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Recommendation 4 Building and Using Research Capacity
How Exemplars successfully built and used research capacity Detailed strategies Country examples and links to more detail

Create or build partnerships with institutions for in-country research

Invest in in-country institutions, including making sure they are linked with and working with the Ministry of Health

Bangladesh leveraged partnerships with local research institutions (e.g. ICDDR,B) that informed government and NGO policies and programs. (Bangladesh narrative)

Embed researchers in the Ministry of Health and other ministries. This can involve

  • Assigning health leaders who are responsible for creating dedicated research capabilities (accountability)
  • Setting incentives to motivate research talent in-country to commit time and effort to research

In Rwanda, health leaders developed a team of decision-makers who allowed the minister of health to delegate decisions and create national capacity with division units who were experts and researchers. In addition, this created embedded research capacity to "produce evidence and science when it may not be available.” They also had incentives to ensure people would commit time and effort to research.1

Rwanda also required that all department and unit heads at the MoH and Rwanda Biomedical Center attain master's degrees. To enable this, they coordinated with the School of Public Health to design a master's degree that could be attained while working, and also gave employees time and funding. This helped establish the MoH as a center of research, and retained skilled staff who could otherwise have found higher salaries outside the MoH. Lastly, it encouraged policymakers to rely on their own data collection and analyses.1 
(Rwanda narrative)
Make research organizations a key step in the decision-making process
 Where feasible, rely on local research orgs for research on burden of disease and selection of evidence-based interventions. Make this evidence a precondition for piloting and policy changes

In Bangladesh, the International Centre for Diarrheal Disease Research (ICDDR,B) provided research leadership and generated statistical evidence that advanced data-driven initiatives to reduce U5M. (Bangladesh narrative) 

In Nepal, local research organizations studied the potential suitability of global U5M interventions to the country's diverse communities (Nepal narrative)
Set up meetings between research organizations and other partners, to decide what EBIs to introduce, implementation strategies, and timeframe of introduction In Bangladesh, the professional bodies of the Obstetrical and Gynecological Society of Bangladesh (OGSB), Bangladesh Neonatal Forum (BNF) and Bangladesh Pediatrics Association (BPA) helped adapt certain EBIs, including FB-IMCI, to local contexts.2
Build in flexibility to fast-track proven interventions, so that researching and piloting doesn't bottleneck rollout of proven interventions
 In Nepal, the practice of requiring pilot testing by local researchers and implementing partners led to delays of PCV and rotavirus. (Nepal narrative) 
In Senegal, even though local research and pilot testing were preconditions for introduction of some interventions (IMCI), they prioritized rapid scale-up when the intervention was already proven to be effective, as was the case with PCV
(Senegal narrative) 
Use research organizations to improve acceptability of interventions
 Use local research to validate global best practices, develop a national sense of ownership, and gain buy-in from local officials  In Nepal, local research provided a critical validation of global best practices, building a sense of national ownership and identifying necessary adaptations. (Nepal narrative) 
Employ local research organizations to study contextual factors underlying implementation challenges for delivering evidence-based interventions (EBIs)  Ethiopia: The EPI and JSI Research and Training Institute conducted a study of 1,181 children from three randomly selected woredas in three regions between February and April 2013. The goal was to assess coverage of the pentavalent vaccine, using immunization coverage surveys (vaccine cards, maternal recall, and EPI registers) and serosurveys. This in turn informed the FMOH’s evidence-based decision-making and the strategies chosen to pursue nationwide universal child immunization, accounting for the contextual factor of geography.3
Adapt EBIs to local context during implementation  In Bangladesh, the Obstetrical and Gynecological Society of Bangladesh (OGSB), Bangladesh Neonatal Forum (BNF) and Bangladesh Pediatrics Association (BPA) adapted FB-IMCI and SBA to local context, by determining perceived need for community-level SBAs, ANC, and postpartum care delivery2  
In Ethiopia, FMOH worked with partners such as the Ethiopian Pediatric Society to adapt the WHO’s generic IMCI materials to fit the local context. In addition to training modules, other materials for use in the facilities such as chart booklets and handbooks were adapted in preparation for introduction of IMCI.3
(Ethiopia narrative) 
In Peru, when malaria cases began to rise in 1990, local and international research organizations built off the WHO's recommendation to use ACT, and instead tailored the treatment plan based on the geography (north shore vs Amazon basin). Also the Peru National Health Institute and Regional Health Directorates of Tumbes and Loreto carried out a study in two health centers in Piura, finding that the proposed treatment was effective and didn't have negative side effects. (Peru narrative) 

In Senegal, local research showed that ITNs needed to be replaced every two years, rather than the three-year window recommended by the WHO. (Senegal narrative) 

In addition, the Cheikh Anta Diop University in Senegal conducted research on chemo-prophylactic malaria treatment, which was used to inform the children’s IPT program4

Adapt EBIs based on monitoring of early results  In Senegal, they changed malaria treatment regimen, based on surveillance findings from National Malaria Control Program in 2003.4
Involve research organizations in training and dissemination of best practices  Work with local universities to integrate new interventions into pre-service training/ healthcare worker curricula  Ethiopia amended mid-wifery curriculum so that new graduates would satisfy requirements of a skilled birth attendant. (Ethiopia narrative) 
Translate materials into local languages

Back to Recommendations

  1. 1
    University of Global Health Equity. Exemplars in Under-5 Mortality: Rwanda Case Study. Kigali, Rwanda; 2019.
  2. 2
    University of Global Health Equity. Exemplars in Under-5 Mortality: Bangladesh Case Study. Kigali, Rwanda; 2019
  3. 3
    University of Global Health Equity. Exemplars in Under-5 Mortality: Ethiopia Case Study. Kigali, Rwanda; 2019.
  4. 4
    University of Global Health Equity. Exemplars in Under-5 Mortality: Senegal Case Study. Kigali, Rwanda; 2019.