Mansour Rania, Naal Hady, Kishawi Tarek, Achi Nassim El, Hneiny Layal, Saleh Shadi
Global Health Institute, American University of Beirut, Beirut, 1107 2020, Lebanon.
St. George's, University of London, London, UK.
Health Res Policy Syst. 2021 May 22;19(1):84. doi: 10.1186/s12961-021-00725-x.
Fragile and conflict-affected settings (FCAS) have a strong need to improve the capacity of local health workers to conduct health research in order to improve health policy and health outcomes. Health research capacity building (HRCB) programmes are ideal to equip health workers with the needed skills and knowledge to design and lead health-related research initiatives. The study aimed to review the characteristics of HRCB studies in FCASs in order to identify their strengths and weaknesses, and to recommend future directions for the field.
We conducted a scoping review and searched four databases for peer-reviewed articles that reported an HRCB initiative targeting health workers in a FCAS and published after 2010. Commentaries and editorials, cross-sectional studies, presentations, and interventions that did not have a capacity building component were excluded. Data on bibliographies of the studies and HRCB interventions and their outcomes were extracted. A descriptive approach was used to report the data, and a thematic approach was used to analyse the qualitative data.
Out of 8822 articles, a total of 20 were included based on the eligibility criteria. Most of the initiatives centred around topics of health research methodology (70%), targeted an individual-level capacity building angle (95%), and were delivered in university or hospital settings (75%). Ten themes were identified and grouped into three categories. Significant challenges revolved around the lack of local research culture, shortages in logistic capability, interpersonal difficulties, and limited assessment and evaluation of HRCB programmes. Strengths of HRCB interventions included being locally driven, incorporating interactive pedagogies, and promoting multidisciplinary and holistic training. Common recommendations covered by the studies included opportunities to improve the content, logistics, and overarching structural components of HRCB initiatives.
Our findings have important implications on health research policy and related capacity building efforts. Importantly, FCASs should prioritize (1) funding HRCB efforts, (2) strengthening equitable international, regional, and national partnerships, (3) delivering locally led HRCB programmes, (4) ensuring long-term evaluations and implementing programmes at multiple levels of the healthcare system, and (5) adopting engaging and interactive approaches.
脆弱和受冲突影响地区（FCAS）迫切需要提高当地卫生工作者开展卫生研究的能力，以改善卫生政策和卫生成果。卫生研究能力建设（HRCB）项目非常适合为卫生工作者提供设计和主导与卫生相关研究倡议所需的技能和知识。本研究旨在回顾FCAS地区HRCB研究的特点，以确定其优势和劣势，并为该领域推荐未来发展方向。
我们进行了一项范围综述，并在四个数据库中搜索了2010年后发表的、报道针对FCAS地区卫生工作者的HRCB倡议的同行评审文章。评论、社论、横断面研究、报告以及没有能力建设部分的干预措施均被排除。提取了研究的参考文献、HRCB干预措施及其结果的数据。采用描述性方法报告数据，采用主题分析法分析定性数据。
在8822篇文章中，根据纳入标准共纳入20篇。大多数倡议围绕卫生研究方法主题（70%），针对个人层面的能力建设角度（95%），并在大学或医院环境中开展（75%）。确定了十个主题并分为三类。重大挑战包括缺乏当地研究文化、后勤能力短缺、人际困难以及HRCB项目的评估和评价有限。HRCB干预措施的优势包括由当地推动、采用互动式教学法以及促进多学科和整体培训。研究涵盖的常见建议包括改善HRCB倡议的内容、后勤和总体结构组成部分的机会。
我们的研究结果对卫生研究政策和相关能力建设工作具有重要意义。重要的是，FCAS地区应优先考虑：（1）为HRCB工作提供资金；（2）加强公平的国际区域和国家伙伴关系；（（3）开展由当地主导的HRCB项目；（4）确保长期评估并在医疗系统的多个层面实施项目；（5）采用引人入胜的互动方法。
