Barriers to sustainable health research leadership in the Global South: Time for a Grand Bargain on localization of research leadership?

BACKGROUND

Strong Global South (GS) health research leadership, itself both dependent on and a requisite for strong health research systems, is essential to generate locally relevant research and ensure that evidence is translated into policy and practice. Strong GS health research systems and leadership are important for health development and in turn for strong health systems. However, many GS countries struggle to produce research and to improve performance on widely used research metrics measuring productivity and reflecting leadership. Drawing on literature from a rapid review, this viewpoint paper considers the barriers to GS health research leadership and proposes strategies to address these challenges.

FINDINGS

GS researchers and institutions face numerous barriers that undermine health research leadership potential. Barriers internal to the GS include researcher-level barriers such as insufficient mentorship, limited financial incentives and time constraints. Institutional barriers include limited availability of resources, restrictive and poorly developed research infrastructures, weak collaboration and obstructive policies and procedures. Structural barriers include political will, politicization of research and political instability. External barriers relate to the nature and extent of Global North (GN) activities and systems and include allocation and distribution of funding and resources, characteristics and focus of GN-GS research collaborations, and publication and information dissemination challenges.

CONCLUSIONS

Strengthening GS health research leadership requires acknowledgement of the many barriers, and adoption of mitigating measures by a range of actors at the institutional, national, regional and global levels. Particularly important are leadership capacity development integrating researcher, institutional and systems initiatives; new GN-GS partnership models emphasizing capacity exchange and shared leadership; supporting GS research communities to set, own and drive their research agendas; addressing biases against GS researchers; ensuring that GS institutions address their internal challenges; enhancing South-South collaborations; diversifying research funding flow to the GS; and learning from models that work. The time has come for a firm commitment to improving localization of research leadership, supported by adequate funding flow, to ensure strong and sustainable research systems and leadership in and from the GS. Just as the humanitarian donor and aid community adopted the Grand Bargain commitment to improve funding flow through local and national responders in times of crisis, we strongly urge the global health research community to adopt a Grand Bargain for research leadership.

The European & Developing Countries Clinical Trials Partnership (EDCTP) Knowledge Hub: developing an open platform for facilitating high-quality clinical research

There is stark global inequity in health research in terms of where studies happen, who leads the research and the ultimate beneficiaries of the results generated. Despite significant efforts made, limited research ideas are conceptualised and implemented in low-resource settings to tackle diseases of poverty, and this is especially true in sub-Saharan Africa. There is strong evidence to show that the barriers to locally led research do not vary largely between disease, study type and location and can be largely solved by addressing these common gaps. The European & Developing Countries Clinical Trials Partnership (EDCTP) was established in 2003 as a European response to the global health crisis caused by the three main poverty-related diseases HIV, tuberculosis and malaria. EDCTP has established a model of long-term sustainable capacity development integrated into clinical trials which addresses this lack of locally led research in sub-Saharan Africa, supporting the development of individual and institutional capacity and research outputs that change the management, prevention and treatment of poverty-related and neglected infectious diseases across Africa. In recognition of emergent data on what the barriers and enablers are to long-term, sustainable capabilities to run studies, EDCTP formed a new collaboration with The Global Health Network (TGHN) in September 2017, with the aim to make a set of cross-cutting tools and resources to support the planning, writing and delivery of high-quality clinical trials available to research staff wherever they are in the world, especially those in low- and middle-income countries (LMICs) via TGHN platform. These new resources developed on the ‘EDCTP Knowledge Hub’ are those identified in the mixed method study described in this commentary as being key to addressing the gaps that the research community report as the most limiting elements in their ability to design and implement studies. The Knowledge Hub aims to make these tools freely available to any potential health research team in need of support and guidance in designing and running their own studies, particularly in low-resource settings. The purpose is to provide open access to the specific guidance, information and tools these teams cannot otherwise access freely. Ultimately, this will enable them to design and lead their own high-quality studies addressing local priorities with global alignment, generating new data that can change health outcomes in their communities.

