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

Abstract

ObjectivesLocally 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.MethodsThis 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.Results3 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.ConclusionsThere 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 Despite an evolution in development thinking, international actors continue to use outdated development models that are recognised as ineffective.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.

Developing a globally applicable evidence-informed competency framework to support capacity strengthening in clinical research

“…Research agendas and practices which are set in high-income settings indeed often fail to adequately target the disease burdens that affect the majority of the world's populations 34 To make real changes to global health outcomes, LMICs must therefore equip themselves with the skills to carry out high-quality research studies that address locally relevant research questions 5…”

Developing nursing research in the United Arab Emirates: a narrative review

“…Consequently, identifying building research capacity as a research process and outcome in itself is fundamental (Franzen et al. ).…”

“…Research culture is one important aspect (Scott & Pollock 2008) but low-and middle-income countries (LMIC) face similar challenges to elsewhere (Edwards et al 2009). Consequently, the lack of an integrated health systems and education approach, limited (local) evaluation (O'Byrne & Smith 2011) and the lack of value placed upon research capacity outcomes (Franzen et al 2016) ensure that the longitudinal approach required to build confidence, leadership (Scala et al 2016) critical mass and a coherent strategy, is perhaps more acutely felt in developing areas.…”

“…'Quick wins' may be encouraging in the short term but are probably unlikely to lead to substantial growth on their own. Consequently, identifying building research capacity as a research process and outcome in itself is fundamental (Franzen et al 2016).…”

Developing an international higher education partnerships between high and low-income countries: two case studies

“…It is well documented that "despite over 25 years of international efforts, health research capacity in LMICs remains insufficient" [5], and Nepal is no exception to this development.…”