1
|
Kalbarczyk A, Rao A, Alonge OO. Determinants of factors affecting readiness of academic institutions to conduct knowledge translation in low- and middle-income countries. Front Public Health 2024; 11:1302756. [PMID: 38259768 PMCID: PMC10800438 DOI: 10.3389/fpubh.2023.1302756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Capacity building strategies have been used to improve uptake of knowledge translation (KT) activities among academic institutions, but little is known about their effectiveness, contextual responsiveness, and adaptability. Many of these strategies target individuals while few address institutional gaps. This research describes the determinants for conducting KT (or readiness to conduct such activities) at the institutional level across diverse LMIC contexts to inform the development of capacity building strategies. Methods We conducted a survey to assess organizational readiness to conduct KT to public health researchers and practitioners from six academic institutions in Bangladesh, Ethiopia, DRC, India, Indonesia and Nigeria and members of a global knowledge-to-action working group. We assessed the frequency of barriers and facilitators to KT and their relationship to age, gender, country, and KT experience. We then performed logistic regression to identify determinants of five underlying factors demonstrated to influence KT readiness in LMICs (Institutional Climate, Organization Change Efficacy, Prioritization and Cosmopolitanism, Self-Efficacy and Financial Resource) along with their composite score, which represented an overall readiness score to conduct KT. Results A total of 111 responses were included in the final analysis. Participants represented 10 LMICs; a majority were 30-49 years old (57%) and most were male (53%). Most participants had professional foci in research (84%), teaching (62%), and project coordination (36%) and 59% indicated they had experience with KT. Common facilitators included motivated faculty (57%) and dedicated personnel (40%). Funding (60%), training (37%), and time (37%) were the most frequently reported barriers. In the adjusted model, age, gender, country, and professional focus were significantly associated with at least one factor. Prior experience with KT was significantly and positively (OR = 9.07; CI: 1.60-51.58; p < 0.05) associated with the overall KT readiness to conduct KT. Discussion Different KT readiness factors are relevant for younger (institutional climate) vs. older (self-efficacy) academic professionals, suggesting value in cross-generational collaborations. Leadership and gender were both relevant for organizational change efficacy indicating a need to engage leaders and promote women to influence organizational change. Institutions in different countries may be at different stages of change; readiness assessments can be used to systematically identify needs and develop targeted strategies.
Collapse
Affiliation(s)
- Anna Kalbarczyk
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | | |
Collapse
|
2
|
Perrotta C, Downey V, Elabbasy D, Ingram C, Lo C, Naseer A, Thorson A, Brizuela V. Remote training for strengthening capacity in sexual and reproductive health and rights research: a systematic review. BMC Public Health 2023; 23:1964. [PMID: 37817136 PMCID: PMC10566165 DOI: 10.1186/s12889-023-16851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Training has been used to develop research skills among sexual and reproductive health and rights (SRHR) researchers. Remote education may accelerate transfer of skills and reduce barriers to strengthening research capacity. This systematic review aimed to assess the effectiveness of remote training on SRHR research and describe enablers and barriers of effective remote training. METHODS PubMed, Embase, and Scielo were searched up to December 2022 for studies that evaluated in any language online research training programmes either on a SRHR topic or tailored for professionals working in SRHR published since 1990. Characteristics of included studies, the programmes they evaluated, the programme's effectiveness, and reported barriers and enablers to remote learning were extracted. Three researchers synthesized and described findings on effectiveness, impact and outcomes mapping them against the Kirkpatrick model. Additionally, thematic analysis from qualitative data was conducted to identify themes relating to the barriers and enablers of remote learning. RESULTS Of 1,510 articles retrieved, six studies that included 2,058 remote learners met the inclusion criteria. Five out of six studies described empirical improvements in participant research knowledge/skills and three studies reported improvements in attitudes/self-efficacy towards research. Follow-up surveys from four studies revealed frequent application of new research skills and improved opportunities for career advancement and publication following online trainings. Cited barriers to effective online SRHR research training included time management challenges and participants' competing professional obligations; limited opportunities for interaction; and lack of support from home institutions. Cited enablers included well-structured and clear courses, learning objectives and expectations with participants; ensuring a manageable workload; facilitating interactions with mentors and hands-on experience; and selecting programme topics relevant to participants' jobs. CONCLUSION Remote SRHR training can lead to improvements in research knowledge, skills, and attitudes, particularly when course learning objectives, structure, and expectations are outlined clearly, and ongoing mentorship is provided.
Collapse
Affiliation(s)
- Carla Perrotta
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland.
| | - Vicky Downey
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Darin Elabbasy
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Carolyn Ingram
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Chungwan Lo
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Amara Naseer
- School of Public Health Physiotherapy and Sports Science, University College Dublin, ROI, Woodview House, Belfield, Dublin 4, Ireland
| | - Anna Thorson
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, CH, Switzerland
| | - Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, CH, Switzerland
| |
Collapse
|
3
|
Tagoe N, Pulford J, Kinyanjui S, Molyneux S. A framework for managing health research capacity strengthening consortia: addressing tensions and enhancing capacity outcomes. BMJ Glob Health 2022; 7:bmjgh-2022-009472. [PMID: 36192051 PMCID: PMC9535163 DOI: 10.1136/bmjgh-2022-009472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022] Open
Abstract
There has been a steady increase in health research capacity strengthening (HRCS) consortia and programmes. However, their structures and management practices and the effect on the capacity strengthening outcomes have been underexamined. We conducted a case study involving three HRCS consortia where we critically examined the consortia’s decision-making processes, strategies for resolving management tensions and the potential implications for consortia outcomes. We conducted 44 in-depth interviews with a range of consortia members and employed the framework method to analyse the data. We assessed the extent to which consortia’s management practices and strategies enabled or hindered research capacity strengthening using a capacity development lens. At the heart of consortium management is how tensions are navigated and the resolution strategies adopted. This study demonstrates that the management strategies adopted by consortia have capacity strengthening consequences. When deciding on tension management strategies, trade-offs often occur, sometimes to the detriment of capacity strengthening aims. When management strategies align with capacity development principles, consortium management processes become capacity strengthening mechanisms for participating individuals and institutions. Such alignment enhances programme effectiveness and value for money. Drawing on these findings, we propose an evidence-informed management framework that consortia leaders can use in practice to support decision-making to optimise research capacity gains. Considering the increasing investment in HRCS consortia, leveraging all consortium processes towards capacity strengthening will maximise the returns on investments made.
