This presentation was written by Sara Bennett, Ligia Paina, Christine Kim, Irene Agyepong, Somsak Chunharas, Di McIntyre and Stefan Nachuk for the Global Symposium on Health Systems Research, November, 2010.
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What must be done to ehance capacity for health systems research?
1. Sara Bennett, Ligia Paina, Christine Kim, Irene Agyepong,
Somsak Chunharas, Di McIntyre, Stefan Nachuk
2. Aims
Map different facets of HSR capacity at
individual, organizational and
environmental/network levels
Identify strategies to promote capacity
development for HSR and those that appear
effective
3. Methods
Defining HSR: health services, health systems research,
operational or intervention research
Mapping – review of existing international databases
Systematic review of capacity development initiatives for
HSR, including papers
Reported implementation of a project or initiative
HIC or LMIC
Whether or not evaluated
Capturing information on: nature of interventions,
context, implementation issues, evaluation design,
evaluation findings
Reflection on authors’ experiences
4. The Gap
The situation in LMICs The situation in US
Population – 5.5
billion
250-300 health
systems research
organizations in
LMICs
6-7,500 health systems
researchers
Population – 310 million
709 research
organizations that housed
PIs for HSR projects
13,000 health services
researchers
Source: Pittman & Holve 2009
5. Region # orgs
offering HS or
policy MScs
# orgs offering
HS or policy
PhDs or DrPHs
Types of course offerings
Africa 10 2 Health services planning
and management, health
economics, health systems
and policy
Americas 20 7 Politics and planning, public
policy and health, politics of
health
Asia 9 5 Health economics, Health
policy and systems, Health
financing
6. Overview of review findings
73 papers – 67% from HICs (especially US, UK,
Canada)
Most initiatives had multiple components
Initiatives targeted most at individual level, then
organizational then environmental/network
Largely targeted university based researchers (43%
HICs, 54% LMICs)
But service providers, especially GPs and nurses also a
key audience in HICs.
7. Interventions identified in systematic
review
HICs
Mentoring 31%
Research seminars 27%
Fellowships 24%
Research grants 24%
Partnerships 20%
Short courses 10%
Networking 18%
Post grad training 10%
Research infrastructure 10%
LMICs
Short courses 58%
Networking 38%
Research grants 29%
Post grad training 29%
Partnerships 25%
Basic training 17%
Mentoring 17%
Research infrastructure 8%
Strategic planning 4%
Research seminar 4%
8. Implementation factors (# studies)
Facilitators Constraints
Enthusiasm and motivation
of participants (5)
Institutional support from
parent organization (4)
Flexibility in program design
(4)
Strong leadership (3)
Builds on existing
partnerships (2)
Participatory approach (2)
Being part of broader
program (2)
Lack of time – participants,
staff and mentors (13)
Insufficient funding
(sustainability) (8)
High coordination costs (7)
Timelines too short (6)
Lack of support from host
organization (4)
Lack of confidence of
participants (4)
Lack of institutional and
managerial support (3)
Language barriers (3)
9. Key Findings
Interventions successful at the individual level had
limited overall effects due to organizational or
environmental level constraints
Few interventions targeted constraints at multiple
levels
Maintaining flexibility in capacity development
programs is key
Mentoring is an effective strategy
Short course training alone is necessary but not
sufficient for developing research capacity
Very few interventions evaluated – weak evaluation
designs, most by internal evaluators, no cost data
10. Evaluation of interventions
HICs LMICs
Total # articles 49 24
% articles with
evaluation
47% 37.5%
No. articles with
independent
evaluation
2 2
# articles with costs 10 7
11.
12. Over-arching
Capacity development interventions should be:
Multi-faceted, responding to capacity needs at different
levels
Tailored to the context where they are being
implemented
As we scale up investment in capacity development,
we must evaluate the effects of CD initiatives
13. Environment/network level
External funders should funnel a larger share of
their funding to local stakeholders
Strengthen networks between different types of
HSR actors within countries
Support capacity development among health
workers and health service organizations
14. Organizational level
Engage with organisational leaders to advocate for
HSR
Intensify efforts to secure predictable and sustainable
core funding, including endowments
Ensure better funding for research networks and
cross-country partnerships
15. Individual Level
Develop open access training modules in HSR that
support training needs of different types of
researchers coming to the field
Provide incentives and innovative schemes for senior
researchers to stay in-country
Hinweis der Redaktion
49 articles HICs, 24 articles LMICs
Problems: no baseline data, no comparison groups……