A scoping review of non-communicable disease research capacity strengthening initiatives in low and middle-income countries

Abstract

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.

A Narrative Review of the Patient Journey Through the Lens of Non-communicable Diseases in Low- and Middle-Income Countries

“…Evidence-based decision-making for NCD prevention and control policies requires reliable and timely data [ 106 ]. The lack of mechanisms to collect high-quality data is a major barrier to successful implementation and monitoring of NCD programs in LMICs [ 107 ]. As a result, NCD policy recommendations at the national and local levels in LMICs are based on evidence from communicable diseases or from studies conducted in high-income countries, which can potentially impact the outcomes of these policies [ 107 ].…”

“…The lack of mechanisms to collect high-quality data is a major barrier to successful implementation and monitoring of NCD programs in LMICs [107]. As a result, NCD policy recommendations at the national and local levels in LMICs are based on evidence from communicable diseases or from studies conducted in high-income countries, which can potentially impact the outcomes of these policies [107]. Similarly, mapping patient journey for NCDs will require local evidence generation and continual monitoring of evidence to inform strategies to improve the patient journeys in LMICs.…”

Diabetes comorbidities in low- and middle-income countries: An umbrella review

“…Only then will it be possible to base LMIC policies and health priority setting on data that is representative of the LMIC context rather than the HIC context. Most of the disease management guidelines, treatments, and policy recommendations used in LMICs, especially with regard to non-communicable diseases, were either developed in HICs or adapted from existing infectious disease programmes [ 57 ]. While LMICs can seek inspiration from strategies that have and have not worked in HICs, it is important that context-specific programmes grounded in relevant data are developed [ 58 ].…”

A Methodology for Mapping the Patient Journey for Noncommunicable Diseases in Low- and Middle-Income Countries

“…Although it is widely recognized that NCDs are a significant issue for development and sustainability in LMICs, 1 , 3 programs to reduce the burden of NCDs have been limited by a lack of specific information on the design and implementation of these initiatives, and on their long-term impact. 49 There are other systemic, social, and financial barriers in LMICs that retard the translation of evidence into policy and practice improvements. 13 Strengthening local research capacity is essential, as noted in the WHO Global Action Plan for the Prevention and Control of NCDs 2013–2020.…”