Monitoring and evaluating capacity building activities in low and middle income countries: challenges and opportunities.

M Schneider,M Sharma,L Price,G Rojas,C Pratt,D J Pilowsky,T Van De Water,S Seedat,R Araya,E Susser,B B Bonini

doi:10.1017/gmh.2016.24

Abstract

Lower and middle income countries (LMICs) are home to >80% of the global population, but mental health researchers and LMIC investigator led publications are concentrated in 10% of LMICs. Increasing research and research outputs, such as in the form of peer reviewed publications, require increased capacity building (CB) opportunities in LMICs. The National Institute of Mental Health (NIMH) initiative, Collaborative Hubs for International Research on Mental Health reaches across five regional 'hubs' established in LMICs, to provide training and support for emerging researchers through hub-specific CB activities. This paper describes the range of CB activities, the process of monitoring, and the early outcomes of CB activities conducted by the five research hubs. The indicators used to describe the nature, the monitoring, and the early outcomes of CB activities were developed collectively by the members of an inter-hub CB workgroup representing all five hubs. These indicators included but were not limited to courses, publications, and grants. Results for all indicators demonstrate a wide range of feasible CB activities. The five hubs were successful in providing at least one and the majority several courses; 13 CB recipient-led articles were accepted for publication; and nine grant applications were successful. The hubs were successful in providing CB recipients with a wide range of CB activities. The challenge remains to ensure ongoing CB of mental health researchers in LMICs, and in particular, to sustain the CB efforts of the five hubs after the termination of NIMH funding.

Highlights

Lower and middle income countries (LMICs) are home to >80% of the global population, but mental health researchers and low- and middle-income countries (LMICs) investigator led publications are concentrated in 10% of LMICs
The National Institute of Mental Health (NIMH) initiative, Collaborative Hubs for International Research on Mental Health reaches across five regional ‘hubs’ established in LMICs, to provide training and support for emerging researchers through hub-specific capacity building (CB) activities
This paper describes the range of CB activities, the process of monitoring, and the early outcomes of CB activities conducted by the five research hubs

Summary

Introduction

Lower and middle income countries (LMICs) are home to >80% of the global population, but mental health researchers and LMIC investigator led publications are concentrated in 10% of LMICs. The 2013 Global Burden of Disease study (Global Burden of Disease Collaborators, 2015) highlights mental disorders as leading causes of years lost to disability This burden falls heavily on LMICs – home to 85% of the world’s population (Sharan et al 2009). The research output regarding mental health is comparatively low for LIMCs. Only 6% of publications on ISI Web of Science (from 1992 to 2001) (Saxena et al 2006) and 3.8% of publications in six prominent psychiatric journals from 2002 to 2004 (unchanged from 1996 to 1998 results) (Patel & Kim, 2007) were from lead authors in LMICs. Reasons for limited published mental health research and limited mental health services in LMICs include: (i) high levels of stigma towards mental disorders, (ii) lack of sufficient and/or appropriate professional development opportunities in mental health research, (iii) limited funding for and culture of research, (iv) few skilled researchers, and (v) few collaborative endeavours (Sharan et al 2007; Sweetland et al 2014)

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