The Political Economy of Universal Health Coverage Reforms: building capacity and engagement of francophone Africa

This project aims to develop a strong, effective and equitable research partnership between research institutions in the UK and francophone Africa and to strengthen research capacity in the area of political economy for UHC. Our goal is to contribute to progress towards UHC by building networks with stakeholders and communities.

Achieving Universal Health Coverage (UHC) is a global priority to ensure health for all and reduce health inequalities (SDG3.8). However, progress towards UHC is an inherently political process.

Political economy analysis (PEA) is an essential tool in the field of health policy and system research to shed light on the barriers and facilitators of UHC reforms. Although recent work has been done to develop PEA frameworks for UHC and to apply PEA, francophone Africa remains understudied and underrepresented in the research arena.

The project aims to develop a research partnership to catalyse a formative, collaborative programme of work and to strengthen research management, dissemination capacity and research skills in the domain of PEA. The objective is to establish an active and engaged programme of PEA research in francophone Africa to support UHC progress, grounded in collaboration with a variety of stakeholders, from government bodies to civil society groups.

Our ambition is to develop a future research project focused on the application of PEA and the creation of a network of national observatories to analyse the political dynamics underlying UHC reforms in a prospective way, with the aim of promoting evidence-informed and politically savvy decision-making and implementation for UHC.

The project is co-led by researchers at the Institute of Global Health and Development (IGHD) of QMU, Edinburgh and the Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD) in Benin.

Other partners include Research for Development International (R4D International) in Cameroon, Recherche pour la Sante et le Developpement (RESADE) in Burkina Faso, and Faculté de Médecine et d’odontostomatologie (FMOS) Bamako (Mali).

This research is funded by the UK’s National Institute for Health Research (NIHR), under the Global Health System and Policy Research (HSPR) funding.



  • To develop a strong and equitable research partnership.
  • To review the existing research literature on political economy approaches to UHC.
  • To develop a needs analysis and refine research questions and priorities through engagement with policy makers and evidence users.
  • To strengthen institutional and individual capacity for political economy research on UHC.
  • To develop a strategy for research uptake and dissemination.
  • To develop a high-quality application able to compete for research funding under NIHR’s planned call for proposals.

External presentations

Skills-building session at the HSR Symposium 2020:

Doing Political Economy Analysis for Health Systems: Challenges and approaches to ensure relevance and policy uptake : ( Available on request via IGHD Email Address )

Presentation at the WHO Health Systems Governance and Finance’s webinar on “COVID-19: the impact on UHC agenda in Africa

Impact of Covi-19 on UHC policy processes : ( Available on request via IGHD Email Address )

Project training and workshops

Due diligence process for research institutions :( Available on request via IGHD Email Address )

The Research Grant and Contract Unit at Queen Margaret University conducted a session on the due diligence process (including how to complete NIHR due diligence questionnaire) required to meet the institutional and funder requirements. A presentation was delivered, with key resources made available and relevant support to help partners through this process.

Stakeholder mapping : ( Available on request via IGHD Email Address )

The objective of this training session - guided by Dr Jean Paul Doussou (project co-PI, CERRUHD, Benin), was to learn to conduct a stakeholder mapping exercise, by providing theoretical and practical understanding of the concept that underpin this tool.

Stakeholder engagement ( Available on request via IGHD Email Address )

This two days’ workshop aimed to strengthen capacity for stakeholder engagement, network building, and research uptake, at country and international level, in line with the project’s overarching goals and the political economy analysis focus. The workshop was delivered by Dr Oliver Escobar (Public Policy, School of Social and Political Science, University of Edinburgh).

Policy  analysis and political economy analysis of UHC ( Available on request via IGHD Email Address )

This one-day workshop, led by Dr Maria Bertone (project PI, QMU), Dr Jean Paul Doussou (co-PI, CERRHUD), Dr Isidore Selenou (Co-I, R4D International) aimed to provide the theoretical basis and practical tools to conduct policy and political economy analysis, particularly applied to UHC. The sessions were a mix of theory and practical exercises that helped participants to become familiar with the main concepts and be able to embed these methods in their research.

Political Settlements for UHC ( Available on request via IGHD Email Address )

This capacity building session aimed to introduce the concept of political settlements. The framework is particularly useful to understand the distribution of organizational power and the economic and political effects of institutions and policies on health. Such theory is complementary to political economy analysis and valuable to better comprehend UHC processes. The training was delivered by Dr Sumit Mazumdar (project advisor, University of York).

Introduction to Social Network Analysis (SNA) for UHC ( Available on request via IGHD Email Address )

This one-day training offered an Introduction to SNA and key background on relational epistemologies, relevant examples and applications of SNA, a practical exercise with UCINet and analysis of the emerging network map. The training was led by Dr Arek Dakessian (Research Fellow, QMU).

Capacity assessment (dropbox files)

A capacity assessment tool (and related guidance) has been developed to assess the capacity needs at individual, organisational and institutional levels of the consortium.

Access of the material and acknowledgment: Partners and colleagues can access the material for fair use (both for individual as well as institutional purposes). Colleagues from low- and middle-income countries do not need to seek permission. We ask all users to acknowledge the source of information (including project name, institution and funder).

NIHR Research Unit on Health in Fragility (RUHF)

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NIHR Research Unit on Health in Fragility (RUHF)

NIHR Research Unit on Health in Fragility (RUHF) 0131 474 0000