Collapse
Affiliation(s)
- Nadia Tagoe
- Office of Grants and Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,Department of Global and International Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justin Pulford
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sam Kinyanjui
- Training, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya,Nuffield Department of Medicine, Oxford University, Oxford, Oxfordshire, UK
| | - Sassy Molyneux
- Nuffield Department of Medicine, Oxford University, Oxford, Oxfordshire, UK,Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| |
Collapse
|
4
|
Bidonde J, Meneses-Echavez JF, Asare B, Chola L, Gad M, Heupink LF, Peacocke EF. Developing a tool to assess the skills to perform a health technology assessment. BMC Med Res Methodol 2022; 22:78. [PMID: 35313812 PMCID: PMC8939100 DOI: 10.1186/s12874-022-01562-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
Abstract
Background Health technology assessment (HTA) brings together evidence from various disciplines while using explicit methods to assess the value of health technologies. In resource-constrained settings, there is a growing demand to measure and develop specialist skills, including those for HTA, to aid the implementation of Universal Healthcare Coverage. The purpose of this study was twofold: a) to find validated tools for the assessment of the technical capacity to conduct a HTA, and if none were found, to develop a tool, and b) to describe experiences of its pilot. Methods First, a mapping review identified tools to assess the skills to conduct a HTA. A medical librarian conducted a comprehensive search in four databases (MEDLINE, Embase, Web of Science, ERIC). Then, incorporating results from the mapping and following an iterative process involving stakeholders and experts, we developed a HTA skills assessment tool. Finally, using an online platform to gather and analyse responses, in collaboration with our institutional partner, we piloted the tool in Ghana, and sought feedback on their experiences. Results The database search yielded 3871 records; fifteen those were selected based on a priori criteria. These records were published between 2003 and 2018, but none covered all technical skills to conduct a HTA. In the absence of an instrument meeting our needs, we developed a HTA skill assessment tool containing four sections (general information, core and soft skills, and future needs). The tool was designed to be administered to a broad range of individuals who would potentially contribute to the planning, delivery and evaluation of HTA. The tool was piloted with twenty-three individuals who completed the skills assessment and shared their initial impressions of the tool. Conclusions To our knowledge, this is the first comprehensive tool enabling the assessment of technical skills to conduct a HTA. This tool allows teams to understand where their individual strengths and weakness lie. The tool is in the early validation phases and further testing is needed. Trial registration Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01562-4.
Collapse
Affiliation(s)
- Julia Bidonde
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway. .,School of Rehabilitation Sciences, College of Medicine, University of Saskatchewan, Suite 3400, 3rd Floor, 104 Clinic Pl, Saskatoon, SK, S7N 2Z4, Canada.
| | - Jose Francisco Meneses-Echavez
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway.,Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, Colombia
| | - Brian Asare
- Ghana Ministry of Health, Ministries Accra, P.O.Box M 44, Accra, Ghana
| | - Lumbwe Chola
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway
| | - Mohamed Gad
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Lieke Fleur Heupink
- Norwegian Institute of Public Health, P.O. Box: 222 Skøyen, 0213, Oslo, Norway
| | | | | |
Collapse
|
5
|
Darling S, Harvey B, Hickey GM. On the individual and organizational capacities supporting impact assessment: the case of the Yukon Environmental and Socio-Economic Assessment Board. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impact assessment (IA) processes rely on the ability of assessment boards and their assessors to gather, synthesize, and interpret knowledge from a variety of sources, making IA a knowledge-based activity. IA boards in northern Canada operate in a context that prioritizes pluralism, where Indigenous knowledge is a key element of decision-making and the ability of practitioners to interact with knowledge—research capacity—affects process effectiveness, credibility, and legitimacy. Drawing on common principles from existing research capacity frameworks, we identify the dimensions of capacity most relevant to more fully realizing inclusive impact assessment processes. We then examine the Yukon Environmental and Socio-Economic Assessment Board (YESAB) as a specialized environmental governance organization with assessors whose research capacity directly impacts process outcomes. Results show that while common dimensions across knowledge-based disciplines, such as sufficient resources (e.g., financial support), are often addressed in the YESAB context, others unique to IA, like contextual understanding, require further examination. The interaction between individual and organizational research capacity is a complex balance between investing in individuals and investing in organizational supports. The proposed framework facilitates multi-scalar supports for individual assessors and assessment bodies alike to navigate balancing technical and value-driven knowledge in assessments.
Collapse
Affiliation(s)
- Samantha Darling
- Department of Natural Resource Sciences, McGill University, Macdonald-Stewart Building, 21111 Lakeshore Road, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada
| | - Blane Harvey
- Department of Integrated Studies in Education, McGill University, Room 244, Education Building, 3700 McTavish Street, Montreal, QC H3A 1Y2, Canada
| | - Gordon M. Hickey
- Department of Natural Resource Sciences, McGill University, Macdonald-Stewart Building, 21111 Lakeshore Road, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada
| |
Collapse
|
6
|
Humphries D, Ma M, Collins N, Ray N, Wat E, Bazelon J, Pettinelli J, Fiellin DA. Assessing Research Activity and Capacity of Community-Based Organizations: Refinement of the CREAT Instrument Using the Delphi Method. J Urban Health 2019; 96:912-922. [PMID: 31350725 PMCID: PMC6904697 DOI: 10.1007/s11524-019-00374-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Community-based organizations (CBOs) are essential partners in community-engaged research, yet little is known about their research capacity. Community experts and organizations bring unique knowledge of the community to research partnerships, but standard validated measures of CBO research capacity do not yet exist. We report here on the refinement through a structured Delphi panel of a previously developed and piloted framework of CBO research capacity and an accompanying instrument, the Community REsearch Activity Assessment Tool (CREAT). A Delphi panel composed of twenty-three experts recruited from community (52%) and academic researchers (48%) from around the USA participated in five rounds of review to establish consensus regarding framework domains, operational definitions, and tool items. Panelists rated the importance of items on a 5-point Likert scale and assessed for the inclusion and language of items. Initial rounds of review began with reviewing the framework and definitions, with subsequent rounds including review of the full instrument. Concluding rounds brought back items that had not yet reached consensus for additional review. Median response values (MRV) and intra-quartile ranges (IQR) were calculated for each Likert item. Items with an MRV > 3.5 were deemed as having reached consensus and were retained. Language changes were made for items with MRV > 2.0 and < 3.5 and an IQR > 1.5. Items with MRV < 2.0 were excluded from the final tool. Panelist response rate was high (> 75%). Consensus was achieved for the inclusion of all domains, subdomains and operational definitions except "evidence-based practices." Extensive changes to the CREAT instrument were made for clarification, to provide additional detail and to ensure applicability for CBOs. The CREAT framework and tool was refined through input from community and academic researchers. Availability of a validated tool to assess research capacity of CBOs will support targeted research capacity building for community organizations and partners, thus strengthening collaborations.
Collapse
Affiliation(s)
- Debbie Humphries
- Yale School of Public Health, New Haven, CT, USA.
- New Haven Healthy Start Program, Community Foundation of Greater New Haven, New Haven, CT, USA.
| | - Maria Ma
- Yale School of Public Health, New Haven, CT, USA
| | | | - Natasha Ray
- New Haven Healthy Start Program, Community Foundation of Greater New Haven, New Haven, CT, USA
| | - Eric Wat
- Special Services for Groups, Los Angeles, CA, USA
| | | | - Jim Pettinelli
- Yale Center for Interdisciplinary Research on AIDS (CIRA), New Haven, CT, USA
| | - David A Fiellin
- Yale School of Public Health, New Haven, CT, USA
- Yale Center for Interdisciplinary Research on AIDS (CIRA), New Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
7
|
Haregu TN, Byrnes A, Singh K, Sathish T, Pasricha N, Wickramasinghe K, Thankappan KR, Oldenburg B. A scoping review of non-communicable disease research capacity strengthening initiatives in low and middle-income countries. Glob Health Res Policy 2019; 4:31. [PMID: 31799408 PMCID: PMC6883517 DOI: 10.1186/s41256-019-0123-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction As the epidemic of non-communicable diseases (NCDs) is rapidly developing in low and middle-income countries (LMICs), the importance of local research capacity and the role of contextually relevant research in informing policy and practice is of paramount importance. In this regard, initiatives in research capacity strengthening (RCS) are very important. The aim of this study was to review and summarize NCD research capacity strengthening strategies that have been undertaken in LMICs. Methods Using both systematic and other literature search, we identified and reviewed NCD-RCS initiatives that have been implemented in LMICs and reported since 2000. Information was extracted from published papers and websites related to these initiatives using a semi-structured checklist. We extracted information on program design, stakeholders involved, and countries of focus, program duration, targeted researchers, disease focus, skill/capacity areas involved and sources of funding. The extracted information was refined through further review and then underwent a textual narrative synthesis. Results We identified a number of different strategies used by research capacity strengthening programs and in the majority of initiatives, a combination of approaches was utilized. Capacity strengthening and training approaches were variously adapted locally and tailored to fit with the identified needs of the targeted researchers and health professionals. Most initiatives focused on individual level capacity and not system level capacity, although some undoubtedly benefited the research and health systems of LMICs. For most initiatives, mid-term and long-term outcomes were not evaluated. Though these initiatives might have enhanced research capacity in the immediate term, the sustainability of the results in the long-term remains unknown. Conclusion Most of NCD-RCS initiatives in LMICs focused on building individual capacity and only a few focused explicitly on institutional level capacity strengthening. Though many of the initiatives appear to have had promising short-term outcomes, evidence on their long-term impact and sustainability is lacking.
