Implementation and evaluation of a technical support center for the Research to Enhance the Adaptation and...

Capacity-strengthening initiatives for health policy and systems research (HPSR) in low- and middle- income countries (LMICs) are often designed with little consideration of LMIC stakeholder needs. We formed a Technical Support Centre to support research teams through the WHO Alliance for HPSR's Research to Enhance the Adaptation and Implementation of Health Systems Guidelines (RAISE) initiative. We describe the implementation and evaluation of the support program.

The support program was rooted in an integrated knowledge translation approach, whereby RAISE teams informed its design, content and delivery. Using mixed methods, we assessed quality of program implementation and its impact on RAISE teams' knowledge and capacity for HPSR and implementation research. Data were collected between August 2019 and November 2021.

A total of 22 participants from six countries completed a needs assessment survey to inform design of the support program. The program included: an in-person capacity-strengthening workshop, 1:1 coaching with methods experts and virtual webinar series, discussion boards and workshops. RAISE teams perceived the supports to be of high quality. Mean scores for 8/9 research capacity outcomes improved over time; significant differences were observed in researchers' ability to develop evidence-based knowledge translation interventions (Z = -2.93, p < 0.05). Barriers to health system guideline adaptation and implementation included competing health system and stakeholder interests, lack of available data and equipment to facilitate data collection and lack of knowledge and skills among those tasked with implementing the guideline. Enablers included partnering with health system stakeholders at project inception, employing a multi-sectoral approach to implementation and building the competencies and skills of the implementation team.

Participants found the capacity strengthening program to be of high quality; participants' research capacity and skills improved over time and significant differences in the ability to develop evidence-based knowledge translation interventions were observed. Despite barriers experienced, particularly in the context of the COVID-19 pandemic, RAISE teams reported that the support program strengthened their knowledge and supported them to engage diverse stakeholders in their research. Ongoing efforts to sustain capacity strengthening for health systems and HPSR implementation in LMICs are warranted.

doi.org/10.17605/OSF.IO/EF43J.