Capacity Building Partnerships Research Articles

Abstract 87: Time From Symptom Development to Care Milestones at the Only Public Oncology Clinic in Belize

Abstract Purpose: Belize is a middle-income Caribbean country with a fragmented healthcare system. In 2018, the first and only public medical oncology clinic was opened through a capacity building partnership with the Ministry of Health. Little is known about the country’s referral infrastructure for cancer. Here we report on the stage at presentation to the clinic, and the time from symptom development to various care milestones (biopsy, oncology clinic visit, chemo, upfront surgery), referred to as time-to-care, to establish a base timeline. Methods: We performed a retrospective review of available data at the Karl Heusner Memorial Hospital (KHMH) oncology clinic from 2018 - 2022, gathering cancer type, stage, and the dates of care milestones (biopsy, initial clinic visit, chemo, upfront surgery). Date of symptom development was consistently documented by the treating physician (RY). Results: The most common presenting malignancies (n=465) were breast (28%), cervical (12%), hematologic (8%), and colorectal (7%). For staged patients (n=352), the most common presentations were stage III (28%) and IV (40%). For time-to-care, patients with available data (n=208) were seen for an initial oncology clinic visit a median of 180 days (IQR 87-382) after self-reported symptom development. For time-to-chemo at any site (ex. Belize, Mexico, Guatemala), the median was 189 days (IQR 108-404). For upfront surgery at any site the median was 188 days (IQR 60-352). In contrast to these long lead times, once established at the KHMH clinic, the time from the initial oncology clinic visit to a biopsy (if not done previously) was 22 days (IQR 11-47, n=42), 18 days (IQR 5-60, n=115) to begin chemo, and 40 days (IQR 24-72, n=22) to surgery. Conclusion: Patients were seen at the KHMH oncology clinic with predominantly late stage disease around six months after symptoms started. This is a higher fraction of stage III/IV disease than previously reported in Central America. Understanding drivers of these delays will allow for the creation of targeted public health interventions. As a marker that building infrastructure in Belize is possible, the partnership between the Belizean government and hospital administration has netted time-to-care intervals comparable to high-income nations. Citation Format: Wayne Wong, James Dickerson, Martha Habet, Margaret Bernard, Lorna Kelly, John Lattin, Philip Garrity, Franklin Huang, Ramon Yacab. Time From Symptom Development to Care Milestones at the Only Public Oncology Clinic in Belize [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 87.

Evolving academic and research partnerships in global health: a capacity-building partnership to assess primary healthcare in the Philippines

ABSTRACT Building fair, equitable, and beneficial partnerships between institutions collaborating in research in low- and middle-income countries (LMIC) and high-income countries (HIC) has become an integral part of research capacity building in global health in recent years. In this paper, we offer an example of an academic collaboration between the University of California Los Angeles, Center for Health Policy and Research (UCLA CHPR) and the University of Philippines, Manila, College of Public Health (UPM CPH) that sought to build an equitable partnership between research institutions. The partnership was built on a project to build capacity for research and produce data for policy action for the prevention and care of non-communicable diseases (NCDs) through primary healthcare in the Philippines. The specific objectives of the project were to: (1) locally adapt the Primary Care Assessment Tool for the Philippines and use the adapted tool to measure facility-level primary care delivery, (2) conduct focus group discussions (FGDs) to gather qualitative observations regarding primary care readiness and capacity, and (3) conduct a comprehensive population-based health survey among adults on NCDs and prior healthcare experience. We describe here the progression of the partnership between these institutions to carry out the project and the elements that helped build a stronger connection between the institutions, such as mutual goal setting, cultural bridging, collaborative teams, and capacity building. This example, which can be used as a model depicting new directionality and opportunities for LMIC-HIC academic partnerships, was written based on the review of shared project documents, including study protocols, and written and oral communications with the project team members, including the primary investigators. The innovation of this partnership includes: LMIC-initiated project need identification, LMIC-based funding allocation, a capacity-building role of the HIC institution, and the expansion of scope through jointly offered courses on global health.

Global Is Local: Leveraging Global Mental-Health Methods to Promote Equity and Address Disparities in the United States.

Structural barriers perpetuate mental health disparities for minoritized US populations; global mental health (GMH) takes an interdisciplinary approach to increasing mental health care access and relevance. Mutual capacity building partnerships between low and middle-income countries and high-income countries are beginning to use GMH strategies to address disparities across contexts. We highlight these partnerships and shared GMH strategies through a case series of said partnerships between Kenya-North Carolina, South Africa-Maryland, and Mozambique-New York. We analyzed case materials and narrative descriptions using document review. Shared strategies across cases included: qualitative formative work and partnership-building; selecting and adapting evidence-based interventions; prioritizing accessible, feasible delivery; task-sharing; tailoring training and supervision; and mixed-method, hybrid designs. Bidirectional learning between partners improved the use of strategies in both settings. Integrating GMH strategies into clinical science-and facilitating learning across settings-can improve efforts to expand care in ways that consider culture, context, and systems in low-resource settings.