Collapse
Affiliation(s)
- Tilahun Nigatu Haregu
- 1Melbourne School of Population and Global Health & WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, University of Melbourne, Melbourne, Australia
| | - Allison Byrnes
- 1Melbourne School of Population and Global Health & WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, University of Melbourne, Melbourne, Australia.,Family Life Limited, Sandringham, Australia
| | - Kavita Singh
- 3Centre for Chronic Disease Control, New Delhi, India
| | - Thirunavukkarasu Sathish
- 1Melbourne School of Population and Global Health & WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, University of Melbourne, Melbourne, Australia.,4Population Health Research Institute, McMaster University, Hamilton, Canada
| | | | | | | | - Brian Oldenburg
- 1Melbourne School of Population and Global Health & WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, University of Melbourne, Melbourne, Australia
| |
Collapse
|
8
|
Mayor A, Martínez-Pérez G, Tarr-Attia CK, Breeze-Barry B, Sarukhan A, García-Sípido AM, Hurtado JC, Lansana DP, Casamitjana N. Training through malaria research: building capacity in good clinical and laboratory practice in Liberia. Malar J 2019; 18:136. [PMID: 30999908 PMCID: PMC6471755 DOI: 10.1186/s12936-019-2767-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/04/2019] [Indexed: 11/20/2022] Open
Abstract
Background Limited health research capacities (HRC) undermine a country’s ability to identify and adequately respond to local health needs. Although numerous interventions to strengthen HRC have been conducted in Africa, there is a need to share the lessons learnt by funding organizations, institutes and researchers. The aim of this report is to identify best practices in HRC strengthening by describing a training programme conducted between 2016 and 2017 at the Saint Joseph’s Catholic Hospital (SJCH) in Monrovia (Liberia). Methods A call for trainees was launched at the SJCH, the Liberia Medicines and Health Products Regulatory Authority (LMHRA), the Ministry of Health and Social Welfare, the Mother Pattern College of Health Sciences (MPCHS) and community members. Selected trainees participated in four workshops on Good Clinical Laboratory Practice (GCLP), standard operating procedures (SOP) and scientific communication, as well as in a 5-months eLearning mentoring programme. After the training, a collectively-designed research project on malaria was conducted. Results Twenty-one of the 28 trainees (14 from the SJCH, 3 from LMHRA, one from MPCHS, and 10 community representatives) completed the programme satisfactorily. Pre- and post-training questionnaires completed by 9 of the trainees showed a 14% increase in the percentage of correct answers. Trainees participated in a mixed-methods cross-sectional study of Plasmodium falciparum infection among pregnant women at the SJCH. Selected trainees disseminated activities and research outcomes in three international meetings and three scientific publications. Conclusion This training-through-research programme successfully involved SJCH staff and community members in a practical research exercise on malaria during pregnancy. The challenge is to ensure that the SJCH remains active in research. Harmonization of effectiveness indicators for HRC initiatives would strengthen the case for investing in such efforts. Electronic supplementary material The online version of this article (10.1186/s12936-019-2767-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
| | | | | | | | - Adelaida Sarukhan
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | | | | | | | - Núria Casamitjana
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
9
|
Ekeroma A. Collaboration as a tool for building research capacity in the Pacific Islands. Ann Hum Biol 2019; 45:295-296. [PMID: 29877155 DOI: 10.1080/03014460.2018.1454510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Alec Ekeroma
- a Head, Pacific Women's Health Research Unit, Department of Obstetrics and Gynaecology , University of Auckland , Auckland , New Zealand
| |
Collapse
|
10
|
Malla C, Aylward P, Ward P. Knowledge translation for public health in low- and middle- income countries: a critical interpretive synthesis. Glob Health Res Policy 2018; 3:29. [PMID: 30377666 PMCID: PMC6196454 DOI: 10.1186/s41256-018-0084-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/27/2018] [Indexed: 11/10/2022] Open
Abstract
Background Effective knowledge translation allows the optimisation of access to and utilisation of research knowledge in order to inform and enhance public health policy and practice. In low- and middle- income countries, there are substantial complexities that affect the way in which research can be utilised for public health action. This review attempts to draw out concepts in the literature that contribute to defining some of the complexities and contextual factors that influence knowledge translation for public health in low- and middle- income countries. Methods A Critical Interpretive Synthesis was undertaken, a method of analysis which allows a critical review of a wide range of heterogeneous evidence, through incorporating systematic review methods with qualitative enquiry techniques. A search for peer-reviewed articles published between 2000 and 2016 on the topic of knowledge translation for public health in low- and middle – income countries was carried out, and 85 articles were reviewed and analysed using this method. Results Four main concepts were identified: 1) tension between ‘global’ and ‘local’ health research, 2) complexities in creating and accessing evidence, 3) contextualising knowledge translation strategies for low- and middle- income countries, and 4) the unique role of non-government organisations in the knowledge translation process. Conclusion This method of review has enabled the identification of key concepts that may inform practice or further research in the field of knowledge translation in low- and middle- income countries. Electronic supplementary material The online version of this article (10.1186/s41256-018-0084-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Catherine Malla
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia 5042 Australia
| | - Paul Aylward
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia 5042 Australia
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia 5042 Australia
| |
Collapse
|
11
|
Cooke J, Gardois P, Booth A. Uncovering the mechanisms of research capacity development in health and social care: a realist synthesis. Health Res Policy Syst 2018; 16:93. [PMID: 30241484 PMCID: PMC6150992 DOI: 10.1186/s12961-018-0363-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 08/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research capacity development (RCD) is considered fundamental to closing the evidence-practice gap, thereby contributing to health, wealth and knowledge for practice. Numerous frameworks and models have been proposed for RCD, but there is little evidence of what works for whom and under what circumstances. There is a need to identify mechanisms by which candidate interventions or clusters of interventions might achieve RCD and contribute to societal impact, thereby proving meaningful to stakeholders. METHODS A realist synthesis was used to develop programme theories for RCD. Structured database searches were conducted across seven databases to identify papers examining RCD in a health or social care context (1998-2013). In addition, citation searches for 10 key articles (citation pearls) were conducted across Google Scholar and Web of Science. Of 214 included articles, 116 reported on specific interventions or initiatives or their evaluation. The remaining 98 articles were discussion papers or explicitly sought to make a theoretical contribution. A core set of 36 RCD theoretical and conceptual papers were selected and analysed to generate mechanisms that map across macro contexts (individual, team, organisational, network). Data were extracted by means of 'If-Then' statements into an Excel spreadsheet. Models and frameworks were deconstructed into their original elements. RESULTS Eight overarching programme theories were identified featuring mechanisms that were triggered across multiple contexts. Three of these fulfilled a symbolic role in signalling the importance of RCD (e.g. positive role models, signal importance, make a difference), whilst the remainder were more functional (e.g. liberate talents, release resource, exceed sum of parts, learning by doing and co-production of knowledge). Outcomes from one mechanism produced changes in context to stimulate mechanisms in other activities. The eight programme theories were validated with findings from 10 systematic reviews (2014-2017). CONCLUSIONS This realist synthesis is the starting point for constructing an RCD framework shaped by these programme theories. Future work is required to further test and refine these findings against empirical data from intervention studies.
