Building reproductive health research and audit capacity and activity in the Pacific Islands (BRRACAP) study: methods, rationale and baseline results.

Alec J Ekeroma,Boaz Shulruf,Lesley Me Mccowan,Andrew Hill,Tim Kenealy

doi:10.1186/1472-6920-14-121

Alec J Ekeroma, Boaz Shulruf + Show 3 more

Open Access

https://doi.org/10.1186/1472-6920-14-121

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Abstract

BackgroundClinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5. Research training, mentoring and a supportive participatory research environment have been shown to increase research activity and capacity in low to middle income countries (LMIC). This paper details the methods, rationale and baseline findings of a research program aimed at increasing clinical research activity and audit in the six Pacific Islands of Fiji, Samoa, Tonga, Vanuatu, Cook Islands and the Solomon Islands.MethodTwenty-eight clinician participants were selected by the five Ministries of Health and the Fiji National University to undergo a research capacity building program which includes a research workshop and mentoring support to perform research and audit as teams in their country. Data on the participants’ characteristics, knowledge and experiences were collected from structured interviews, questionnaires, focus groups, and an online survey. The interviews and the two focus groups were audio-recorded and all replies were analysed in a thematic framework.ResultsThe 28 participants included 9 nurses/midwives, 17 medical doctors of whom 8 were specialists in reproductive health and 2 other health workers. Most (24, 86%) were required to perform research as part of their employment and yet 17 (61%) were not confident in writing a research proposal, 13 (46%) could not use an electronic spreadsheet and the same number had not analysed quantitative data. The limited environmental enablers contributed to poor capacity with only 11 (46%) having access to a library, 10 (42%) receiving management support and 6 (25%) having access to an experienced researcher. Barriers to research that affected more than 70% of the participants were time constraints, poor coordination, no funding and a lack of skills.ConclusionBuilding a research capacity program appropriate for the diversity of Pacific clinicians required research evidence and collaborative effort of key stakeholders in the Pacific Islands and the region. The participants had limited research knowledge, skills and experience and would require individualized training and continuous intensive mentorship to realize their potential as clinician researchers for their services in the Pacific.

Highlights

Clinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5
Health research and clinical audit are fundamental components of functioning health systems as they are important at addressing Millenium Development Goals (MDG) and quality of health service delivery [1,2,3,4]
The success in launching this research capacity building (RCB) program depended on the collaboration and support of key stakeholders in the six Pacific states and the region

Summary

Introduction

Successful research capacity building (RCB) programs tend to be located at dedicated research institutions [14] and universities systems and sustainability are often weak where there is no reciprocal local funding [15]. Such RCB programs are commonly aimed at developing research scientists [16] with only a few targeting clinicians [17]. While many agencies have concentrated efforts at developing research systems capacity from top down, an effort should be made to develop research capacity from the bottom up [18] Such an approach acknowledges the clinicians role in identifying research priorities at the clinical interface [19,20]

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