Updated demographics at the only public oncology clinic in Belize.

e18787 Background: Belize is a middle-income Caribbean country without comprehensive cancer care capacity and poorly described cancer epidemiology. In 2020, we reported some of the first cancer demographics from the country. This was made possible by a capacity building partnership with the only public oncology clinic in the country at Karl Heusner Memorial Hospital (KHMH). Here we provide an update on demographic trends at this clinic. Methods: We performed a retrospective chart review of all available patient data at the KHMH clinic from December 2020 to December 2021. This was compared to data from the clinic’s founding in 2018 through its first 12 months. Results: From December 2020 through December 2021, the clinic saw 332 patients, an increase of 141% from the 236 patients seen over the first 12-month period of the clinic. In 2021, 250 (75%) patients had a confirmed pathologic diagnosis of cancer, with 78 (23%) remaining under clinical suspicion. This is in comparison to 63% of patients with a pathologic diagnosis in 2018. H&E staining alone remained the only publicly available pathologic service. Patients were predominantly female (67%) with a median age of 54 (Range: 2-95). The most common histologies (n = 332) were breast (29%), cervical (11%), colorectal (8%), prostate (4%), gastric (4%), and lung (3%). Of patients with histologically confirmed cancer, 221 (66%) were able to be fully staged. Patients predominantly presented with later stage disease (25% Stage III, 34% Stage IV). At the end of 2021, out of all patients tracked longitudinally over the year (n = 332), 24% remained in need of full diagnostic assessment, 34% were on curative treatment (predominantly cytotoxic chemotherapy), 22% were under surveillance, and 18% were receiving palliative chemotherapy or best supportive care due to advanced disease. This is in comparison to 2018, when there was no capacity to administer chemotherapy at KHMH and patients were referred to either private clinics or out of the country. Conclusions: The burden of cancer in Belize is significant and diverse. Compared to 2018, in 2021, the number of patients seen at KHMH increased 141%, as did the percentage of patients with histologically confirmed cancer (120% increase). Chemotherapy treatment was made possible through procurement of a chemotherapeutic stock at KHMH due to key partnerships with the Belizean government, hospital administration, and crucially, the only medical oncologist in the nation. This has led to chemotherapy being available at a public clinic in the country for the first time. Despite this progress, patients continue to present at late stages and many cannot access cancer care due to limited resources, cost, and low public awareness. This further affirms the need for infrastructure investment and early detection programs to improve cancer outcomes in Belize.

Utilizing Causal Loop Diagramming to Explore a Research and Evaluation Capacity Building Partnership.

The capacity to engage in research, evaluation and evidence-informed decision-making supports effective public health policy and practice. Little is known about partnership-based approaches that aim to build capacity across a system or how to evaluate them. This study examines the impacts of a research and evaluation capacity building partnership called the Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (hereafter, SiREN). SiREN aims to strengthen capacity across a system of clinical and medical services and government and non-government organizations. These organizations are connected through their shared aim of preventing and managing sexually transmissible infections and blood-borne viruses. To examine SiREN, systems concepts and methods were used. Data were collected from SiREN organizational documents (n = 42), a survey tool (n = 104), in-depth interviews (n = 17), a workshop and three meetings with SiREN stakeholders and used to develop two causal loop diagrams. Findings show engagement with SiREN was influenced by a complex interplay of contextual (e.g., organizational capacity) and process (e.g., presence of trusting relationships) factors. SiREN contributed to system level changes, including increased resources for research and evaluation, the development of networks and partnerships that led to more efficient responses to emerging health issues, evidence sharing, and sustainable research and evaluation practice. The use of causal loop diagrams enabled the identification of key leverage points that SiREN can use for continuous improvement or evaluation. The focus on how contextual factors influenced SiREN's ability to create change provides valuable information for researchers, policymakers or practitioners seeking to develop a similar partnership.

In Reply: Operationalizing Global Neurosurgery Research in Neurosurgical Journals

In Reply: Operationalizing Global Neurosurgery Research in Neurosurgical Journals

Evaluation Results From the Healthy Work Collaborative: A Cross-Sectoral Capacity Building Partnership to Address Precarious Employment.

