The document aims to map health services research (HSR) capacity across individual, organizational, and environmental levels and identify effective strategies for capacity development. It reviews existing databases and initiatives related to HSR, highlighting various interventions and their success factors and constraints, particularly in low- and middle-income countries (LMICs) versus high-income countries (HICs). Key findings indicate that while individual-level interventions are prevalent, they often have limited overall effectiveness due to higher-level constraints, underscoring the need for multi-faceted and context-tailored approaches in capacity development.

1. Sara Bennett, Ligia Paina, Christine Kim, Irene Agyepong,
Somsak Chunharas, Di McIntyre, Stefan Nachuk

2. Aims
Map different facets of HSR capacity at
individual, organizational and
environmental/network levels
Identify strategies to promote capacity
development for HSR and those that appear
effective

3. Methods
Defining HSR: health services, health systems research,
operational or intervention research
Mapping – review of existing international databases
Systematic review of capacity development initiatives for
HSR, including papers
Reported implementation of a project or initiative
HIC or LMIC
Whether or not evaluated
Capturing information on: nature of interventions,
context, implementation issues, evaluation design,
evaluation findings
Reflection on authors’ experiences

4. The Gap
The situation in LMICs The situation in US
Population – 5.5
billion
250-300 health
systems research
organizations in
LMICs
6-7,500 health systems
researchers
Population – 310 million
709 research
organizations that housed
PIs for HSR projects
13,000 health services
researchers
Source: Pittman & Holve 2009

5. Region # orgs
offering HS or
policy MScs
# orgs offering
HS or policy
PhDs or DrPHs
Types of course offerings
Africa 10 2 Health services planning
and management, health
economics, health systems
and policy
Americas 20 7 Politics and planning, public
policy and health, politics of
health
Asia 9 5 Health economics, Health
policy and systems, Health
financing

6. Overview of review findings
73 papers – 67% from HICs (especially US, UK,
Canada)
Most initiatives had multiple components
Initiatives targeted most at individual level, then
organizational then environmental/network
Largely targeted university based researchers (43%
HICs, 54% LMICs)
But service providers, especially GPs and nurses also a
key audience in HICs.

7. Interventions identified in systematic
review
HICs
Mentoring 31%
Research seminars 27%
Fellowships 24%
Research grants 24%
Partnerships 20%
Short courses 10%
Networking 18%
Post grad training 10%
Research infrastructure 10%
LMICs
Short courses 58%
Networking 38%
Research grants 29%
Post grad training 29%
Partnerships 25%
Basic training 17%
Mentoring 17%
Research infrastructure 8%
Strategic planning 4%
Research seminar 4%

8. Implementation factors (# studies)
Facilitators Constraints
Enthusiasm and motivation
of participants (5)
Institutional support from
parent organization (4)
Flexibility in program design
(4)
Strong leadership (3)
Builds on existing
partnerships (2)
Participatory approach (2)
Being part of broader
program (2)
Lack of time – participants,
staff and mentors (13)
Insufficient funding
(sustainability) (8)
High coordination costs (7)
Timelines too short (6)
Lack of support from host
organization (4)
Lack of confidence of
participants (4)
Lack of institutional and
managerial support (3)
Language barriers (3)

9. Key Findings
Interventions successful at the individual level had
limited overall effects due to organizational or
environmental level constraints
Few interventions targeted constraints at multiple
levels
Maintaining flexibility in capacity development
programs is key
Mentoring is an effective strategy
Short course training alone is necessary but not
sufficient for developing research capacity
Very few interventions evaluated – weak evaluation
designs, most by internal evaluators, no cost data

10. Evaluation of interventions
HICs LMICs
Total # articles 49 24
% articles with
evaluation
47% 37.5%
No. articles with
independent
evaluation
2 2
# articles with costs 10 7

12. Over-arching
Capacity development interventions should be:
Multi-faceted, responding to capacity needs at different
levels
Tailored to the context where they are being
implemented
As we scale up investment in capacity development,
we must evaluate the effects of CD initiatives

13. Environment/network level
External funders should funnel a larger share of
their funding to local stakeholders
Strengthen networks between different types of
HSR actors within countries
Support capacity development among health
workers and health service organizations

14. Organizational level
Engage with organisational leaders to advocate for
HSR
Intensify efforts to secure predictable and sustainable
core funding, including endowments
Ensure better funding for research networks and
cross-country partnerships

15. Individual Level
Develop open access training modules in HSR that
support training needs of different types of
researchers coming to the field
Provide incentives and innovative schemes for senior
researchers to stay in-country