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      Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity

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          Abstract

          Background

          Inadequate research capacity impedes the development of evidence-based health programming in sub-Saharan Africa. However, funding for research capacity building (RCB) is often insufficient and restricted, limiting institutions’ ability to address current RCB needs. The Doris Duke Charitable Foundation’s African Health Initiative (AHI) funded Population Health Implementation and Training (PHIT) partnership projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia) to implement health systems strengthening initiatives inclusive of RCB.

          Methods

          Using Cooke’s framework for RCB, RCB activity leaders from each country reported on RCB priorities, activities, program metrics, ongoing challenges and solutions. These were synthesized by the authorship team, identifying common challenges and lessons learned.

          Results

          For most countries, each of the RCB domains from Cooke’s framework was a high priority. In about half of the countries, domain specific activities happened prior to PHIT. During PHIT, specific RCB activities varied across countries. However, all five countries used AHI funding to improve research administrative support and infrastructure, implement research trainings and support mentorship activities and research dissemination. While outcomes data were not systematically collected, countries reported holding 54 research trainings, forming 56 mentor-mentee relationships, training 201 individuals and awarding 22 PhD and Masters-level scholarships. Over the 5 years, 116 manuscripts were developed. Of the 59 manuscripts published in peer-reviewed journals, 29 had national first authors and 18 had national senior authors. Trainees participated in 99 conferences and projects held 37 forums with policy makers to facilitate research translation into policy.

          Conclusion

          All five PHIT projects strongly reported an increase in RCB activities and commended the Doris Duke Charitable Foundation for prioritizing RCB, funding RCB at adequate levels and time frames and for allowing flexibility in funding so that each project could implement activities according to their trainees’ needs. As a result, many common challenges for RCB, such as adequate resources and local and international institutional support, were not identified as major challenges for these projects. Overall recommendations are for funders to provide adequate and flexible funding for RCB activities and for institutions to offer a spectrum of RCB activities to enable continued growth, provide adequate mentorship for trainees and systematically monitor RCB activities.

          Electronic supplementary material

          The online version of this article (10.1186/s12913-017-2657-6) contains supplementary material, which is available to authorized users.

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          Most cited references33

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          Building capacity in health research in the developing world.

          Strong national health research systems are needed to improve health systems and attain better health. For developing countries to indigenize health research systems, it is essential to build research capacity. We review the positive features and weaknesses of various approaches to capacity building, emphasizing that complementary approaches to human resource development work best in the context of a systems and long-term perspective. As a key element of capacity building, countries must also address issues related to the enabling environment, in particular: leadership, career structure, critical mass, infrastructure, information access and interfaces between research producers and users. The success of efforts to build capacity in developing countries will ultimately depend on political will and credibility, adequate financing, and a responsive capacity-building plan that is based on a thorough situational analysis of the resources needed for health research and the inequities and gaps in health care. Greater national and international investment in capacity building in developing countries has the greatest potential for securing dynamic and agile knowledge systems that can deliver better health and equity, now and in the future.
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            Knowledge for better health: a conceptual framework and foundation for health research systems.

            Health research generates knowledge that can be utilized to improve health system performance and, ultimately, health and health equity. We propose a conceptual framework for health research systems (HRSs) that defines their boundaries, components, goals, and functions. The framework adopts a systems perspective towards HRSs and serves as a foundation for constructing a practical approach to describe and analyse HRSs. The analysis of HRSs should, in turn, provide a better understanding of how research contributes to gains in health and health equity. In this framework, the intrinsic goals of the HRS are the advancement of scientific knowledge and the utilization of knowledge to improve health and health equity. Its four principal functions are stewardship, financing, creating and sustaining resources, and producing and using research. The framework, as it is applied in consultation with countries, will provide countries and donor agencies with relevant inputs to policies and strategies for strengthening HRSs and using knowledge for better health.
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              Operational research in low-income countries: what, why, and how?

              Operational research is increasingly being discussed at institutional meetings, donor forums, and scientific conferences, but limited published information exists on its role from a disease-control and programme perspective. We suggest a definition of operational research, clarify its relevance to infectious-disease control programmes, and describe some of the enabling factors and challenges for its integration into programme settings. Particularly in areas where the disease burden is high and resources and time are limited, investment in operational research and promotion of a culture of inquiry are needed so that health care can become more efficient. Thus, research capacity needs to be developed, specific resources allocated, and different stakeholders (academic institutions, national programme managers, and non-governmental organisations) brought together in promoting operational research.
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                Author and article information

                Contributors
                617-432-7262 , Bethany_Hedt@hms.harvard.edu
                Roma.Chilengi@cidrz.org
                ej2217@columbia.edu
                cathy.michel@healthallianceinternational.org
                mnapua@hotmail.com
                ojacklineatieno@gmail.com
                aabawah@gmail.com
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                21 December 2017
                21 December 2017
                2017
                : 17
                Issue : Suppl 3 Issue sponsor : Publication of this supplement has been funded by the African Health Initiative of the Doris Duke Charitable Foundation. The articles have undergone the journal's standard peer review process for supplements. LA declares that she is the Director for the African Health Initiative which was the primary funder for the projects described in this supplement as well as the funder for the supplement itself. LH and AG declare that they have no competing interests.
                : 825
                Affiliations
                [1 ]Partners In Health, Kigali, Rwanda
                [2 ]ISNI 000000041936754X, GRID grid.38142.3c, Department of Global Health and Social Medicine, , Harvard Medical School, ; Boston, MA 02115 USA
                [3 ]ISNI 0000 0004 0463 1467, GRID grid.418015.9, Centre for Infectious Disease Research in Zambia, ; Lusaka, Zambia
                [4 ]ISNI 0000000122483208, GRID grid.10698.36, University of North Carolina at Chapel Hill, ; Chapel Hill, USA
                [5 ]ISNI 0000000419368729, GRID grid.21729.3f, Heilbrunn Department of Population and Family Health, , Mailman School of Public Health, Columbia University, ; New York City, USA
                [6 ]Health Alliance International, Beira, Mozambique
                [7 ]Beira Operational Research Center, National Institute of Health, Beira, Mozambique
                [8 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Regional Institute for Population Studies, University of Ghana, ; Accra, Ghana
                Article
                2657
                10.1186/s12913-017-2657-6
                5763288
                29297405
                31a35588-7634-4e91-8457-116da2c7f75b
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                research capacity strengthening,research policy,research funding,africa,health programs,ghana,mozambique,rwanda,tanzania,zambia

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