Collapse
Affiliation(s)
- Jo Cooke
- NIHR CLAHRC Yorkshire & Humber, Research Capacity and Engagement Programme Management, 11 Broomfield Road, Sheffield, S10 2SE, United Kingdom
| | - Paolo Gardois
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, United Kingdom.
| |
Collapse
|
12
|
Gheorghe A, Griffiths U, Murphy A, Legido-Quigley H, Lamptey P, Perel P. The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review. BMC Public Health 2018; 18:975. [PMID: 30081871 PMCID: PMC6090747 DOI: 10.1186/s12889-018-5806-x] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/05/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The evidence on the economic burden of cardiovascular disease (CVD) in low- and middle- income countries (LMICs) remains scarce. We conducted a comprehensive systematic review to establish the magnitude and knowledge gaps in relation to the economic burden of CVD and hypertension on households, health systems and the society. METHODS We included studies using primary or secondary data to produce original economic estimates of the impact of CVD. We searched sixteen electronic databases from 1990 onwards without language restrictions. We appraised the quality of included studies using a seven-question assessment tool. RESULTS Eighty-three studies met the inclusion criteria, most of which were single centre retrospective cost studies conducted in secondary care settings. Studies in China, Brazil, India and Mexico contributed together 50% of the total number of economic estimates identified. The quality of the included studies was generally low. Reporting transparency, particularly for cost data sources and results, was poor. The costs per episode for hypertension and generic CVD were fairly homogeneous across studies; ranging between $500 and $1500. In contrast, for coronary heart disease (CHD) and stroke cost estimates were generally higher and more heterogeneous, with several estimates in excess of $5000 per episode. The economic perspective and scope of the study appeared to impact cost estimates for hypertension and generic CVD considerably less than estimates for stroke and CHD. Most studies reported monthly costs for hypertension treatment around $22. Average monthly treatment costs for stroke and CHD ranged between $300 and $1000, however variability across estimates was high. In most LMICs both the annual cost of care and the cost of an acute episode exceed many times the total health expenditure per capita. CONCLUSIONS The existing evidence on the economic burden of CVD in LMICs does not appear aligned with policy priorities in terms of research volume, pathologies studied and methodological quality. Not only is more economic research needed to fill the existing gaps, but research quality needs to be drastically improved. More broadly, national-level studies with appropriate sample sizes and adequate incorporation of indirect costs need to replace small-scale, institutional, retrospective cost studies.
Collapse
Affiliation(s)
- Adrian Gheorghe
- Oxford Policy Management Ltd, Level 3 Clarendon House, 52 Cornmarket St, Oxford, OX1 3HJ UK
- Department of Global Health and Development, LSHTM, Keppel Street, London, WC1E 7HT UK
| | - Ulla Griffiths
- UNICEF, 3 United Nations Plaza, New York, NY 10017 USA
- Department of Global Health and Development, LSHTM, Keppel Street, London, WC1E 7HT UK
| | - Adrianna Murphy
- Centre for Global Chronic Conditions, LSHTM, Keppel Street, London, WC1E 7HT UK
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549 Singapore
- LSHTM, Keppel Street, London, WC1E 7HT UK
| | - Peter Lamptey
- Department of Non-communicable Disease Epidemiology, LSHTM, Keppel Street, London, WC1E 7HT UK
| | - Pablo Perel
- Centre for Global Chronic Conditions, LSHTM, Keppel Street, London, WC1E 7HT UK
| |
Collapse
|
13
|
Dean L, Gregorius S, Bates I, Pulford J. Advancing the science of health research capacity strengthening in low-income and middle-income countries: a scoping review of the published literature, 2000-2016. BMJ Open 2017; 7:e018718. [PMID: 29217727 PMCID: PMC5728300 DOI: 10.1136/bmjopen-2017-018718] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Substantial development assistance and research funding are invested in health research capacity strengthening (HRCS) interventions in low-income and middle-income countries, yet the effectiveness, impact and value for money of these investments are not well understood. A major constraint to evidence-informed HRCS intervention has been the disparate nature of the research effort to date. This review aims to map and critically analyse the existing HRCS effort to better understand the level, type, cohesion and conceptual sophistication of the current evidence base. The overall goal of this article is to advance the development of a unified, implementation-focused HRCS science. METHODS We used a scoping review methodology to identify peer-reviewed HRCS literature within the following databases: PubMed, Global Health and Scopus. HRCS publications available in English between the period 2000 and 2016 were included. 1195 articles were retrieved of which 172 met the final inclusion criteria. A priori thematic analysis of all included articles was completed. Content analysis of identified HRCS definitions was conducted. RESULTS The number of HRCS publications increased exponentially between 2000 and 2016. Most publications during this period were perspective, opinion or commentary pieces; however, original research publications were the primary publication type since 2013. Twenty-five different definitions of research capacity strengthening were identified, of which three aligned with current HRCS guidelines. CONCLUSIONS The review findings indicate that an HRCS research field with a focus on implementation science is emerging, although the conceptual and empirical bases are not yet sufficiently advanced to effectively inform HRCS programme planning. Consolidating an HRCS implementation science therefore presents as a viable option that may accelerate the development of a useful evidence base to inform HRCS programme planning. Identifying an agreed operational definition of HRCS, standardising HRCS-related terminology, developing a needs-based HRCS-specific research agenda and synthesising currently available evidence may be useful first steps.
