How can the voices of French-speaking health policy and systems researchers be better heard?

Emilie Robert1,2, Isidore Sieleunou1,3, Kadidiatou Kadio1,4, Oumar Mallé Samb5
1 Centre de recherche du Centre hospitalier de l’Université de Montréal (CR-CHUM), Canada
2 Sherpa, Centre de recherche du CSSS de la Montagne, Montréal, Canada
3 Research for Development International, Yaoundé, Cameroun
4 Institut de Recherche en Science de la Santé (IRSS), Ouagadougou, Burkina Faso
5 Institut de santé et développement de l’Université Cheikh Anta Diop de Dakar, Sénégal

“Every language sees the world in a different way”

Federico FELLINI

Although French is the official language of half of the countries in Sub-Saharan Africa, French-speaking countries are underrepresented in the new movement of health policy and systems research (HPSR). At the 3rd Global Symposium on Health Systems Research, only 9% of the participants came from a country where French is an official language, and half of those were from Canada, Switzerland and Belgium. Among the 696 participants from Africa, only 8% came from a French-speaking country. This underrepresentation is also observed among the editorial boards of journals concerned with HPSR (e.g. Health Policy and Planning, Health Research Policy and Systems, BMC Health Services Research) where researchers from French-speaking institutions are rarely included.

HPSR is, indeed, dominated by the lingua franca of academia, English. The economic power of Anglo-Saxon countries, the United States and England in particular, their colonial history and the international reputation of their universities explain this linguistic dominance. If English is only the third most spoken language in the world, however, it is the one used in the greatest number of countries. It is, therefore, not surprising to find this language in the heart of knowledge transmission.

As concerns HPSR, this linguistic hegemony presents two challenges for French-speaking researchers. The first is related to access to knowledge: reading scientific documents written in English or attending international conferences in that language, requires a high level of English proficiency, which not all of us possess. The second is the dissemination of our research at the international level, either by publishing articles in journals with impact factors or through participation in international conferences. These steps, which are necessary for the development of our careers, require once again a very good command of the English language.

These challenges unfairly affect the scope of the voices of researchers from French-speaking Africa, as well as the development of scientific knowledge. As a matter of fact, if a language carries its own worldview, as suggested by the film director Federico Fellini, it is urgent to create linguistic bridges, in the manner of transdisciplinarity promoted by HPSR pioneers. In the meantime, we can only give evidence of the many missed opportunities that could enrich our perspectives.

In addition to the difficulties in attending scientific meetings, International Scientific Indexing is biased in favour of articles published in English, thus limiting the development of research published in French. Moreover, many reviews published in English exclude articles on the basis of the linguistic criterion. This limits the scope of cross-lessons on common issues affecting Sub-Saharan Africa.

The field of HPSR is concerned by the need to integrate French-speaking researchers. This is evidenced by initiatives seeking to promote access to research in French, such as the International Health Policies newsletter, and translating abstracts, as done by Health Policy and Planning and the WHO Bulletin. The dissemination and exchange of knowledge in French are also encouraged through several networks, including EVIPNet, some communities of practice from Health Financing in Africa, and the blog Health Policy and Planning Debated, which allows the publication of blog posts in French. Inside Health Systems Global, the thematic working group SHaPeS has also mobilised volunteers to translate the minutes of its meetings.

These initiatives are welcomed and should be perpetuated. However, we believe they are insufficient. We suggest the following recommendations:

1) Promote access to research published in English:

  • Encourage the mobilisation of volunteer networks for the translation of abstracts of articles published in English;
  • Sustain efforts to offer simultaneous translation services at plenary sessions of international conference;
  • Subtitle videos and reruns of conferences on the Internet.

2) Promote the dissemination of Francophone research on health policy and systems:

  • Use the hashtag #French4HSR on Twitter to facilitate the identification and dissemination of research in French;
  • Facilitate presentations in French at international conferences, through the promotion of visual aids in English, and open scientific committees to French-speakers to allow selection of abstracts in French;
  • Allow the publication of articles in French in internationally renowned journals related to HPSR, and open scientific committees to French-speakers for the review of articles in French;
  • Provide grants for translation and linguistic revision of scientific articles, blog posts, and presentations at international conferences, and encourage the allocation of part of research budgets for translation.

3) Promote cooperation for the development of knowledge:

  • Encourage and support bilingual collaboration in research teams;
  • Promote Francophone representation in the governing bodies of HPSR, for example in Health Systems Global, and encourage bilingual initiatives, for example, among the thematic groups of  Health Systems Global, by providing spaces and opportunities for dissemination;
  • Create an inventory of initiatives in French, bilingual or multilingual, and make it available on a website.

We are realistic: English is, and will remain, the academic lingua franca, in spite of the projected growth of the French language. We hope that future generations of French-speaking researchers will master this language better than we have. Meanwhile, we must act now to promote the sharing of knowledge in both languages. The many challenges facing health systems in sub-Saharan Africa require it.