Research funding impact and priority setting – advancing universal access and quality healthcare research in Malaysia

Abstract

Background Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia. Methods Research impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search. Results Seventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders’ expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare. Conclusion The concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential. Electronic supplementary material The online version of this article (10.1186/s12913-019-4072-7) contains supplementary material, which is available to authorized users.

What funders are doing to assess the impact of their investments in health and biomedical research

“…The 2017 report utilized the updated Researchfish ® 18 data set and included the new revised set of United Kingdom Research Councils common indicators for research assessment. Finally, some funders commissioned impact assessment studies to explore a specific dimension of their portfolio’s impact: Fun et al in Malaysia examined how RIA could be incorporated into the research priority-setting and funding allocation process [ 84 ], and Pelletier et al in Canada explored how RIA could be used to understand a research programme’s field-building reach [ 61 ].…”

“…Among the 18 projects that conducted surveys to gather information on project outputs, outcomes and impacts, surveys were typically sent to project leads, who were described as principal investigators (PIs), grantees or contracting officer/project representatives. In two instances, surveys were used to gather viewpoints on stakeholder impressions of research relevance [ 84 ] and to ask Cochrane Review Groups staff about their views on the impacts of funded Cochrane reviews [ 70 ]. Semi-structured interviews were typically used in two ways: (1) to talk more in depth with PIs or project leads about their views on what factors contributed to project impacts, or (2) to capture viewpoints on project impacts from other stakeholders or key informants.…”

“…Other methods utilized included (1) expert workshops or consensus meetings to discuss case studies and impact pathways [ 69 , 71 ]; (2) project scoring [ 68 ] using methodology from Kwan et al [ 92 ], project scoring using the FAIT scorecard narrative and review method [ 65 ], project scoring using the Agency for Healthcare Research and Quality (AHRQ) impact scoring methodology [ 59 ], or expert review panels to determine whether projects produced statistically significant changes in project outcomes [ 67 ]; (3) assessing the relevance of the project to the thematic priority areas [ 82 ]; and (4) determining the impact of journal publications through expert review [ 76 ]. Some articles employed literature reviews [ 51 , 60 , 77 , 84 ] or landscape analyses [ 61 ]. Fun et al explored the research priority-setting processes of stakeholders using the Child Health and Nutrition Research Initiative methodology as part of a study to determine stakeholder values around research priority-setting [ 84 ].…”

“…Some articles employed literature reviews [ 51 , 60 , 77 , 84 ] or landscape analyses [ 61 ]. Fun et al explored the research priority-setting processes of stakeholders using the Child Health and Nutrition Research Initiative methodology as part of a study to determine stakeholder values around research priority-setting [ 84 ]. Three studies used the internal rate of return to determine research returns [ 35 , 62 , 72 ], and one study used cost–benefit analysis [ 65 ].…”

Challenges and opportunities for health policy and systems research funding in the Western Pacific region

“…Malaysia has had a Health Research Priority program to support informed funding decisions since the late 2000s, but it is focused on biomedical or clinical research, rather than HPSR. 8 Involvement of political leaders increases overall research funding Some countries have political input into their research priorities; for example the Prime Minister of Singapore and the Federal Health Minister of Australia are involved in shaping research priorities (and therefore funding priorities). Other countries rely on senior technocrats for research priority-setting, for example, Malaysia and Hong Kong.…”