Understanding global health research collaborations: an Indigenous realist evaluation of the African Research...

Global North-South research collaborations are complex and dynamic despite their centrality to global health research. We conducted an Indigenous-inspired realist evaluation to examine how and why research collaborations under the 'African Research Initiative for Scientific Excellence' programme work to strengthen African researchers' health research capacity. With funding from a Global North partner, the programme supports multiple research projects, each led by an African principal investigator (PI).

We adopted a multicase study design with three cases covering laboratory-based, policy-based and innovation-based health research projects. Realist-informed qualitative methods were used to test an initial programme theory (IPT). We conducted 32 realist interviews with the PIs, collaborators, research support staff, masters/PhD trainees and 4 programme-level staff. Retroductive theorising guided the testing of the IPT through context-mechanism-outcome configurations (CMOs). We adopted a realist approach to thematic analysis, identifying experiential, inferential and dispositional themes to formulate CMOs. Through retrodiction-theoretical abstraction-we refined the IPT using CMOs from the within-case theories.

Multiple mechanisms (ie, trust, empowerment, motivation, inspiration, sense of agency and responsibility, and psychological readiness for policy leadership) were triggered to generate varied outcomes (ie, equitable research collaboration established, improved knowledge exchange and learning and appointment of the PI to policy leadership role) across the three cases. Where the African PI has autonomy over research resources, but research expertise and equipment are locally unavailable, the PI's access to research funding and liberty to choose collaborators from anywhere enacts a sense of agency to establish equitable, collaborative relationships with Global North partners to leverage resources. A longstanding relationship between the PI and the collaborator engenders trust, while a sense of responsibility is enacted if the collaborator is committed and renowned in their research field. Also, continued government engagement motivates and engenders 'psychological readiness for policy leadership', leading to meaningful collaborations.

Increasing direct funding support to African PIs and giving them the autonomy to define research priorities and implement their research initiatives can enhance their ability to conduct impactful research addressing local health concerns.