Background: Within the Cochrane Africa Network (CAN), stakeholder-driven priority setting informs the conduct of relevant reviews to inform local policy and practice. It also ensures efficient use of resources to address relevant health care issues. Although there is no gold standard, there are common principles about what constitutes good practice in setting priorities.

Objectives: To describe priority setting approaches taken and lessons learned across three countries in the CAN.

Methods:We conducted tailored priority setting in three African sub-regions (West, Francophone and Southern-Eastern Africa) through adapting recognised principles of successful priority setting: i) use of an explicit process, ii) stakeholder engagement, iii) information management, iv) consideration of values and context, and v) having in place mechanisms for reviewing decisions.

Results: West African Hub: Delphi-like approach with stakeholder engagement. Process involved identifying national priority health problems, searching online database, conducting a gap analysis of the outputs, nominating potential review topics and ranking the topics using pre-determined criteria.
Francophone Hub: Door-to-door priority setting with Ministry of Health staff supplemented with systematic review workshops with researchers and key stakeholders meetings.
South Eastern Hub: Identifying relevant decision makers, engagement with professional society, hosting workshops to define key priorities, conduct evidence mapping and identify systematic reviews topics
Lessons learned: Stakeholder involvement essential but may miss emerging priorities. Door-to-door priority setting is very effective and should be encouraged although requires enormous resources. Important to identify appropriate policy opportunities.

Conclusions: A regional collaborative group can facilitate reflections of process and lessons learned. Priority setting is an iterative process, with issues emerging over time, each sub-region using different methods to elicit priorities. We learned that emerging priorities may be missed, face-to-face contact and follow up after engagement is important and language can be a barrier.