Impact of Health Research Capacity Strengthening in Low- and Middle-Income Countries: The Case of WHO/TDR Programmes

Minja, Happiness; Nsanzabana, Christian; Maure, Christine; Hoffmann, Axel; Rumisha, Susan F.; Ogundahunsi, Olumide; Zicker, Fábio; Tanner, Marcel; Launois, Pascal

doi:10.1371/journal.pntd.0001351

Cited by 75 publications

(89 citation statements)

References 9 publications

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“…There is still insufficient capacity and ownership for health systems and health economics research in LMICs [38, 39]. Despite long-standing international interest in research capacity strengthening [40, 41] with some promising results [42, 43], good practice recommendations in this area are relatively recent [44–46]. Second, before their explicit inclusion in the Sustainable Development Goals (Target 3.4 “ reduce by one third premature mortality from NCDs through prevention and treatment, and promote mental health and wellbeing ”), NCDs received insufficient attention from national governments relative to the yet unfinished agenda of infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review

et al. 2018

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BackgroundThe evidence on the economic burden of cardiovascular disease (CVD) in low- and middle- income countries (LMICs) remains scarce. We conducted a comprehensive systematic review to establish the magnitude and knowledge gaps in relation to the economic burden of CVD and hypertension on households, health systems and the society.MethodsWe included studies using primary or secondary data to produce original economic estimates of the impact of CVD. We searched sixteen electronic databases from 1990 onwards without language restrictions. We appraised the quality of included studies using a seven-question assessment tool.ResultsEighty-three studies met the inclusion criteria, most of which were single centre retrospective cost studies conducted in secondary care settings. Studies in China, Brazil, India and Mexico contributed together 50% of the total number of economic estimates identified. The quality of the included studies was generally low. Reporting transparency, particularly for cost data sources and results, was poor. The costs per episode for hypertension and generic CVD were fairly homogeneous across studies; ranging between $500 and $1500. In contrast, for coronary heart disease (CHD) and stroke cost estimates were generally higher and more heterogeneous, with several estimates in excess of $5000 per episode. The economic perspective and scope of the study appeared to impact cost estimates for hypertension and generic CVD considerably less than estimates for stroke and CHD. Most studies reported monthly costs for hypertension treatment around $22. Average monthly treatment costs for stroke and CHD ranged between $300 and $1000, however variability across estimates was high. In most LMICs both the annual cost of care and the cost of an acute episode exceed many times the total health expenditure per capita.ConclusionsThe existing evidence on the economic burden of CVD in LMICs does not appear aligned with policy priorities in terms of research volume, pathologies studied and methodological quality. Not only is more economic research needed to fill the existing gaps, but research quality needs to be drastically improved. More broadly, national-level studies with appropriate sample sizes and adequate incorporation of indirect costs need to replace small-scale, institutional, retrospective cost studies.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5806-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review

et al. 2018

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“…The WHO and others have recognized that development of healthcare infrastructure is partly dependent on locally produced research [27,31], but less than 10% of global research resources and funding are dedicated to the population experiencing 90% of health problems worldwide-the 10/90 gap [13,31]. This skewed resource allocation is particularly pronounced in the orthopaedic literature where increased global musculoskeletal disease and trauma in the developing world have not been met with a concomitant increase in attention or funding [2,17,30].…”

Section: Introductionmentioning

confidence: 99%

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Elliott

Sonshine

Akhavan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Research addressing the burden of musculoskeletal disease in low-and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low-and middle-income countries. Purpose We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Materials Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. Results We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to This study was supported by private donations to the Institute for Global Orthopaedics and Traumatology (IGOT, San Francisco, CA, USA). No authors received payment or in-kind benefit for this study, nor are any authors members of a company that provided funding to IGOT. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the research process (26%) and institutional barriers (28%). Drivers of research discussed at least once were proportionally similar across the three domains. Some themes such as research ethics boards, technology, and literature access occurred with similar frequency as barriers to and drivers of orthopaedic surgery research. Conclusions The barriers we identified most often among East African academic orthopaedic faculty members focused on resources to accomplish research, followed by institutional barriers, and method or process ba...

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“…Another approach, and the one that we have adopted here, is using the output of peer‐reviewed publications as a surrogate measure of research capacity. Previous analyses have described the complex interaction of variables that result in peer‐reviewed publications: ‘Publishing in peer‐reviewed journals is not an end in itself, but rather a means of communicating research‐generated knowledge which can be translated into health policies, operational guidelines or health products ’. In addition, peer‐reviewed publications are essential for individual career progression, and access to research funding grants is often included as independent goals for research development funding schemes and has been used in previous studies as measures of effective health research .…”

Section: Discussionmentioning

confidence: 99%

Use of a bibliometric literature review to assess medical research capacity in post‐conflict and developing countries: Somaliland 1991–2013

Boyce

Rosch

Finlayson

et al. 2015

Tropical Med Int Health

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Abstractobjectives Effective healthcare systems require high-quality research to guide evidence-based interventions and strategic planning. In low-and middle-income countries, especially those emerging from violent conflict, research capacity often lags behind other aspects of health system development.Here, we sought to bibliometrically review health-related research output in Somaliland, a postconflict self-declared, autonomous nation on the Horn of Africa, as a means of assessing research capacity.methods We reviewed articles on health-related research conducted in Somaliland between 1991 and 2013 that included a description of the experimental design, and articles were published in either a peer-reviewed journal or as part of a scholarly programme receiving formal review. We did not include policy or social science research that did not enrol or interact with subjects from Somaliland. Using online databases, all studies meeting minimum eligibility criteria were reviewed in regard to Somaliland-based co-authorship, topic of research and specific measures of quality.results A total of 37 studies were included in this review. Of these, only 19 (51%) included coauthorship by Somaliland-based researchers. Of the 21 studies reporting ethical approval, 16 (64%) received approval from the Somalia or Somaliland Ministry of Health, while five received approval from a university or national commission. More than two-thirds of published research was limited to a few areas of investigation with most (19, 51%) following basic cross-sectional study designs. The number of articles published per year increased from 0 to 1 in the years 1991-2007 to a maximum of 8 in 2013.conclusions Research activity in Somaliland is extremely limited. Investigators from high-income countries have largely directed the research agenda in Somaliland; only half of the included studies list co-authors from institutions in Somaliland. Leadership and governance of health research in Somaliland is required to define national priorities, promote scholarly activity and guide the responsible conduct of research. The methods used here to assess research capacity may be generalisable to other low-and middle-income countries and post-conflict settings to measure the impact of research capacity-building efforts.

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Impact of Health Research Capacity Strengthening in Low- and Middle-Income Countries: The Case of WHO/TDR Programmes

Cited by 75 publications

References 9 publications

The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review

The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Use of a bibliometric literature review to assess medical research capacity in post‐conflict and developing countries: Somaliland 1991–2013

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