Can the use of a structured professional development scheme measure and contribute to fostering capacity development in low-and-middle-income countries' health research?

Background:
Health research capacity development (HRCD) for healthcare workers (HCW) has been recognised as a critical element in overcoming global health challenges, especially in low-and middle-income countries (LMIC). LMIC still carry 90% of the global disease burden, but only 10% of the global funding for health research is devoted to addressing these persistent health challenges. One of the crucial barriers to supporting HRCD is the lack of empirical measurement of competencies for HCW in relation to the performance of research activities.
Aim:
This research aims to explore whether the use of a structured professional development scheme can measure and contribute to fostering capacity development in LMIC health research.
Methods:
A mixed-methods explanatory sequential design was applied. A systematic review to investigate the existence of tools and schemes to measure HRCD was conducted. One of them was selected to be used to measure competency scores at two time-points among participants. A survey including quantitative and qualitative questions gathered a preliminary evaluation of the experience of using the tool. A selected group of participants were interviewed to contextualise the experience of using the selected tool and explore the link between measuring and fostering HRCD.
Results:
The results of the systematic review identified 16 papers describing various tools to measure HRCD. The Professional Development Scheme (PDS) was selected among them due to its potential to adequately measure HRCD. The use of the PDS among 45 HCW from 5 research institutions in Zambia, Thailand, and Brazil showed a significant difference in research competencies between two time-points, yet leaving some unanswered questions. Results of the survey confirmed a need for a deeper exploration of the experience of using the PDS. In-depth interviews with 21 participants showed that the PDS can contribute to measuring HRCD, nonetheless not without limitations. The scope of using the PDS was not immediately clear to the participants and the link with training opportunities was reported as missing. The PDS was used within the context of international research collaborations that were perceived as an opportunity to foster HRCD, yet reiterating a sense of dependency on funds and research priorities set by high-income countries (HIC). An increased value of research competencies in the existing research culture was registered but very limited time to devote for the acquisition of them was reported by participants. Findings also confirmed that the COVID-19 pandemic had accelerated the transfer of research competencies and improved inclusivity by moving conferences online.
Discussion:
The findings were contextualised within the existing literature. According to the epistemic injustice narrative, the PDS may tend to promote HRCD according to requirements set in HIC not always matching health research needs emerging in LMIC. The creation of more localised versions of the PDS was recommended, aiming at 1) increasing the relevance of using the PDS for HCW in LMIC and 2) helping to overcome the sense of dependency experienced by HCW based in LMIC. The perception of having limited time for research was interpreted in light of the existing knowledge economy paradigm where the responsibility of reaching the expected standards is shifted towards the individual. To mitigate these unfair expectations the PDS should include features that allow focusing on research as a team effort.
Conclusion:
This research represents an eloquent example of how theoretic debate and praxis promoting HRCD should be bridged to support the process of decolonising global health. The PDS in its current version can contribute to measuring HRCD. If appropriately presented it can also generate awareness of research capacities at a personal level. The aspiration of the PDS of being able to foster HRCD in HCW based in LMIC does require further revisions that consider a deeper connection with the local environment and engage with the debate about coloniality and epistemic injustice. The process of adaptation of the PDS to local research ecosystems may represent an opportunity for further research to investigate the link between interventions promoting research capacities and the discourse on decolonising the global health space. HRCD has been shown as a crucial element in overcoming health challenges at both local and global levels. Measuring HRCD can serve the purpose of deliberately pursuing capacity development as a goal without relegating it to be a “side effect” of research projects.

Keywords: coloniality
global health
clinical research
research culture
capacity development
international research collaborations
Advisor: Lang, T
Rapa, E
Bernays, S