An Assessment of the performance of the National Health Research System in Mauritius to accelerate progress towards Universal Health Coverage

Abstract Background: The goal of universal health coverage (UHC) is that every individual has access to quality health services without running the consequences of financial hardship. The World health report 2013 "Research for universal health coverage" states a performant National Health Research Systems (NHRS) can contribute by providing solutions to challenges encountered in advancing towards UHC by 2030. The WHO Regional Committee for Africa adopted a resolution in 2015 urging member states to strengthen their NHRS to facilitate production and utilization of evidence in policy development, planning, product development, innovation, and decision-making. This study aimed to calculate NHRS barometer score for Mauritius in 2020, identify the gaps in NHRS performance, and recommend interventions for boosting the Mauritius NHRS in the pursuit of UHC.Methods: The study used a cross-sectional survey design. A semi-structured NHRS questionnaire was administered and complemented with a review of documents archived in pertinent Mauritius Government Ministries, universities, research-oriented departments and non-governmental organizations websites. The African NHRS barometer developed in 2016 for countries to monitor the RC resolution implementation was applied. The barometer consists of four NHRS functions (leadership and governance, developing and sustaining resources, producing and utilizing research, financing research for health [R4H]), and 17 sub-functions.Results: In 2020, Mauritius had an overall average NHRS barometer score of 60.84%, a 38.27% improvement compared to a score of 44.0% in 2018. The four NHRS functions average indices were 50.0% for leadership and governance, 77.0% for developing and sustaining resources, 52.0% for producing and utilizing R4H, and 58.2% for financing R4H. The overall NHRS barometer score improvements are attributed to the underlying performance growth of 50.0% in leadership and governance, 29.0% in developing and sustaining resources, and 16.4% in financing R4H. Conclusion: The performance of NHRS could be improved further through the development of a national R4H policy, strategic plan, prioritized agenda, and national multi-stakeholder health research management forum. Furthermore, increased funding for the NHRS may nurture the human resources for health research capacities, hence the number of pertinent publications and health innovations.