Rethinking health research capacity strengthening

Abstract

Health research capacity strengthening (HRCS) is a strategy implemented worldwide to improve the ability of developing countries to tackle the persistent and disproportionate burdens of disease they face. Drawing on a review of existing HRCS literature and our experiences over the course of an NIH-funded HRCS project in Vietnam, we summarise major challenges to the HRCS enterprise at the interpersonal, institutional and macro levels. While over the course of several decades of HRCS initiatives many of these challenges have been well documented, we highlight several considerations that remain under-articulated. We advance critical considerations of the HRCS enterprise by discussing 1) how the organisation of US public health funding shapes the ecology of knowledge production in low- and middle-income country contexts, 2) the barriers US researchers face to effectively collaborating in capacity strengthening for research-to-policy translation, and 3) the potential for unintentional negative consequences if HRCS efforts are not sufficiently reflexive about the limitations of dominant paradigms in public health research and intervention.

A research capacity strengthening project for infectious diseases in Honduras: experience and lessons learned

“…Both terms are often regarded as synonymous but we coincide with other authors that the former is more encompassing as it conveys the intention to enhance pre-existing capacity (31). Our project implementation used a ‘multi-level approach’ (32).…”

“…The fact that the Canadian principal investigator (PI) was a Honduran expatriate, former faculty member of the School of Microbiology and KIRT graduate, minimized the challenges that sometimes arise at the interpersonal level during RCS initiatives (31). Partnerships operating with expatriate research leaders can lead to sophisticated and yet neo-colonial models of collaborations (38), but the present partnership responded was relevant to the Honduran partner needs.…”

“The way the country has been carved up by researchers”: ethics and power in north–south public health research

“…Perhaps these changes in north–south health research are subtle and the increasing opportunities for Zambian researchers (in agenda setting, data analysis and authorship) have not yet been fully recognised or taken on board by the Zambian researchers. Studies in the area of north–south health research consistently report a lack of capacity in the south as being one of the major reasons for north–south power imbalances [41, 42]. It may also be the case that research donor claims that they wish to see southern-driven research has been lip-service, not supported by institutional capacity-building action.…”

Caught in the Middle: The Contested Politics of HIV/AIDS and Health Policy in Vietnam

“…The unexpected consequences of HIV scale-up and donor involvement have included, for example, Hanoi Pride 2012, a public event which would hardly have been imaginable only a decade before. Nor should one be too celebratory about the valence of the unintentional; as noted above, there have been significant negative consequences of scale-up in terms of the ways in which the structure of global funding has created disincentives for independent health scholarship (Vasquez et al 2013). This final observation just underlines the critical nature of further work on the interplay between global actors, civil society, and the state in shaping health policy.…”

“…The vast external funds that began to pour into the country within a relatively short period of time as the result of PEPFAR and similar Global Health Initiatives, perhaps ironically, created new human resource challenges, beyond even those noted in terms of clinical capacity (Friedman et al 2006; Sumartojo 2000; Davis and Howden-Chapman 1996). The opportunities for external consultancies offered by well-funded, multi-lateral organizations have led to a kind of ‘brain drain’ from universities to the local and international NGOs that leapt at the opportunity to compete for donor funding (Vasquez et al 2013). …”