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Research within international non-governmental organisation programmes in low and middle-income countries: challenges amid opportunities

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Salisu Mohammed Ishaku, Maria van der Harst, Charlotte E Warren, Arie Franx, Gbenga Ayodele Kayode, Diederick Grobbee, Joyce L Browne

Correspondence to Dr Salisu Mohammed Ishaku; salisuishaku@yahoo.com

Summary box

  • Despite the increasing number of health programme activities implemented by the international non-governmental organisations (INGO) in low and middle-income countries (LMICs), there has not been commensurate rise in research outputs in these settings.

  • Lack of quality research that addresses pertinent health challenges in this population is retarding our progress to answering relevant health questions.

  • Weak health systems with poor quality routine data, lack of objective outcome measures and conflict of interest between donors, implementers and researchers are some of the challenges militating against research outcomes in LMICs.

  • Promoting INGO–academia collaboration could enhance generation of quality research outputs from LMICs as the two partners complement their strengths and shortcomings.

  • While academia is better placed to provide sound theoretical, methodological, technical expertise, NGOs align research efforts with local needs and political realities and communicate research findings to policymakers.

Introduction

Over the past decades, enormous efforts have gone into improving access to quality health services in low and middle-income countries (LMICs) through the activities of international non-governmental organisations (INGOs). However, for most of these INGO-implemented interventions, responding to health research needs of these populations is not a priority, with a few exceptions. In instances where research is of interest, the capacities to generate valid evidence are limited. This is compounded by the limited number of academic research institutions with the capacity to conduct the required research in many LMICs despite the urgent need for locally led research efforts.

Although there has been an expansion in INGO-led implementation science programmes recently in many LMICs, they are mainly motivated by the need to bridging the ‘know-do-gaps’, rather than providing answers to emerging health research questions based on implementation research principles. Without rigorous research methods, concepts and methods of current implementation science programmes in both high-income countries (HIC) and LMICs cannot be applied to achieve widespread health impact, and consequently, opportunities for continuous learning are not fully realised. A crucial strategy to bridge research gaps in LMIC settings is to strengthen the collaboration between INGOs and in-country academic research institutions in both fundamental and implementation science/operational research.

Prominent among the reasons why neither the routine INGO service delivery models nor the current implementation programmes are able to adequately provide quality research are discussed below. The implication is that the bulk of INGO-derived evidence can end up as programme reports for ‘donors’ needs’ without broader scientific dissemination and uptake. To illustrate, a reported 45% of evaluation results were shared publicly on projects’ websites, with up to 72% shared with targeted internal audience. In this commentary, we put forward some evidence-based approaches to ensure mutual and effective collaboration between these entities.