While there is increasing recognition of the importance of stakeholder involvement in health research priority setting there is a paucity of literature reporting on stakeholder involvement in health research priority setting in low income countries. This paper fills this gap by identifying and discussing the roles and legitimacy of different stakeholders (including the public and patients) involved in the health research priority setting process in Zambia; identifying the barriers to public participation and proposing improvement strategies. We interviewed 28 policy makers and practitioners who had participated in the national level health research priority setting in Zambia. Reported participants in health research priority setting included research users, researchers, research funders and the community/ public. Research funders were thought to have undue influence while the public and patients were not effectively involved. This could be due to the public’s lack of education, lack of resources to facilitate public involvement and limited skills to meaningfully engage the public. Participation of people from rural areas, women and young professionals was also limited. While there is a commitment to broad stakeholder involvement in health research priority setting, there’s limited public/patient involvement. Public education, availing more resources, and skills to meaningfully engage the public need to be explored. The undue influence of research funders should be mitigated and incentives availed to ensure that they align their research funding with the national priorities. These efforts would strengthen meaningful stakeholder engagement in health research prioritization within Zambia and other similar contexts. Background Stakeholder involvement in health research priority setting contributes to the legitimacy and acceptability of the priorities. Hence legitimate priority setting should involve a broad representation of stakeholders including the public. While there is a growing body of literature on health research prioritization in low income countries, there is a paucity of literature reporting on stakeholder involvement in the process. The objectives of this paper are to; 1) identify the stakeholders who were involved in the health research priority setting process in Zambia; 2) discuss the roles and perceived legitimacy of the stakeholders and analyze the degree to which patients/ public was involved; 3) To discuss some of the barriers to stakeholder participation in Zambia and similar contexts and to propose improvement strategies. Methods This was a qualitative study involving 28 in-depth interviews with stakeholders who had participated in the national level health research priority setting exercises in Zambia. An interview guide was used. Audio recorded interviews were transcribed and analyzed using INVIVO 10. Analysis of the Stakeholders’ theme involved identifying the different dimensions of stakeholder involvement as discussed in the interviews. Results Identified stakeholders included; research users, researchers, research funders and the community/ public. We found that health research priority setting involved research users, researchers, research funders and the community/ public. However, research funders were thought to have undue influence while the public and patients were not effectively involved. While the respondents recognized the advantages of involving the public and patients, they were not effectively involved. This could be due to the public’s limited understanding of the technicalities of priority setting, lack of resources to facilitate public involvement and limited skills to meaningfully engage the public. Participation from rural areas, women, and young professionals was also limited. Conclusions While there is a commitment to broad stakeholder involvement in health research priority setting, the public is left out. Efforts such as public education, availing more resources, and skills to meaningfully engage the public need to be explored. The undue influence of research funders should be mitigated through their direct involvement in the prioritization process and incentives to ensure that they align their research funding with the national priorities. These efforts would strengthen meaningful stakeholder engagement in health research prioritization within Zambia and other similar contexts.

中文翻译：

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利益相关者参与低收入国家卫生研究重点的确定：赞比亚案例

虽然人们越来越认识到利益相关者参与卫生研究重点设置的重要性，但关于利益相关者参与低收入国家卫生研究重点设置的文献报道却很少。本文通过确定和讨论参与赞比亚卫生研究优先事项确定过程的不同利益相关者（包括公众和患者）的作用和合法性来填补这一空白；识别公众参与的障碍并提出改进策略。我们采访了 28 位参与赞比亚国家级卫生研究重点设置的政策制定者和从业人员。报告的健康研究重点设置参与者包括研究用户、研究人员、研究资助者和社区/公众。研究资助者被认为具有不当影响，而公众和患者并未有效参与。这可能是由于公众缺乏教育、缺乏促进公众参与的资源以及有效地让公众参与的技能有限。来自农村地区的人、妇女和年轻专业人员的参与也受到限制。虽然承诺广泛的利益相关者参与健康研究优先事项的设置，但公众/患者的参与有限。需要探索公共教育，利用更多资源和技能来有意义地吸引公众。应减轻研究资助者的不当影响，并采取激励措施确保他们的研究资助与国家优先事项保持一致。这些努力将加强利益相关者在赞比亚和其他类似情况下对健康研究优先事项的有意义参与。背景 利益相关者参与卫生研究优先事项的设置有助于优先事项的合法性和可接受性。因此，合理的优先级设置应该涉及包括公众在内的利益相关者的广泛代表。虽然关于低收入国家卫生研究优先次序的文献越来越多，但关于利益相关者参与该过程的文献报道却很少。本文的目标是；1) 确定参与赞比亚卫生研究重点确定过程的利益相关者；2) 讨论利益相关者的角色和感知的合法性，并分析患者/公众参与的程度；3) 讨论利益相关者参与赞比亚和类似情况的一些障碍，并提出改进策略。方法 这是一项定性研究，涉及对参与赞比亚国家级卫生研究优先事项确定活动的利益相关者进行的 28 次深入访谈。使用了面试指南。使用 INVIVO 10 转录和分析录音采访。利益相关者的主题分析涉及识别采访中讨论的利益相关者参与的不同方面。结果 确定的利益相关者包括在内；研究用户、研究人员、研究资助者和社区/公众。我们发现，健康研究优先级设置涉及研究用户、研究人员、研究资助者和社区/公众。然而，研究资助者被认为具有不当影响，而公众和患者并未有效参与。虽然受访者承认让公众和患者参与的好处，但他们并没有有效地参与。这可能是由于公众对确定优先事项的技术了解有限，缺乏促进公众参与的资源，以及有意义地让公众参与的技能有限。来自农村地区、妇女和年轻专业人士的参与也很有限。结论 虽然有广泛的利益相关者参与健康研究重点设置的承诺，但公众却被排除在外。需要探索诸如公共教育、利用更多资源和技能以有意义地吸引公众的努力。研究资助者的不当影响应通过他们直接参与优先排序过程和激励措施来减轻，以确保他们将研究资金与国家优先事项保持一致。这些努力将加强利益相关者在赞比亚和其他类似情况下对健康研究优先事项的有意义参与。