IntroductionAs 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.MethodsUsing 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.ResultsWe 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.ConclusionMost 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.
This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees’ research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.
Program is delighted that this supplementary issue of the Asia-Pacific Journal of Public Health has come to fruition. This special edition of the journal features research articles from a number of the research trainees from the ASCEND program, a noncommunicable disease (NCD) research training and mentoring program for early-and mid-career researchers from India, Malaysia, and Sri Lanka, which has been established by funding from the Fogarty International Center, United States National Institutes of Health 1 since 2010.As noted by Mehta 2 in his commentary piece in this same issue, NCDs including cardiovascular disease (CVD), diabetes, chronic respiratory diseases, and cancers now account for the highest burden of disease and mortality in both the developing and developed world. Alarmingly, rates of NCDs such as CVD, diabetes, mental health disorders, and cancers are continuing to rise, particularly in low-and middle-income countries (LMICs), including in South Asia. Too little research has been undertaken in LMICs about how to implement programs and policies that can improve health, prevent chronic conditions, and also help improve their management. This improved evidence base needs to take account of the many special issues and challenges that confront low and middle income countries in addressing the prevention and control of NCDs. Often, there are health system challenges, a lack of health professionals and most importantly, a lack of a health research workforce to undertake the research to develop an evidence base that considers the enablers of and barriers to effective implementation in the local context.The ASCEND Program strives to build this evidence-base by strengthening NCD research capacity across Asia, providing high-quality research training and building a regional network of NCD researchers and research institutions with a special focus on prevention and more "upstream" determinants of health and interventions. The program has also focused on the new field of implementation science as applied to public health interventions and programs. To date, it has provided training to 50 young researchers from university and research institutions within participating countries and it has also established a diverse network of regional collaborators from government, nongovernment and other organizations as well as researchers from a number of other countries.
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