Table 1 Policies to strengthen National Health Research Systems and supporting evidence

Conduct context or situational analyses of current national position to inform strengthening activities

COHRED, in particular, has developed tools to assist countries in conducting situational analyses as part of wider advice [52] and this approach was an important element in the WAHO interventions being successful to the extent that they were [5, 37, 53, 54]. Strategies informed by analyses of their current situation include those for the English NIHR [34] and the Irish HRB [35]

Develop a comprehensive and coherent NHRS strategy

Comprehensive and coherent strategies with at least some degree of success (as seen in progress on some or all of the NIHR functions) had set out how they intended to take action on the range of health research system functions and components, even if not necessarily explicitly using the WHO framework [3]; examples include the strategies for the English NIHR [34], the Irish HRB [35], and in the Philippines [36] and Rwanda [14]

Engage stakeholders in the development and operation of the NHRS strategy

Strategy documents such as those for the NIHR [34] and HRB [35], plus ones in British Columbia [55], Malta [41] and New Zealand [56], describe the importance and/or range of stakeholders engaged in developing the strategy. Articles describing the approach in South Africa [44] and Zambia [57] also highlighted the importance of wide stakeholder engagement. An analysis of stakeholder engagement in the creation and operation of the NIHR identified it as making a key contribution to its success [23]. There is increasing support for the engagement of stakeholders in setting the priorities for research as well as in research processes and translation [7, 38, 51, 58, 59]

Adopt monitoring and evaluation tools that focus on the objectives of the NHRS, including health system improvement

A range of documents, including ones on the NIHR [24], HRB [60] and Rwandan strategies [14], and the World Health Report 2013 [1], demonstrate the importance of adopting monitoring and evaluation approaches that include a focus on assessing the impacts of research on health polices/practice and the economy, e.g. through application of the Payback Framework [60, 61]

Develop/participate in partnerships across regions, bilaterally or within the NHRS

Examples of progress made by partnerships between countries, sometimes along with international organisations and donors, include the WAHO interventions [5, 37, 53, 54] and the work of WHO regional offices for Africa [11, 26] and the PAHO [28, 62]