Collapse
Affiliation(s)
- Laura Dean
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Stefanie Gregorius
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Imelda Bates
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Justin Pulford
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| |
Collapse
|
14
|
Renwick L, Irmansyah, Keliat BA, Lovell K, Yung A. Implementing an innovative intervention to increase research capacity for enhancing early psychosis care in Indonesia. J Psychiatr Ment Health Nurs 2017; 24:671-680. [PMID: 28786548 DOI: 10.1111/jpm.12417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE TOPIC?: In low- and middle-income settings (LMICs) such as Indonesia, the burden from psychotic illness is significant due to large gaps in treatment provision Mental health workers and community nurses are a growing workforce requiring new evidence to support practice and enhanced roles and advanced competencies among UK mental health nurses also requires greater research capacity Research capacity building projects can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. WHAT THIS PAPER ADDS?: Delivering innovative, cross-cultural workshops to enhance research capacity to multidisciplinary, early career researchers in Indonesia and the UK are rated highly by attendees Supporting people in this way helps them to gain competitive grant funding to complete their own research which can improve the health of the population To our knowledge, there are no other studies reporting the attainment of grant income as a successful outcome of international research partnerships for mental health nursing so our finding is novel. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This method could be implemented to improve networking and collaboration between UK academics and early career researchers in other lower- and middle-income settings This strategy can also strengthen existing partnerships among early career researchers in the UK to meet the demands for greater research mentorship and leadership among mental health nurses and enhance nurses capabilities to contribute to evidence for practice. ABSTRACT Aim To strengthen research capacity for nurses and early career researchers in Indonesia and the UK to develop a local evidence base in Indonesia to inform policy and improve the nation's health. These strategies can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. Methods Four days of workshops were held in Jakarta, Indonesia developing collaborative groups of academic nurses and early career researchers from the UK and Indonesia (30 people including mentors) to produce competitive grant bids to evaluate aspects of early psychosis care. Qualitative and quantitative evaluations were conducted. Results Participants evaluated the workshops positively finding benefit in the structure, content and delivery. Research impact was shown by attaining several successful small and large grants and developing offshoot collaborative relationships. Discussion These novel findings demonstrate that collaborative workshops can strengthen research capacity by developing partnerships and instigating new collaborations and networks. No other studies of international research partnerships among mental health nurses have reported this outcome to our knowledge. Implications for Practice This method could be implemented to improve networking and collaboration between UK academics and early career researchers and also with external colleagues in other LMICs.
Collapse
Affiliation(s)
- L Renwick
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Irmansyah
- Marzoeki Mahdi Hospital, Bogor, Indonesia
| | - B A Keliat
- Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - K Lovell
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - A Yung
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| |
Collapse
|
15
|
Gregorius S, Dean L, Cole DC, Bates I. The peer review process for awarding funds to international science research consortia: a qualitative developmental evaluation. F1000Res 2017; 6:1808. [PMID: 29333239 PMCID: PMC5750705 DOI: 10.12688/f1000research.12496.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Evaluating applications for multi-national, multi-disciplinary, dual-purpose research consortia is highly complex. There has been little research on the peer review process for evaluating grant applications and almost none on how applications for multi-national consortia are reviewed. Overseas development investments are increasingly being channelled into international science consortia to generate high-quality research while simultaneously strengthening multi-disciplinary research capacity. We need a better understanding of how such decisions are made and their effectiveness. Methods: An award-making institution planned to fund 10 UK-Africa research consortia. Over two annual rounds, 34 out of 78 eligible applications were shortlisted and reviewed by at least five external reviewers before final selections were made by a face-to-face panel. We used an innovative approach involving structured, overt observations of award-making panel meetings and semi-structured interviews with panel members to explore how assessment criteria concerning research quality and capacity strengthening were applied during the peer review process. Data were coded and analysed using pre-designed matrices which incorporated categories relating to the assessment criteria. Results: In general the process was rigorous and well-managed. However, lack of clarity about differential weighting of criteria and variations in the panel’s understanding of research capacity strengthening resulted in some inconsistencies in use of the assessment criteria. Using the same panel for both rounds had advantages, in that during the second round consensus was achieved more quickly and the panel had increased focus on development aspects. Conclusion: Grant assessment panels for such complex research applications need to have topic- and context-specific expertise. They must also understand research capacity issues and have a flexible but equitable and transparent approach. This study has developed and tested an approach for evaluating the operation of such panels and has generated lessons that can promote coherence and transparency among grant-makers and ultimately make the award-making process more effective.
Collapse
Affiliation(s)
- Stefanie Gregorius
- Capacity Research Unit, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool , L3 5QA, UK
| | - Laura Dean
- Capacity Research Unit, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool , L3 5QA, UK
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, 155 College St. , Toronto, ON , M5T3M7 , Canada
| | - Imelda Bates
- Capacity Research Unit, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool , L3 5QA, UK
| |
Collapse
|
16
|
Memiah P, Ah Mu T, Penner J, Owour K, Ngunu-Gituathi C, Prevot K, Mochache V, Wekesa P, Oyore J, Muhula S, Komba P. Bridging the Gap in Implementation Science: Evaluating a Capacity-Building Program in Data Management, Analysis, Utilization, and Dissemination in Low- and Middle-Income Countries. Popul Health Manag 2017; 21:245-251. [PMID: 28885892 DOI: 10.1089/pop.2017.0093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Building capacity in implementation science within health programs is dependent on training in theory and practice of epidemiology, statistics, and research in addition to high self-efficacy toward application of training. This article describes a training program providing technical assistance to more than 300 health facilities in Kenya and Tanzania, its evaluation results, and its ability to improve participants' knowledge, competencies, and self-efficacy on data management, analysis, and dissemination among health care professionals. Two months prior to the training, participants (n = 98) were emailed a pre-course survey including 19 questions using a Likert-type response for planning the content of the workshop. Six to 12 weeks after the training, a post-course survey was emailed to all participants. Five different trainings were conducted indicating 5 participant cohorts. The questions posed involved course satisfaction, course impact on knowledge and skills, and self-efficacy in data analysis and utilization. Post-course survey results revealed that the participants had confidence in data analysis, which was significantly different from the pre-test results (0.05 α). Qualitative commentary complemented the findings of the impact of the workshop. Four manuscripts and 13 abstracts have been submitted post training. Results suggest that a short-term training program can achieve immediate gains in data and research self-efficacy among health care professionals. Although increasing self-efficacy is a necessary first step in developing skills, educators should engage in continuing education for sustainable dissemination practices. There is an urgent need to determine the current infrastructure to promote scientific dissemination. This will assist countries to produce better evidence to support their programs, policies, and overall health programs.
Collapse
Affiliation(s)
- Peter Memiah
- 1 Department of Public Health, College of Health, University of West Florida , Pensacola, Florida
| | - Tristi Ah Mu
- 1 Department of Public Health, College of Health, University of West Florida , Pensacola, Florida
| | - Jeremy Penner
- 2 Division of International Health, Department of Family Practice, Faculty of Medicine , St Paul, Canada
| | - Kevin Owour
- 3 Kenya Medical Research Institute , Nairobi, Kenya
| | | | - Kourtney Prevot
- 1 Department of Public Health, College of Health, University of West Florida , Pensacola, Florida
| | | | - Paul Wekesa
- 6 Centre for Health Solutions-Kenya (CHS) , Nairobi, Kenya
| | - John Oyore
- 7 Department of Community Health, Kenyatta University , Nairobi, Kenya
| | - Sam Muhula
- 8 Department of Monitoring, Evaluation and Research, Amref Health Africa in Kenya , Nairobi, Kenya
| | - Patience Komba
- 9 Sydney Medical School, School of Public Health, University of Sydney , Sydney, Australia
| |
Collapse
|
17
|
Wallis S, Cole DC, Gaye O, Mmbaga BT, Mwapasa V, Tagbor H, Bates I. Qualitative study to develop processes and tools for the assessment and tracking of African institutions' capacity for operational health research. BMJ Open 2017; 7:e016660. [PMID: 28877945 PMCID: PMC5588986 DOI: 10.1136/bmjopen-2017-016660] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/31/2017] [Accepted: 07/03/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps. SETTING Four African universities. PARTICIPANTS 83 university staff and students from 11 cadres. INTERVENTION/METHODS A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified. RESULTS Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges. CONCLUSIONS Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be a 'smart' investment for governments and health research funders.
