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      Strengthening research capacity in LMICs to address the global NCD burden

      research-article
      , , , ,
      Global Health Action
      Taylor & Francis
      Noncommunicable diseases, capacity building, global health, scientific research, research training

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          ABSTRACT

          The burden of noncommunicable diseases (NCDs) continues to rise across the globe, and the risk of dying prematurely from an NCD in a low- and middle-income country (LMIC) is almost double that in a high-income country. Confronting this crisis requires a critical mass of scientists who are well versed in regional health problems and understand the cultural, social, economic, and political contexts that influence the effectiveness of interventions to address NCDs. Investing in research capacity strengthening in LMICs is critical to effectively combating disease, and local researchers are best poised to address the health challenges in their home countries given their understanding of the unique culture and context in which they are working. The Fogarty International Center of the U.S. National Institutes of Health has a set of programs focused on building individual and institutional NCD research capacity in LMICs. The Programs provide models for sustainable scientific research capacity strengthening, innovative funding mechanisms and partnership-building approaches. Investing in the training and scientific capacity of LMIC individuals and institutions not only helps foster a research culture and solidify local ownership of research, but it also ensures that the most appropriate solutions are developed, increasing the likelihood that those solutions will sustain over time. In addition, the Programs’ investigators have advanced the science across a range of NCDs and associated risk factors. This article describes key lessons and compelling cases from the Programs that can be harnessed by other health researchers and funders to further the global response to the NCD burden.

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          Most cited references19

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          The Lancet Commission on pollution and health

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            Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature

            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.
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              A narrative review of health research capacity strengthening in low and middle-income countries: lessons for conflict-affected areas

              Conducting health research in conflict-affected areas and other complex environments is difficult, yet vital. However, the capacity to undertake such research is often limited and with little translation into practice, particularly in poorer countries. There is therefore a need to strengthen health research capacity in conflict-affected countries and regions. In this narrative review, we draw together evidence from low and middle-income countries to highlight challenges to research capacity strengthening in conflict, as well as examples of good practice. We find that authorship trends in health research indicate global imbalances in research capacity, with implications for the type and priorities of research produced, equity within epistemic communities and the development of sustainable research capacity in low and middle-income countries. Yet, there is little evidence on what constitutes effective health research capacity strengthening in conflict-affected areas. There is more evidence on health research capacity strengthening in general, from which several key enablers emerge: adequate and sustained financing; effective stewardship and equitable research partnerships; mentorship of researchers of all levels; and effective linkages of research to policy and practice. Strengthening health research capacity in conflict-affected areas needs to occur at multiple levels to ensure sustainability and equity. Capacity strengthening interventions need to take into consideration the dynamics of conflict, power dynamics within research collaborations, the potential impact of technology, and the wider political environment in which they take place.
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                Author and article information

                Journal
                Glob Health Action
                Glob Health Action
                Global Health Action
                Taylor & Francis
                1654-9716
                1654-9880
                29 December 2020
                2020
                : 13
                : 1
                : 1846904
                Affiliations
                [0001]Fogarty International Center, National Institutes of Health; , Bethesda, MD, USA
                Author notes
                CONTACT Arianne Malekzadeh arianne.malekzadeh@ 123456nih.gov Fogarty International Center, National Institutes of Health; , MD 20892USA
                Author information
                https://orcid.org/0000-0002-7083-1817
                Article
                1846904
                10.1080/16549716.2020.1846904
                7782223
                33373280
                b0233ea5-900f-46f5-a9b2-9257234646ff
                © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 2, Tables: 2, References: 21, Pages: 1
                Categories
                Research Article
                Capacity Building

                Health & Social care
                noncommunicable diseases,capacity building,global health,scientific research,research training

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