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      Building capacity for maternal, newborn and child health research in low-income country settings: A research fellowship experience in Ethiopia

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          Abstract

          Background

          There is a need to build research capacity to improve maternal, newborn, and child health (MNCH) in low- and middle-income countries (LMICs). To address this gap, we co-designed the HaSET (meaning ‘happiness’ in Amharic) MNCH Research Fellowship programme for academics and policymakers in collaboration with the Ministry of Health (MOH) and academic institutions in Ethiopia.

          Methods

          Based on interviews and focus group discussions regarding a landscape analysis of the MNCH research environment, we developed an innovative ‘learning by doing’ model in which fellows identified research questions, developed proposals, obtained institutional review board (IRB) approvals, conducted research, analysed data, disseminated their findings, and developed policy briefs. Postdoctoral fellows were paired with policymakers and health professionals at the MoH to facilitate the translation of research findings into policy and programmes. Each pair received mentorship from a member of the HaSET’s scientific advisory group (SAG) who had expertise in research methods, data analysis, dissemination, and translation of evidence into policy.

          Results

          The HaSET MNCH Research Fellowship curriculum included 10 modules covering topics from biostatistics to study operations and professional development. From March 2021 to July 2023, five postdoctoral fellows from local universities and four policymakers from the MoH and government research institutes underwent the HaSET programme, where they learned to gather high-quality evidence on priority research questions and guide the implementation of national policies and programmes. Leveraging existing data, the fellows produced 15 manuscripts and 11 policy briefs. The programme established a functional research link between the MoH, regional health bureaus, and local universities, while utilising the SAG’s expertise in mentorship.

          Conclusions

          This robust and comprehensive HaSET MNCH Research Fellowship produced the first cohort of dedicated fellows trained in evidence-based medicine and mentored them to become effective public health professionals. They conducted high-quality studies to inform policy decisions on MNCH interventions in Ethiopia. Given its sustainability and scalability, researchers and academic institutions can further adapt the fellowship curriculum within capacity-building programmes to educate the next generation of research leaders in LMICs.

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          Most cited references22

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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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            Building Research Capacity in Africa: Equity and Global Health Collaborations

            Kathryn Chu and colleagues discuss the impact of high-income country investigators conducting research in low- and middle-income countries and explore lessons from the effective and equitable relationships that exist. Please see later in the article for the Editors' Summary
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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
                J Glob Health
                J Glob Health
                JGH
                Journal of Global Health
                International Society of Global Health
                2047-2978
                2047-2986
                29 November 2024
                2024
                : 14
                : 04198
                Affiliations
                [1 ]HaSET Maternal and Child Health Research Program, Addis Ababa, Ethiopia
                [2 ]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
                [3 ]Department of Pediatric and Child Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
                [4 ]College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
                [5 ]Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
                [6 ]Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia, Addis Ababa, Ethiopia
                [7 ]Director General, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
                [8 ]Deputy Director General Office for Research and Technology Transfer Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
                [9 ]Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
                Author notes
                Correspondence to:
Grace Chan, MD, MPH, PhD
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School
677 Huntington Avenue, Boston, 02115 Massachusetts
USA
 grace.chan@ 123456hsph.harvard.edu
                Author information
                https://orcid.org/0000-0003-4647-5178
                https://orcid.org/0000-0002-9840-7559
                https://orcid.org/0000-0001-9956-0099
                https://orcid.org/0000-0002-3992-891X
                https://orcid.org/0000-0001-7585-0120
                https://orcid.org/0000-0002-3779-0718
                https://orcid.org/0000-0002-9243-2622
                https://orcid.org/0000-0002-2716-1643
                Article
                jogh-14-04198
                10.7189/jogh.14.04198
                11605490
                39611220
                807400d0-c052-4ae5-bd27-f8ebac99b107
                Copyright © 2024 by the Journal of Global Health. All rights reserved.

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 25, Pages: 9
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                Public health
                Public health

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