October was a very busy month in the global health arena. There was the biennial Global Health Symposium on health system research which took place at the ACC Liverpool in England.
It was chiefly advancing health systems for all in the Sustainable Development Goals (SDG) era. Then came the 10thWorld Health Summit that took place in Berlin Germany whose key themes were health system strengthening, access to medicine, and health digital revolution.
Finally, there was the Global Conference on Primary Health Care (PHC) in Astana, Kazakhstan supported by the WHO, Unicef and the government of Kazakhstan that was also marking the 40th year since Alma Ata primary care declaration.
The three events had two things in common. One, they were focusing on eliciting solutions to support the achievement of SDGs and Universal Health Coverage (UHC) in the primary healthcare and health system space.
This agenda is in line with one of the four pillars that jubilee government has been seeking to achieve by 2022: UHC. Second, they provided strategic avenues for development of critical discourse in the current global health agenda shaping the political economies of healthcare.
There was a lot of diversity within the conferences with interdisciplinary and international attendees from across the globe and the atmosphere was of academic freedom. Of the attendees, Kenya was well represented; however, nearly all Kenyan participants were from non-governmental organisations, private sector, local research institutions, and private universities. A few were from either the county or national governments. Notable absentees were dons, researchers, or students from our local public universities despite the meetings providing an enabling environment for participants from low- and middle-income countries to attend.
It was appalling not to have a single don or at least a student present research finding or even co-create ideas with such global audience especially amid the ongoing debate of Kenyan health system strengthening domain. Also astounding, was the fact that of all the PhD and master’s students in different domains of healthcare in our local public universities, none was out there to disseminate their findings to the larger global audience. Notable subjects that were being discussed were health economics, healthcare management, health policy, governance etc. for which Kenya is a leader. In fact, some of the success stories that were being presented and celebrated were based in Kenya but done by non-Kenyans. Thus, this left me wondering whether the absence of pubic university participants was due to lack of interest or lack of knowledge especially in the priority government discussions of PHC or UHC. So, what could be the problem?
Firstly, I acknowledge that local public universities have put in place some incentives to encourage and support lecturers to participate in research, attend conferences, and be a first author in a high impact peer reviewed publication. However, the problem is that most lecturers particularly in the research field see this as “peanuts” and hence look for better sources of finance in things such as short-term consultancies which are easy and provide quick money. With the current economic downfall, most dons in public universities are obsessed with get-rich quick schemes and running their own consultancy firms, clinics, and hospital in bids to compete and appear better than some of their rich students. The trade-off is significant: Money or research. The latter requires you to have done so much work in reading and writing before making the former. At what point do we say that the dons have made enough money and thus need to expose themselves or at least their students to such international events that shape the global healthcare discourse?
Secondly, public universities are still trailing behind in developing strategic collaborations particularly in health research. This could be explained by the fact that there is stiff competition for such collaborations or that we have little interest in them; hence, fewer research work. Where collaborations exist, majority of the dons are not capacity-building their student enough to compete for opportunities or even present their work in such global gatherings. We must appreciate that, aside from traditional teaching methods, appearance in such international sphere has a potential to catapult a university higher in terms of ranking.
Thirdly, to keep with the current requirement that lecturers must publish and present original work, majority are left to rely on their students to churn out work as part of their masters and PhD studies for which they present or publish together. A small part of the work is of high impact but is rarely disseminated to the global audience and only shelved as part of the achievement of the “degree”.
On the other hand, the bulk of students from local universities — both masters and PhD — are more concerned about finishing their degrees than acquiring knowledge. It is not uncommon to find a masters or a PhD graduate from our local public institutions in Kenya who cannot do a basic literature review or critiquing work without plagiarising or even apply basic research skills. Students are also not incentivised enough to learn the benefits of being exposed to such international symposia. Developing an abstract, the basic requirement for participation in the events, is an essential skill that takes little time to build.
Boniface Oyugi, PhD Fellow in Health Policy and Health Economics,Centre for Health Services Studies (CHSS),University of Kent.
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