Bates Imelda, Boyd Alan, Aslanyan Garry, Cole Donald C
Liverpool School of Tropical Medicine, Liverpool, UK, Manchester Business School, Booth St W, Manchester, Greater Manchester M15 6PB, UK, Tropical Disease Research, World Health Organization, 20, Avenue Appia, CH-1211 Geneva 27, Switzerland and Dalla Lana School of Public Health University of Toronto, 155 College St. Toronto, ON M5T3M7, Canada
Liverpool School of Tropical Medicine, Liverpool, UK, Manchester Business School, Booth St W, Manchester, Greater Manchester M15 6PB, UK, Tropical Disease Research, World Health Organization, 20, Avenue Appia, CH-1211 Geneva 27, Switzerland and Dalla Lana School of Public Health University of Toronto, 155 College St. Toronto, ON M5T3M7, Canada.
Health Policy Plan. 2015 Apr;30(3):334-44. doi: 10.1093/heapol/czu016. Epub 2014 Apr 8.
Strengthening research capacity in low- and middle-income countries is one of the most effective ways of advancing their health and development but the complexity and heterogeneity of health research capacity strengthening (RCS) initiatives means it is difficult to evaluate their effectiveness. Our study aimed to enhance understanding about these difficulties and to make recommendations about how to make health RCS evaluations more effective. Through discussions and surveys of health RCS funders, including the ESSENCE on Health Research initiative, we identified themes that were important to health RCS funders and used these to guide a systematic analysis of their evaluation reports. Eighteen reports, produced between 2000 and 2013, representing 12 evaluations, were purposefully selected from 54 reports provided by the funders to provide maximum variety. Text from the reports was extracted independently by two authors against a pre-designed framework. Information about the health RCS approaches, tensions and suggested solutions was re-constructed into a narrative. Throughout the process contacts in the health RCS funder agencies were involved in helping us to validate and interpret our results. The focus of the health RCS evaluations ranged from individuals and institutions to national, regional and global levels. Our analysis identified tensions around how much stakeholders should participate in an evaluation, the appropriate balance between measuring and learning and between a focus on short-term processes vs longer-term impact and sustainability. Suggested solutions to these tensions included early and ongoing stakeholder engagement in planning and evaluating health RCS, modelling of impact pathways and rapid assimilation of lessons learned for continuous improvement of decision making and programming. The use of developmental approaches could improve health RCS evaluations by addressing common tensions and promoting sustainability. Sharing learning about how to do robust and useful health RCS evaluations should happen alongside, not after, health RCS efforts.
加强低收入和中等收入国家的研究能力是促进其健康与发展的最有效方式之一，但卫生研究能力加强（RCS）举措的复杂性和异质性意味着难以评估其有效性。我们的研究旨在加深对这些困难的理解，并就如何使卫生RCS评估更有效提出建议。通过与包括卫生研究领域的ESSENCE倡议在内的卫生RCS资助者进行讨论和调查，我们确定了对卫生RCS资助者重要的主题，并以此为指导对其评估报告进行系统分析。从资助者提供的54份报告中，有目的地选取了2000年至2013年期间产生的18份报告，代表12项评估，以提供最大的多样性。两位作者根据预先设计的框架独立提取报告中的文本。有关卫生RCS方法、矛盾点和建议解决方案的信息被重新构建成一篇叙述文。在整个过程中，卫生RCS资助机构的联系人参与帮助我们验证和解释研究结果。卫生RCS评估的重点范围从个人和机构到国家、区域和全球层面。我们的分析确定了围绕利益相关者应在多大程度上参与评估、衡量与学习之间以及关注短期过程与长期影响及可持续性之间的适当平衡存在的矛盾点。针对这些矛盾点提出的建议解决方案包括让利益相关者在规划和评估卫生RCS的过程中尽早并持续参与、对影响路径进行建模以及迅速吸收经验教训以持续改进决策和规划。采用发展性方法可以通过解决常见矛盾点和促进可持续性来改进卫生RCS评估。关于如何进行有力且有用的卫生RCS评估的经验分享应与卫生RCS工作同步进行，而非在其之后。
