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

Abstract

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.

Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries

“…Therefore, there is limited understanding as to the extent to which researchers are engaged in KT or what types of supports or interventions encourage and enhance their KT practice. A LMIC-specific focus is warranted given the inherent challenges related to equity that LMIC researchers and research institutions face [25][26][27][28]. For instance, health research capacity in LMICs is insufficient [25][26][27].…”

“…A LMIC-specific focus is warranted given the inherent challenges related to equity that LMIC researchers and research institutions face [25][26][27][28]. For instance, health research capacity in LMICs is insufficient [25][26][27]. In addition, research in LMIC regions is largely funded by donors from high-income countries (HICs) and, typically, a requirement for accessing the funding is the formation of partnerships between LMIC and HIC researchers, which are led by the HIC researchers [25][26][27][28].…”

“…For instance, health research capacity in LMICs is insufficient [25][26][27]. In addition, research in LMIC regions is largely funded by donors from high-income countries (HICs) and, typically, a requirement for accessing the funding is the formation of partnerships between LMIC and HIC researchers, which are led by the HIC researchers [25][26][27][28]. These issues compromise the extent to which the research produced aligns to LMIC country research priorities, is perceived as relevant and credible, and is ultimately taken up in policy and practice [27,28].…”

Challenges of Publishing in High Impact Medical Journals from Lower- And Middle- Income Countries

“…Otherwise, research findings without distributing and disseminating are death 26 . Conducting research in low-and middle-income countries (LMICs) often very difficult because of funding, structural capacity, "flexibility, persistence, cultural humility, patience, and passion 11 " for the study 27,28 . Research funding allocated in LMICs were only 10% whereas these countries disease burden were 80-90% 29-.…”

“…Subsequently, publishing research findings from LMICs extremely difficult 1 . Nevertheless, the proficiency to carry out a research study and interpret research outcome were found frequently very inadequate, predominantly in resource-limited countries 27 . Additionally, health research capability is universally accepted as an index development in LMICs and is an essential prerequisite for attaining the Millennium Development Goals [32][33][34] .…”