After a nine-month consultative process, the President's Malaria Initiative (PMI) Insights Project has identified 33 priority operational research (OR) and program evaluation (PE) topics for the sub-Saharan Africa (SSA) region that aim to address key pressing gaps in malaria policy, strategy, and implementation guidance. The prioritized list of research topics will serve as a key resource for maximizing the relevance and impact of OR and PE investments by galvanizing a coordinated effort among funding agencies, national malaria programs, and research partners to fill critical knowledge gaps identified by malaria-endemic country stakeholders.
Given the emphasis placed on locally-led research in the U.S. President's Malaria Initiative’s (PMI) latest strategy to end malaria faster, the consultive process engaged 128 global, national, and local stakeholders in order to ground the topics in malaria endemic country perspectives. An external evaluation committee assessed each topic’s relevance and potential for impact across SSA countries. The committee was composed of seventeen malaria experts from national malaria programs, research institutions, and the World Health Organization across fifteen different countries in SSA.
Professor Evelyn Ansah served as co-chair on the evaluation committee. Professor Ansah is the Director for the Center for Malaria Research at the University of Health and Allied Sciences in Ghana. She leads and co-leads several studies on malaria diagnostics, a qualitative evaluation of the new RTS,S vaccine, and implementation research on the delivery and uptake of new medical interventions.
Professor Ansah shared her reflections on the evaluation committee’s role in the research prioritization process.
Q: How would you describe your experience participating as co-chair of the evaluation committee?
A: The evaluation process was consultative and interesting. I was consulted earlier in the research prioritization process when different experts and stakeholders were interviewed on the areas of research that they thought were important. I was subsequently asked to serve as one of the co-chairs for the prioritization of the collated research topics.
During the first phase of the evaluation process, we were asked to individually score the OR and PE topics across a set of evaluation criteria, including: whether the topic is broadly relevant across malaria-endemic settings, contributes to high impact on malaria burden, improves efficiency in the delivery of malaria interventions, addresses inequities in coverage and malaria burden, addresses an intervention or approach that is scalable and sustainable, and is feasible to implement the research. We then came together to review and discuss the aggregate scores. Committee members were so engaged in the discussion of the topics that when we ran out of time during our scheduled meeting; the committee happily agreed to reconvene for a second meeting to finish up the work.
These meetings were very critical. We found that committee members scored the topics from their different perspectives as program managers, policy makers, and researchers across a range of transmission contexts, from high burden to low transmission and elimination settings. The discussion allowed us to better understand the context and rationale behind how various committee members evaluated the topics.
Q: Which of the topics that emerged from the prioritization process are most relevant for the setting you work in?
A: Many of the research topics are relevant for Ghana where there is a high burden of malaria. Some of the topics I can see being used in Ghana are those that are focused on data (see box on right). These topics are relevant across many country settings where data quality is not quite up to standard, making it difficult for countries to make evidence-based decisions. So, I was glad to see topics on data quality improvement included in the prioritized list.
Q: What are your hopes for how the list of prioritized topics will be used globally?
A: I hope to see the list of OR and PE topics used by many different stakeholders. First, national malaria programs could pick from these topics that have been crafted well and carry out those that support the implementation of their program. In addition, research institutions could use the priority list to inform what they want to focus on in support of the national country program. Finally, funders could use this priority list to call for proposals so that solutions to implementation challenges could be found in as many settings as possible.
There should also be a platform to house information on the evidence generated across these topics. Program managers, partners, and other stakeholders could use the platform to find the information on studies carried out in different settings. Given the scarce resources available for research, this can help avoid duplication of efforts and improve the efficiency of research efforts.
I look forward to seeing how this list is used to coordinate malaria research and maximize impact globally and for the sub-Saharan Africa region in particular where the burden of malaria is highest.
Additional information on the malaria OR and PE research prioritization setting process and the latest updates on related research can be found at https://www.insightsmalaria.org.