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Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature
  1. Samuel R P Franzen1,2,
  2. Clare Chandler3,
  3. Trudie Lang1
  1. 1The Global Health Network, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
  2. 2Oxford Policy Management, Oxford, UK
  3. 3Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Dr Samuel R P Franzen; sam.franzen{at}opml.co.uk

Abstract

Objectives Locally 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.

Methods This 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.

Results 3 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.

Conclusions There 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 Despite an evolution in development thinking, international actors continue to use outdated development models that are recognised as ineffective.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.

  • QUALITATIVE RESEARCH
  • TROPICAL MEDICINE
  • EDUCATION & TRAINING (see Medical Education & Training)

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Collaborators Sisira Siribaddana and Julius Atashili.

  • Contributors SRPF, CC and TL conceived and designed the study. SF collected and analysed the data and drafted the manuscript with intellectual input and assistance from CC and TL. All authors approved the final version of the manuscript.

  • Funding This work was supported by a grant from The Bill and Melinda Gates Foundation to Professor Trudie Lang (grant reference: OPP1053843), and in part by a Nuffield Department of Medicine Doctoral Prize Studentship to Dr SRPF (http://www.ndm.ox.ac.uk/ndm-prize-studentships).

  • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.