Data sharing and data governance in sub-Saharan Africa: Perspectives from researchers and scientists engaged in data-intensive research

Impact of the free healthcare policies in Burkina Faso: underscoring important nuances

The article recently published by Aye et al. (2024) in Health Policy and Planning is a major contribution to understanding the medium-term (5 years) effects of the free healthcare policy introduced in 2016 in Burkina Faso. The study makes rigorous use of interrupted time series with a nonequivalent control group and presents a wealth of information on the methodology used. Remarkably, numerous sensitivity analyses were conducted to strengthen the credibility of the results and limit the risk of bias. Three salient conclusions are presented: (I) free healthcare had no effect on the proportion of pregnant women who gave birth in a health center, either immediately or after 5 years; (II) free healthcare led to an immediate and significant increase in the rate of consultations for children <5 years of age; and (III) after this immediate increase, free healthcare led to a gradual decrease in the rate of consultations for children <5 years in the medium term. We believe it is essential to highlight some important nuances regarding these conclusions and highlight some methodological issues.

Equitable Data Sharing in Collaborative Health Research in Sub-Saharan Africa: A Translational Bioethics Perspective

Clinical research is essential for establishing the safety, efficacy, and contextualized effectiveness of medical products. Data from multiple sources such as representative target population studies and health and demographic data obtained through health surveillance systems are required for designing clinical research protocols and for recruitment of participants. In this essay, we review barriers from a complex interplay of ethical, legal, and practical challenges in data governance that hamper sharing health data from these sources in Sub-Saharan Africa. We suggest that a translational bioethics approach offers a valuable framework for addressing these challenges to bridge the gap between theory and practical application of ethical principles in data governance.

Genomics and Health Data Governance in Africa: Democratize the Use of Big Data and Popularize Public Engagement

Effectively addressing ethical issues in precision medicine research in Africa requires a holistic social contract that integrates biomedical knowledge with local cultural values and Indigenous knowledge systems. Drawing on African epistemologies such as ubuntu and ujamaa and on our collective experiences in genomics and big data research for sickle cell disease, hearing impairment, and fragile X syndrome and the project Public Understanding of Big Data in Genomics Medicine in Africa, we envision a transformative shift in health research data governance in Africa that could help create a sense of shared responsibility between all stakeholders in genomics and data-driven health research in Africa. This shift includes proposing a social contract for genomics and data science in health research that is grounded in African communitarianism such as solidarity, shared decision-making, and reciprocity. We make several recommendations for a social contract for genomics and data science in health, including the coproduction of genomics knowledge with study communities, power sharing between stakeholders, public education on the ethical and social implications of genetics and data science, benefit sharing, giving voice to data subjects through dynamic consent, and democratizing data access to allow wide access by all research stakeholders. Achieving this would require adopting participatory approaches to genomics and data governance.

Trust as moral currency: Perspectives of health researchers in sub-Saharan Africa on strategies to promote equitable data sharing

Groundbreaking data-sharing techniques and quick access to stored research data from the African continent are highly beneficial to create diverse unbiased datasets to inform digital health technologies and artificial intelligence in healthcare. Yet health researchers in sub-Saharan Africa (SSA) experience individual and collective challenges that render them cautious and even hesitant to share data despite acknowledging the public health benefits of sharing. This qualitative study reports on the perspectives of health researchers regarding strategies to mitigate these challenges. In-depth interviews were conducted via Microsoft Teams with 16 researchers from 16 different countries across SSA between July 2022 and April 2023. Purposive and snowball sampling techniques were used to invite participants via email. Recorded interviews were transcribed, cleaned, coded and managed through Atlas.ti.22. Thematic Analysis was used to analyse the data. Three recurrent themes and several subthemes emerged around strategies to improve governance of data sharing. The main themes identified were (1) Strategies for change at a policy level: guideline development, (2) Strengthening data governance to improve data quality and (3) Reciprocity: towards equitable data sharing. Building trust is central to the promotion of data sharing amongst researchers on the African continent and with global partners. This can be achieved by enhancing research integrity and strengthening micro and macro level governance. Substantial resources are required from funders and governments to enhance data governance practices, to improve data literacy and to enhance data quality. High quality data from Africa will afford diversity to global data sets, reducing bias in algorithms built for artificial intelligence technologies in healthcare. Engagement with multiple stakeholders including researchers and research communities is necessary to establish an equitable data sharing approach based on reciprocity and mutual benefit.

Data sharing considerations and practice among health researchers in Africa: A scoping review

Objective

To examine the way African health researchers share data. It summarized the types of data collected, the data sharing platforms, and how the geographical distribution of the African-based health researchers influenced data sharing practices. Ethical, legal, and social aspects were considered. Institutional and government matters such as research support and funding were identified.

Methods

PubMed, Web of Science, LILAC, African Journal Archive, and Scopus databases were searched. Full-text screening was conducted, and data was extracted using the data extraction tool published in an a priori Joanna Briggs Institute-published protocol. Discrepancies were resolved by consensus. Data were illustrated using a Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram, figures, tables, and a narrative text.

Results

Of the 3869 studies that were identified, 32 studies were included in the final study. There was a spike in the number of published studies from 2015 to 2019 (n = 24, 75.0%), while a decline followed in the number of publications from 2020 to April 2023 (n = 6, 18.8%). Ten of the studies included were from South Africa, five were from Kenya, three each were from Nigeria and Tanzania, two were from Ghana and Sierra Leone respectively, while one each was from Malawi, Ethiopia, Cameroon, Mali, Gambia, Senegal, and Burkina Faso. Negative factors impacting data sharing practices of health researchers in Africa included barriers to individual research capacity, governmental bureaucracy and corruption, legal obstacles, technological problems, prohibitive costs of publication, lack of funding, institutional delays, and ethical issues.

Conclusion

This review identified how African health researchers undertook data sharing in their countries. It pinpointed how geographical location and the resultant challenges to data distribution both individually and institutionally influenced health researchers' ability to achieve data sharing and publication of their research. It was clear that many parts of Africa are still not participating in research due to the many factors that negatively impact health data sharing in Africa.