Strengthening capacities and resource allocation for co-production of health research in low and middle income countries

Ghana’s universal health insurance scheme provides a good example of co-production of research. In 1991, Ghana’s director of medical services asked researchers to determine whether health insurance could be an equitable and feasible health financing option in a low income country, such as Ghana, with a large informal sector. The research team, which had expertise in public health, health policy and systems, and medical anthropology, worked with frontline health workers and managers, local government, community members, and leaders to explore the acceptability, design, and feasibility of a district-wide health insurance scheme. The resulting design embedded principles of equity and social solidarity and ensured financial sustainability in a resource constrained context, and evidence from this research informed the Ghana national health insurance scheme (NHIS), which was launched in 2001.1234

This example shows the important role that co-production of health research can have in generating relevant evidence and innovative, context specific solutions for public health and clinical care challenges. Despite this potential and the growing literature, co-production remains relatively limited in low and middle income countries (LMICs).56789 Globally, researchers in high income countries lead most current work. For example, a rapid PubMed search on 19 October 2020 yielded 2009 articles for the terms “co-production” and “research.” Adding the terms “developing country/countries” or “low- and middle-income country/countries” reduced the results to fewer than 30. This neglect in LMICs is partly because of capacity and funding challenges. In this article we share experiences and ideas for capacity strengthening and resource allocation for health research co-production in LMICs.