In the past decade, global health funders, non-government organisations and policymakers have increased their efforts to support health research capacity in developing low- and middle-income countries (LMICs). These efforts are aimed at securing the provision of—and eventually access to—high-quality health services.
The African Institutions Initiative (AII) supports seven capacity-building consortia, including fifty-four institutions across the continent, as well as twenty institutions from Europe and North America, to
- broaden the research base for scientific endeavour in under-resourced environments
- support areas of science with the potential to contribute to health benefits for people and livestock, and
- support international networks and partnerships focused on health problems of resource-poor countries.
The Wellcome Trust commissioned RAND Europe to lead a real-time evaluation of the African Institutions Initiative. More information about the initiative itself is available from the Wellcome Trust.
Over four years, the work of the evaluation and learning team, led by RAND Europe, included the following:
- initial training and capacity building in evaluation and learning;
- the development of ‘logic models’ and associated indicators for the overall Initiative and individual consortia;
- regular compilation and analysis of data relating to progress against objectives and goals;
- the production of annual reports; regular email and phone correspondence with consortia administrators and managers; and
- interviews with consortia directors.
Through these different means the team captured data and insight about the performance of each consortium and the Trust’s engagement with them.
Findings and Recommendations
The African Institutions Initiative was not designed to deliver ‘quick wins.’ Rather it plans to lay the foundations for increased research capacity and the emergence of locally relevant health research agendas over time, which is reflected in the Trust’s direct engagement with African universities and research institutes to develop African-led research programmes.
However, programme-wide achievements during the first phase of funding are evident, which include:
- A significant contribution to health research related PhD and MSc provision in Africa and the emergence of popular new models of provision
- Contribution to the profile and prominence of African research leaders
- Creation of new South-South and South-North collaborations around African-led research
- Significant uptake of diverse training in research governance, management and administration
- Active engagement of university leadership and relevant policy makers
- Over £80 million has been leveraged by consortia in external grants from other international funders
Despite the proliferation of capacity-building initiatives from the donor community in the last decade, few initiatives to date have adopted a bottom-up approach which focusses efforts on local needs, as defined by African institutions, rather than global health interests. Nevertheless the Trust should consider the following considerations for the next phase of the Initiative:
- Developing suitable metrics to measure the outputs of capacity building initiatives is a major issue for the next phase and the ability to show impact will be crucial to demonstrate the value of the Initiative to stakeholders.
- Clarification on what it considers the parameters of success: whether it expects one route towards sustainable research capacity, or whether various pathways could be encouraged.
- Consider the distinction between “capacity building” and “capacity strengthening” both in terms of measuring the relative successes of each of the consortia and for developing meaningful support systems that correspond to consortia’s needs.
- Clearly defined roles for Northern partners in facilitating ‘capacity building’ efforts through training activities, equipment procurement and laboratory improvements are needed.
- Limitations in research infrastructure across Africa underscores the need for continued advocacy of investment in ICT and research infrastructure