Collapse
Affiliation(s)
- Selina Wallis
- International health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Oumar Gaye
- Faculty of Medicine, Pharmacy and Dentistry, L'Université Cheikh Anta Diop, Dakar, Senegal
| | | | | | - Harry Tagbor
- School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Imelda Bates
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
18
|
Franzen SRP, Chandler C, Lang T. Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature. BMJ Open 2017; 7:e012332. [PMID: 28131997 PMCID: PMC5278257 DOI: 10.1136/bmjopen-2016-012332] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Locally led health research in low and middle income countries (LMICs) is critical for overcoming global health challenges. Yet, despite over 25 years of international efforts, health research capacity in LMICs remains insufficient and development attempts continue to be fragmented. The aim of this systematic review is to identify and critically examine the main approaches and trends in health research capacity development and consolidate key thinking to identify a more coherent approach. METHODS This review includes academic and grey literature published between January 2000 and July 2013. Using a predetermined search strategy, we systematically searched PubMed, hand-searched Google Scholar and checked reference lists. This process yielded 1668 papers. 240 papers were selected based on a priori criteria. A modified version of meta-narrative synthesis was used to analyse the papers. RESULTS 3 key narratives were identified: the effect of power relations on capacity development; demand for stronger links between research, policy and practice and the importance of a systems approach. Capacity development was delivered through 4 main modalities: vertical research projects, centres of excellence, North-South partnerships and networks; all were controversial, and each had their strengths and weaknesses. A plurality of development strategies was employed to address specific barriers to health research. However, lack of empirical research and monitoring and evaluation meant that their effectiveness was unclear and learning was weak. CONCLUSIONS There has been steady progress in LMIC health research capacity, but major barriers to research persist and more empirical evidence on development strategies is required. Despite an evolution in development thinking, international actors continue to use outdated development models that are recognised as ineffective. To realise newer development thinking, research capacity outcomes need to be equally valued as research outputs. While some development actors are now adopting this dedicated capacity development approach, they are in the minority.
Collapse
Affiliation(s)
- Samuel R P Franzen
- The Global Health Network, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Oxford Policy Management, Oxford, UK
| | - Clare Chandler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Trudie Lang
- The Global Health Network, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| |
Collapse
|
19
|
Feehally J, Brusselmans A, Finkelstein FO, Harden P, Harris D, Manuzi G, Naicker S, Tonelli M, Cameron H. Improving global health: measuring the success of capacity building outreach programs: a view from the International Society of Nephrology. Kidney Int Suppl (2011) 2016; 6:42-51. [PMID: 30675419 DOI: 10.1016/j.kisu.2016.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Capacity building is key to the advance of health care in the developing world, but capacity building can take several forms, and it is not yet clear which forms and funding models are most effective. The International Society of Nephrology (ISN) has developed and sustained a portfolio of global outreach programs that make a unique contribution at low cost to the appropriate training and continuing support of nephrologists throughout the developing world. We describe the programs and present encouraging findings of their outcomes. Finally, we reflect on how the ISN interventions and evaluations measure up against recommended approaches in the literature and consider lessons for ISN and other organizations involved in planning, evaluating, and benchmarking similar programs.
Collapse
Affiliation(s)
- John Feehally
- International Society of Nephrology, Brussels, Belgium
| | | | | | - Paul Harden
- International Society of Nephrology, Brussels, Belgium
| | - David Harris
- International Society of Nephrology, Brussels, Belgium
| | | | | | | | - Helen Cameron
- Centre for Medical Education, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
20
|
Huber J, Nepal S, Bauer D, Wessels I, Fischer MR, Kiessling C. Tools and instruments for needs assessment, monitoring and evaluation of health research capacity development activities at the individual and organizational level: a systematic review. Health Res Policy Syst 2015; 13:80. [PMID: 26691766 PMCID: PMC4687225 DOI: 10.1186/s12961-015-0070-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/07/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In the past decades, various frameworks, methods, indicators, and tools have been developed to assess the needs as well as to monitor and evaluate (needs assessment, monitoring and evaluation; "NaME") health research capacity development (HRCD) activities. This systematic review gives an overview on NaME activities at the individual and organizational level in the past 10 years with a specific focus on methods, tools and instruments. Insight from this review might support researchers and stakeholders in systemizing future efforts in the HRCD field. METHODS A systematic literature search was conducted in PubMed and Google Scholar. Additionally, the personal bibliographies of the authors were scanned. Two researchers independently reviewed the identified abstracts for inclusion according to previously defined eligibility criteria. The included articles were analysed with a focus on both different HRCD activities as well as NaME efforts. RESULTS Initially, the search revealed 700 records in PubMed, two additional records in Google Scholar, and 10 abstracts from the personal bibliographies of the authors. Finally, 42 studies were included and analysed in depth. Findings show that the NaME efforts in the field of HRCD are as complex and manifold as the concept of HRCD itself. NaME is predominately focused on outcome evaluation and mainly refers to the individual and team levels. CONCLUSION A substantial need for a coherent and transparent taxonomy of HRCD activities to maximize the benefits of future studies in the field was identified. A coherent overview of the tools used to monitor and evaluate HRCD activities is provided to inform further research in the field.
Collapse
Affiliation(s)
- Johanna Huber
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Sushil Nepal
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Daniel Bauer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Insa Wessels
- bologna.lab, Humboldt-Universität zu Berlin, Hausvogteiplatz 5-7, 10117, Berlin, Germany.
| | - Martin R Fischer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany.
| | - Claudia Kiessling
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ziemssenstraße 1, 80336, Munich, Germany. .,Medizinische Hochschule Brandenburg Theodor Fontane, Fehrbelliner Straße 38, 16816, Neuruppin, Germany.
| |
Collapse
|
21
|
Iribagiza MK, Manikuzwe A, Aquino T, Amoroso C, Zachariah R, van Griensven J, Schneider S, Finnegan K, Cortas C, Kamanzi E, Hamon JK, Hedt-Gauthier BL. Fostering interest in research: evaluation of an introductory research seminar at hospitals in rural Rwanda. Public Health Action 2015; 4:271-5. [PMID: 26400708 DOI: 10.5588/pha.14.0093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/12/2014] [Indexed: 11/10/2022] Open
Abstract
SETTINGS Partners In Health Rwanda, in collaboration with the Ministry of Health, leads a multipronged approach to develop research capacity among health workers, particularly in rural areas. OBJECTIVES To describe the characteristics of participants and to assess the impact of an introductory research seminar series in three district hospitals in rural Rwanda. DESIGN This was a retrospective cohort study of seminar participants. Data were sourced from personnel records, assessment sheets and feedback forms. RESULTS A total of 126 participants, including 70 (56%) clinical and 56 (44%) non-clinical staff, attended the research seminar series; 61 (48%) received certification. Among those certified, the median assessment score on assignments was 79%. Participants read significantly more articles at 6 and 12 months (median 2 and 4 respectively, compared to 1 at baseline, P < 0.01). There was also a significant increase (P ⩽ 0.05) in self-reported involvement in research studies (28%, baseline; 59%, 12 months) and attendance at other research training (36%, baseline; 65%, 12 months). CONCLUSION The introductory research seminar series provided an important opportunity for engagement in research among clinical and non-clinical staff. Such an activity is a key component of a comprehensive research capacity building programme at rural sites, and serves as an entry point for more advanced research training.
