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Balancing the personal, local, institutional, and global: multiple case study and multidimensional scaling analysis of African experiences in addressing complexity and political economy in health research capacity strengthening.

Ager A, Zarowsky C - Health Res Policy Syst (2015)

Bottom Line: Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work.We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment.A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, University of Western Cape, Robert Sobukwe Road, Bellville, Cape Town 7535, South Africa. czarowsky@gmail.com.

ABSTRACT

Background: Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa.

Methods: We reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work.

Results: Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalization of knowledge and the linked mobility of (elite) individuals, and institutionalization of research within universities and research centres and, increasingly, national research and development agendas.

Conclusions: We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.

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Related in: MedlinePlus

Map of emerging clusters with assigned thematic labels.
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Fig1: Map of emerging clusters with assigned thematic labels.

Mentions: Figure 1 shows the clustering of items and the consensus labels for each thematic cluster. This two-dimensional map accounts for 80.7% of total variance in item grouping, and was thus deemed to represent a valid basis for interpretation of the overall patterning of items. The map identifies 10 distinct, though clearly related, challenges. Given that the proximity of clusters reflects the likelihood of items within them being grouped together, their positioning clearly suggests a basis for their interpretation. However, there are a number of ways of ‘reading’ the sequence of clusters, and pathways linking them should be considered multidirectional. Thus, while the clusters are considered in turn below in a broadly clockwise direction, this should not be taken to suggest a dominant sequence of causality.Figure 1


Balancing the personal, local, institutional, and global: multiple case study and multidimensional scaling analysis of African experiences in addressing complexity and political economy in health research capacity strengthening.

Ager A, Zarowsky C - Health Res Policy Syst (2015)

Map of emerging clusters with assigned thematic labels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4325946&req=5

Fig1: Map of emerging clusters with assigned thematic labels.
Mentions: Figure 1 shows the clustering of items and the consensus labels for each thematic cluster. This two-dimensional map accounts for 80.7% of total variance in item grouping, and was thus deemed to represent a valid basis for interpretation of the overall patterning of items. The map identifies 10 distinct, though clearly related, challenges. Given that the proximity of clusters reflects the likelihood of items within them being grouped together, their positioning clearly suggests a basis for their interpretation. However, there are a number of ways of ‘reading’ the sequence of clusters, and pathways linking them should be considered multidirectional. Thus, while the clusters are considered in turn below in a broadly clockwise direction, this should not be taken to suggest a dominant sequence of causality.Figure 1

Bottom Line: Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work.We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment.A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, University of Western Cape, Robert Sobukwe Road, Bellville, Cape Town 7535, South Africa. czarowsky@gmail.com.

ABSTRACT

Background: Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa.

Methods: We reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work.

Results: Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalization of knowledge and the linked mobility of (elite) individuals, and institutionalization of research within universities and research centres and, increasingly, national research and development agendas.

Conclusions: We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.

Show MeSH
Related in: MedlinePlus