Building leadership capacity and future leaders in operational research in low-income countries: Why and how?

Medical Department, Médecins Sans Frontières, Operational Centre Brussels, MSF-Luxembourg, Luxembourg.
The International Journal of Tuberculosis and Lung Disease (Impact Factor: 2.32). 11/2011; 15(11):1426-35, i. DOI: 10.5588/ijtld.11.0316
Source: PubMed


Very limited operational research (OR) emerges from programme settings in low-income countries where the greatest burden of disease lies. The price paid for this void includes a lack of understanding of how health systems are actually functioning, not knowing what works and what does not, and an inability to propose adapted and innovative solutions to programme problems. We use the National Tuberculosis Control Programme as an example to advocate for strong programme-level leadership to steer OR and build viable relationships between programme managers, researchers and policy makers. We highlight the need to create a stimulating environment for conducting OR and identify some of the main practical challenges and enabling factors at programme level. We focus on the important role of an OR focal point within programmes and practical approaches to training that can deliver timely and quantifiable outputs. Finally, we emphasise the need to measure successful OR leadership development at programme level and we propose parameters by which this can be assessed. This paper 1) provides reasons why programmes should take the lead in coordinating and directing OR, 2) identifies the practical challenges and enabling factors for implementing, managing and sustaining OR and 3) proposes parameters for measuring successful leadership capacity development in OR.

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Available from: Unni Karunakara
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    • "The need for health systems research (HSR) to inform healthcare-related decision-making and policy making has long been underscored [1]. To enable HSR results to be used, however, their translation and communication is imperative [2]. Low-income countries (LICs) must begin to focus on how to improve evidence-based policy making by investing in HSR for better health service delivery and to achieve Millennium Development Goals [3,4]. "
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    ABSTRACT: Background Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa. Methods Capacity assessment done included document analysis to establish staff numbers, qualifications and publications; self-assessment using a tool developed to capture individual perceptions on the capacity for HSR and institutional dialogues. Key informant interviews (KIIs) were held with Deans from each SPH and Ministry of Health and non-governmental officials, focusing on perceptions on capacity of SPHs to engage in HSR, access to funding, and organizational support for HSR. Results A total of 123 people participated in the self-assessment and 73 KIIs were conducted. Except for the National University of Rwanda and the University of Nairobi SPH, most respondents expressed confidence in the adequacy of staffing levels and HSR-related skills at their SPH. However, most of the researchers operate at individual level with low outputs. The average number of HSR-related publications was only <1 to 3 per staff member over a 6-year period with most of the publications in international journals. There is dependency on external funding for HSR, except for Rwanda, where there was little government funding. We also found that officials from the Ministries of Health often formulate policy based on data generated through ad hoc technical reviews and consultancies, despite their questionable quality. Conclusions There exists adequate skilled staff for HSR in the SPHs. However, HSR conducted by individuals, fuelled by Ministries’ of Health tendency to engage individual researchers, undermines institutional capacity. This study underscores the need to form effective multidisciplinary teams to enhance research of immediate and local relevance. Capacity strengthening in the SPH needs to focus on knowledge translation and communication of findings to relevant audiences. Advocacy is needed to influence respective governments to allocate adequate funding for HSR to avoid donor dependency that distorts local research agenda.
    Full-text · Article · Jun 2014 · Health Research Policy and Systems
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    • "Engaging them at the conceptual and planning stages is vital so that studies are of direct relevance to their programmes and cover areas where maximal policy impact can be achieved. In OR, the guiding principles for generating research questions involve reviewing the objectives of the programmes, identifying the constraints that prevent these objectives from being met, and developing research questions around these constraints so that solutions can be found to enable realisation of programme objectives (Harries 2003; Zachariah et al. 2011). As national programme managers are most aware of their programme constraints, involving them in the early stages of generating study questions ensures that those questions are relevant. "

    Full-text · Article · May 2013 · Tropical Medicine & International Health

  • No preview · Article · Nov 2011 · The International Journal of Tuberculosis and Lung Disease
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