Clinical academic radiographers - A challenging but rewarding career

OBJECTIVES

To explain what a clinical academic career can be, what it can lead to for the individual, profession and most importantly the patient, and why these roles are so important to radiography.

KEY FINDINGS

Multiple challenges to the adoption of clinical academic careers exist, including achievable measurable outcomes, visibility & senior support, and balancing different time demands. Equally the rewards are wide ranging and can advance both the individual and profession through role extension opportunities, increased career progression, patient benefits, and academic and research skills.

CONCLUSION

Clinical academic careers can provide advantages for the individual, department, profession and most importantly the patient with advanced clinical practice through evidenced based research.

IMPLICATIONS FOR PRACTICE

Improving clinical academic careers within Radiography will promote research participation and increase radiographic roles in patient-centred research delivery and development. Combining evidenced based research with academic skills will lead to improved patient care and better clinical outcomes.

Characterizing research leadership on geographically weighted collaboration network

Research collaborations, especially long-distance and international collaborations, have become increasingly prevalent worldwide. Recent studies highlighted the significant role of research leadership in collaborations. However, existing measures of the research leadership do not take into account the intensity of leadership in the co-authorship network. More importantly, the spatial features, which influence the collaboration patterns and research outcomes, have not been incorporated in measuring the research leadership. To fill the gap, we construct an institution-level weighted co-authorship network that integrates two types of weight on the edges: the intensity of collaborations and the spatial score (the geographical distance adjusted by the cross-linguistic-border nature). Based on this network, we propose a novel metric, namely the spatial research leadership rank, to identify the leading institutions while considering both the collaboration intensity and the spatial features. The leadership of an institution is measured by the following three criteria: (a) the institution frequently plays the corresponding rule in papers with other institutions; (b) the institution frequently plays the corresponding rule in longer distance and even cross-linguistic-border collaborations; (c) the participating institutions led by the institution have high leadership status themselves. Harnessing a dataset of 323,146 journal publications in pharmaceutical sciences during 2010-2018, we perform a comprehensive analysis of the geographical distribution and dynamic patterns of research leadership flows at the institution level. The results demonstrate that the SpatialLeaderRank outperforms baseline metrics in predicting the scholarly impact of institutions. And the result remains robust in the field of Information Science and Library Science.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11192-021-03943-w.

Successful research capacity building in academic nursing and midwifery in Ireland: an exemplar

BACKGROUND

Nursing and midwifery education have comparatively recently moved into academia in Ireland. In 2002, nurse tutors who were qualified to Master's degree level assimilated into the third-level sector. Only 11 of the 35 staff (31%) in one university School held, or were undertaking, a PhD. In 2006, children's nursing and midwifery tutors also moved into third-level institutions. The culture of all assimilating tutors was focussed on teaching, rather than research.

OBJECTIVES

The School set ambitious plans to develop the research abilities of all academics, setting the goal that 75% of academic staff would either hold, or be undertaking, a PhD by 2010. Objectives were also set to increase external research funding, peer-reviewed publications and conference presentations.

METHODS

A combination of sabbatical leaves, student stipends and periods of reduced teaching load was introduced to provide staff with protected time for doctoral studies. Funding for conference and research expenses was provided, based on the previous year's research output of publications, conference presentations and external funding submissions.

RESULTS

By October 2010, 79% of the 66 School staff either had (n=23), or were conducting (n=29), PhDs, surpassing goals set. Peer-reviewed publications and conference presentations had increased by >20% per year and external research funding totalled €6,351,101 for the previous 5 years.

CONCLUSIONS

Strong research leadership, generous support and liberal encouragement can change a predominantly teaching-focussed culture to one of academic research excellence. This increase in research expertise will lead to better patient/client care and improved education of nursing and midwifery students.