership with other global actors in the research for development sector.
As an African beginning a career in global health policy research, I am certainly encouraged by my experiences while working with researchers and mentors in UKCDR and the Centre for Tropical Medicine and Global Health, University of Oxford, who have through their work advocated for inclusivity of diverse perspectives and equitable partnerships in global health research. Their current efforts to facilitate context-tailored research during this COVID-19 pandemic in Africa and less-resourced settings exemplify the purposeful steps needed to be taken to address research challenges in Africa and the developing world.
Dr Emilia Antonio trained as a medical doctor and practised for four years in both public and private hospitals in Ghana. She has just completed a Master’s degree in International Health and Tropical at the University of Oxford and is currently working as a freelance research and policy assistant with the UKCDR. Her research interests are in global health policy and maternal and child health.
Image credit: Shubham Dhage via Unsplash