Collapse
Affiliation(s)
- M K Iribagiza
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda ; International Health Science University, Kampala, Uganda
| | - A Manikuzwe
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
| | - T Aquino
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
| | - C Amoroso
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
| | - R Zachariah
- Médecins Sans Frontières Luxembourg, Operational Center Brussels, Brussels, Belgium
| | | | - S Schneider
- Médecins Sans Frontières Luxembourg, Operational Center Brussels, Brussels, Belgium
| | - K Finnegan
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda ; Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - C Cortas
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda ; Brigham and Women's Hospital, Boston, Massachusetts, USA ; Harvard Medical School, Boston, Massachusetts, USA
| | - E Kamanzi
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
| | - J K Hamon
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
| | - B L Hedt-Gauthier
- Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda ; Harvard Medical School, Boston, Massachusetts, USA ; National University of Rwanda School of Public Health, Kigali, Rwanda
| |
Collapse
|
22
|
Jessani N, Lewy D, Ekirapa-Kiracho E, Bennett S. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool. Health Res Policy Syst 2014; 12:21. [PMID: 24888213 PMCID: PMC4067125 DOI: 10.1186/1478-4505-12-21] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 04/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. METHODS Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. RESULTS The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. CONCLUSIONS This institutional HSR capacity assessment tool and the process for its utilization may be valuable for any SPH. The self-assessments, as well as interviews with external stakeholders, provided diverse sources of input and galvanized interest around HSR at multiple levels.
Collapse
Affiliation(s)
- Nasreen Jessani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Daniela Lewy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Elizabeth Ekirapa-Kiracho
- Department of Health Policy Planning and Management, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Sara Bennett
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| |
Collapse
|
23
|
Cole DC, Boyd A, Aslanyan G, Bates I. Indicators for tracking programmes to strengthen health research capacity in lower- and middle-income countries: a qualitative synthesis. Health Res Policy Syst 2014; 12:17. [PMID: 24725961 PMCID: PMC3999501 DOI: 10.1186/1478-4505-12-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/31/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The monitoring and evaluation of health research capacity strengthening (health RCS) commonly involves documenting activities and outputs using indicators or metrics. We sought to catalogue the types of indicators being used to evaluate health RCS and to assess potential gaps in quality and coverage. METHODS We purposively selected twelve evaluations to maximize diversity in health RCS, funders, countries, and approaches to evaluation. We explored the quality of the indicators and extracted them into a matrix across individual, institutional, and national/regional/network levels, based on a matrix in the ESSENCE Planning, Monitoring and Evaluation framework. We synthesized across potential impact pathways (activities to outputs to outcomes) and iteratively checked our findings with key health RCS evaluation stakeholders. RESULTS Evaluations varied remarkably in the strengths of their evaluation designs. The validity of indicators and potential biases were documented in a minority of reports. Indicators were primarily of activities, outputs, or outcomes, with little on their inter-relationships. Individual level indicators tended to be more quantitative, comparable, and attentive to equity considerations. Institutional and national-international level indicators were extremely diverse. Although linkage of activities through outputs to outcomes within evaluations was limited, across the evaluations we were able to construct potential pathways of change and assemble corresponding indicators. CONCLUSIONS Opportunities for improving health RCS evaluations include work on indicator measurement properties and development of indicators which better encompass relationships with knowledge users. Greater attention to evaluation design, prospective indicator measurement, and systematic linkage of indicators in keeping with theories of change could provide more robust evidence on outcomes of health RCS.
Collapse
Affiliation(s)
- Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
| | | | | | | |
Collapse
|
24
|
Njelesani J, Dacombe R, Palmer T, Smith H, Koudou B, Bockarie M, Bates I. A systematic approach to capacity strengthening of laboratory systems for control of neglected tropical diseases in Ghana, Kenya, Malawi and Sri Lanka. PLoS Negl Trop Dis 2014; 8:e2736. [PMID: 24603407 PMCID: PMC3945753 DOI: 10.1371/journal.pntd.0002736] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 01/29/2014] [Indexed: 11/23/2022] Open
Abstract
Background The lack of capacity in laboratory systems is a major barrier to achieving the aims of the London Declaration (2012) on neglected tropical diseases (NTDs). To counter this, capacity strengthening initiatives have been carried out in NTD laboratories worldwide. Many of these initiatives focus on individuals' skills or institutional processes and structures ignoring the crucial interactions between the laboratory and the wider national and international context. Furthermore, rigorous methods to assess these initiatives once they have been implemented are scarce. To address these gaps we developed a set of assessment and monitoring tools that can be used to determine the capacities required and achieved by laboratory systems at the individual, organizational, and national/international levels to support the control of NTDs. Methodology and principal findings We developed a set of qualitative and quantitative assessment and monitoring tools based on published evidence on optimal laboratory capacity. We implemented the tools with laboratory managers in Ghana, Malawi, Kenya, and Sri Lanka. Using the tools enabled us to identify strengths and gaps in the laboratory systems from the following perspectives: laboratory quality benchmarked against ISO 15189 standards, the potential for the laboratories to provide support to national and regional NTD control programmes, and the laboratory's position within relevant national and international networks and collaborations. Conclusion We have developed a set of mixed methods assessment and monitoring tools based on evidence derived from the components needed to strengthen the capacity of laboratory systems to control NTDs. Our tools help to systematically assess and monitor individual, organizational, and wider system level capacity of laboratory systems for NTD control and can be applied in different country contexts. Capacity strengthening activities such as technical training for staff, student research project supervision, and equipment provision are being carried out in laboratories worldwide as part of the global effort to control neglected tropical diseases (NTDs). However, these activities often focus on developing the skill sets of an individual and are not being thoroughly monitored and assessed. To address these gaps we developed a set of monitoring and assessment tools that can be used to determine the capacities required and achieved by laboratory systems to support the control of NTDs. The tools simultaneously focus on individuals (e.g., technicians, students, researchers), organisations (e.g., universities, research institutions, clinical facilities), national governments, and international agencies. Using the tools highlighted the strengths and limitations of each laboratory system in addition to the role of the laboratory regionally and internationally. We used the tools in Kenya, Ghana, Malawi and Sri Lanka, and concluded that our tools can be adapted and tailored to use in other countries and laboratories.
Collapse
Affiliation(s)
- Janet Njelesani
- Capacity Research Unit, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
| | - Russell Dacombe
- Capacity Research Unit, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Tanith Palmer
- Capacity Research Unit, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Helen Smith
- Capacity Research Unit, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Benjamin Koudou
- Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Moses Bockarie
- Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Imelda Bates
- Capacity Research Unit, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| |
Collapse
|
25
|
Bennett S, Paina L, Ssengooba F, Waswa D, M'Imunya JM. The impact of Fogarty International Center research training programs on public health policy and program development in Kenya and Uganda. BMC Public Health 2013; 13:770. [PMID: 23964653 PMCID: PMC3851767 DOI: 10.1186/1471-2458-13-770] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 08/06/2013] [Indexed: 11/18/2022] Open
Abstract
Background The Fogarty International Center (FIC) has supported research capacity development for over twenty years. While the mission of FIC is supporting and facilitating global health research conducted by U.S. and international investigators, building partnerships between health research institutions in the U.S. and abroad, and training the next generation of scientists to address global health needs, research capacity may impact health policies and programs and therefore have positive impacts on public health. We conducted an exploratory analysis of how FIC research training investments affected public health policy and program development in Kenya and Uganda. Methods We explored the long term impacts of all FIC supported research training programs using case studies, in Kenya and Uganda. Semi-structured in-depth interviews were conducted with 53 respondents and 29 focus group discussion participants across the two countries. Qualitative methods were supplemented by structured surveys of trainees and document review, including a review of evidence cited in policy documents. Results In the primary focal areas of FIC grants, notably HIV/AIDS, there were numerous examples of work conducted by former FIC trainees that influenced national and global policies. Facilitators for this influence included the strong technical skills and scientific reputations of the trainees, and professional networks spanning research and policy communities. Barriers included the fact that trainees typically had not received training in research communication, relatively few policy makers had received scientific training, and institutional constraints that undermined alignment of research with policy needs. Conclusions While FIC has not focused its programs on the goal of policy and program influence, its investments have affected global and national public health policies and practice. These influences have occurred primarily through strengthening research skills of scientists and developing strong in-country networks. Further success of FIC and similar initiatives could be stimulated by investing more in the training of policy-makers, seeking to better align research with policy needs through more grants that are awarded directly to developing country institutions, and grants that better incorporate policy maker perspectives in their design and governance. Addressing structural constraints, for example supporting the development of national research agendas that inform university research, would further support such efforts.
Collapse
Affiliation(s)
- Sara Bennett
- Johns Hopkins School of Public Health, Baltimore, MD, USA.
| | | | | | | | | |
Collapse
|
26
|
Sanchez AL, Canales M, Enriquez L, Bottazzi ME, Zelaya AA, Espinoza VE, Fontecha GA. A research capacity strengthening project for infectious diseases in Honduras: experience and lessons learned. Glob Health Action 2013; 6:21643. [PMID: 23930937 PMCID: PMC3739968 DOI: 10.3402/gha.v6i0.21643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 07/17/2013] [Accepted: 07/18/2013] [Indexed: 11/17/2022] Open
Abstract
Background In Honduras, research capacity strengthening (RCS) has not received sufficient attention, but an increase in research competencies would enable local scientists to advance knowledge and contribute to national priorities, including the Millennium Development Goals (MDGs). Objective This project aimed at strengthening research capacity in infectious diseases in Honduras, focusing on the School of Microbiology of the National Autonomous University of Honduras (UNAH). The primary objective was the creation of a research-based graduate program for the continued training of researchers. Parallel objectives included institutional strengthening and the facilitation of partnerships and networks. Methods Based on a multi-stakeholder consultation, an RCS workplan was designed and undertaken from 2007 to 2012. Due to unexpected adverse circumstances, the first 2 years were heavily dedicated to implementing the project's flagship, an MSc program in infectious and zoonotic diseases (MEIZ). In addition, infrastructure improvements and demand-driven continuing education opportunities were facilitated; biosafety and research ethics knowledge and practices were enhanced, and networks fostering collaborative work were created or expanded. Results The project coincided with the peak of UNAH's radical administrative reform and an unprecedented constitutional crisis. Challenges notwithstanding, in September 2009, MEIZ admitted the first cohort of students, all of whom undertook MDG-related projects graduating successfully by 2012. Importantly, MEIZ has been helpful in expanding the School of Microbiology's traditional etiology-based, disciplinary model to infectious disease teaching and research. By fulfilling its objectives, the project contributed to a stronger research culture upholding safety and ethical values at the university. Conclusions The resources and strategic vision afforded by the project enhanced UNAH's overall research capacity and its potential contribution to the MDGs. Furthermore, increased research activity and the ensuing improvement in performance indicators at the prime Honduran research institution invoke the need for a national research system in Honduras.
Collapse
Affiliation(s)
- Ana Lourdes Sanchez
- Department of Community Health Sciences, Brock University, St. Catharines, Ontario, Canada.
| | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Health research capacity strengthening (HRCS) is a strategy implemented worldwide to improve the ability of developing countries to tackle the persistent and disproportionate burdens of disease they face. Drawing on a review of existing HRCS literature and our experiences over the course of an HRCS project in Vietnam, we summarise major challenges to the HRCS enterprise at the interpersonal, institutional and macro levels. While over the course of several decades of HRCS initiatives many of these challenges have been well documented, we highlight several considerations that remain underarticulated. We advance critical considerations of the HRCS enterprise by discussing (1) how the organisation of US public health funding shapes the ecology of knowledge production in low- and middle-income country contexts, (2) the barriers US researchers face to effectively collaborate in capacity strengthening for research-to-policy translation, and (3) the potential for unintentional negative consequences if HRCS efforts are not sufficiently reflexive about the limitations of dominant paradigms in public health research and intervention.
Collapse
Affiliation(s)
- Emily E Vasquez
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | | | | | | |
Collapse
|
28
|
Minja H, Nsanzabana C, Maure C, Hoffmann A, Rumisha S, Ogundahunsi O, Zicker F, Tanner M, Launois P. Impact of health research capacity strengthening in low- and middle-income countries: the case of WHO/TDR programmes. PLoS Negl Trop Dis 2011; 5:e1351. [PMID: 22022630 PMCID: PMC3191138 DOI: 10.1371/journal.pntd.0001351] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 08/25/2011] [Indexed: 12/03/2022] Open
Abstract
Background Measuring the impact of capacity strengthening support is a priority for the international development community. Several frameworks exist for monitoring and evaluating funding results and modalities. Based on its long history of support, we report on the impact of individual and institutional capacity strengthening programmes conducted by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and on the factors that influenced the outcome of its Research Capacity Strengthening (RCS) activities. Methodology and Principal Findings A mix of qualitative and quantitative methods (questionnaires and in-depth interviews) was applied to a selected group of 128 individual and 20 institutional capacity development grant recipients that completed their training/projects between 2000 and 2008. A semi-structured interview was also conducted on site with scientists from four institutions. Most of the grantees, both individual and institutional, reported beneficial results from the grant. However, glaring inequities stemming from gender imbalances and a language bias towards English were identified. The study showed that skills improvement through training contributed to better formulation of research proposals, but not necessarily to improved project implementation or communication of results. Appreciation of the institutional grants' impact varied among recipient countries. The least developed countries saw the programmes as essential for supporting basic infrastructure and activities. Advanced developing countries perceived the research grants as complementary to available resources, and particularly suitable for junior researchers who were not yet able to compete for major international grants. Conclusion The study highlights the need for a more equitable process to improve the effectiveness of health research capacity strengthening activities. Support should be tailored to the existing research capacity in disease endemic countries and should focus on strengthening national health research systems, particularly in the least developing countries. The engagement of stakeholders at country level would facilitate the design of more specific and comprehensive strategies based on local needs. The UNICEF/UNDP/World Bank /WHO Special Programme for Research and Training in Tropical Diseases (TDR) has over the 2000–2008 period supported the development of individual and institutional grants. Although the TDR research capacity development programmes has had a substantial impact on the development of tropical disease research and research capacity in disease endemic countries, a review of the lessons learnt and benefits of this approach has never been completed. A study was conducted to analyse TDR's inputs in research capacity in endemic countries and to assist TDR in the improvement of its future activities. An analysis (by variables of gender, age, language, country of origin, country of studies, type of grant, scientific interest etc) of the grantees that have benefited from TDR support in terms of their career development and research capacity, including any important financial implications was conducted. The study identify opportunities that are a broader relevance to objectives to international development agencies such as addressing inequities such as the gender imbalance language bias towards English and building a supportive research environment in DECs in which researchers can develop their scientific career and pursue their research.
Collapse
Affiliation(s)
- Happiness Minja
- Ifakara Health Institute, Ifakara, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Christine Maure
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
| | - Axel Hoffmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Susan Rumisha
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Olumide Ogundahunsi
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
| | - Fabio Zicker
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Pascal Launois
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland
- * E-mail:
| |
Collapse
|