The COVID-19 pandemic has illuminated the profound health and safety risks of precariously employed workers, many of whom are disproportionately Latinx and Black. Precarious employment (PE) is a social determinant of health (SDOH) characterized by low wages, hazardous conditions, unstable work schedules, no termination protection, and few benefits. Even before COVID-19, calls for more effective health promotion efforts to address SDOH like PE existed. The University of Illinois at Chicago Center for Healthy Work, Healthy Communities Through Healthy Work developed the Healthy Work Collaborative (HWC) as an evidence-informed capacity building policy, systems, and environmental change (PSE) initiative. The HWC aimed to facilitate cross-sectoral partnerships between health and labor sector partners. The labor sector provided technical assistance (TA) to participants to improve their ability to address PE through PSE. This article reports findings from a mixed-methods evaluation using the Kirkpatrick training model including participants' reactions, learning, behavior, and outcomes. A pre-post survey was administered to participants (N = 21) and analyzed descriptively; 3-month post HWC interviews were conducted (N = 13) and thematically analyzed. Findings included positive results at all Kirkpatrick levels. Participants' reported that the HWC curriculum and delivery was valuable and well received; they demonstrated gains toward addressing PE through PSE knowledge and skills and increased or strengthened health/labor partnerships. In addition, HWC influenced participants' application of HWC concepts, and in a few cases, participants' made changes in policies and plans in their organizational settings. The HWC may serve as a model to address other SDOH through cross-sectoral PSE change.

Critical factors that affect the functioning of a research and evaluation capacity building partnership: A causal loop diagram.

IntroductionPublic health policy and practice is strengthened by the application of quality evidence to decision making. However, there is limited understanding of how initiatives that support the generation and use of evidence in public health are operationalised. This study examines factors that support the internal functioning of a partnership, the Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (SiREN). SiREN aims to build research and evaluation capacity and increase evidence-informed decision making in a public health context.MethodsThis study was informed by systems concepts. It developed a causal loop diagram, a type of qualitative system model that illustrated the factors that influence the internal operation of SiREN. The causal loop diagram was developed through an iterative and participatory process with SiREN staff and management (n = 9) via in-depth semi-structured interviews (n = 4), workshops (n = 2), and meetings (n = 6).ResultsFindings identified critical factors that affected the functioning of SiREN. Central to SiREN’s ability to meet its aims was its capacity to adapt within a dynamic system. Adaptation was facilitated by the flow of knowledge between SiREN and system stakeholders and the expertise of the team. SiREN demonstrated credibility and capability, supporting development of new, and strengthening existing, partnerships. This improved SiREN’s ability to be awarded new funding and enhanced its sustainability and growth. SiREN actively balanced divergent stakeholder interests to increase sustainability.ConclusionThe collaborative development of the diagram facilitated a shared understanding of SiREN. Adaptability was central to SiREN achieving its aims. Monitoring the ability of public health programs to adapt to the needs of the systems in which they work is important to evaluate effectiveness. The detailed analysis of the structure of SiREN and how this affects its operation provide practical insights for those interested in establishing a similar project.

Biomedical Ethics and Regulatory Capacity Building Partnership for Portuguese-Speaking African Countries (BERC-Luso): A pioneering project

Biomedical research has a strong impact on a country’s scientific-technological and socioeconomic development. It can make a significant contribution at three different levels: promotion of public health; the exchange of knowledge within the scientific community; and economic/ financial profitability. Africa only attracts ~3.3% of the world’s clinical research. This small proportion is due to, among several factors, the absence of two fundamental aspects: specific robust legislation and capacity for regulatory and ethical evaluation. There are five Portuguese- speaking African countries – Angola, Cabo Verde, Guinea-Bissau, Mozambique and São Tomé and Príncipe. Despite presenting different degrees of clinical research development, these countries show a common serious insufficiency in the minimum conditions necessary for hosting, collaborating or leading biomedical research projects. These countries are also excluded from the support of international organisations for capacity building because of the language barrier. The Biomedical Ethics and Regulatory Capacity Building Partnership for Portuguese-Speaking African Countries (BERC-Luso) project has developed methods to build capacity and partnership through research on national law, comparisons with international standards and by issuing recommendations at a national level. Through collaborative intensive training, trainees are taught to become educators at a national level. This, in turn, creates a sustainable impact at country level. BERC-Luso is a pioneering project, owing to a combination of innovative features. The partnership project: (i) was developed exclusively in Portuguese; (ii) involves a large number of African countries, and national and international institutions; (iii) has been further enhanced by the diversity and complementarity of its action plans; and (iv) has also benefited from a broad participatory methodology based on resolution of recipients’ problems by the recipients themselves. It thus stands out as a model for similar future projects.

Capacitação e parcerias norte/sul em saúde: o exemplo de implementação do programa de doutoramento em ciências biomédicas em Angola

This article is articulated with the need to evaluate North/South research and capacity building partnerships in intercultural contexts. It aims to understand the expectations and motivations of the actors involved in the PhD programme in biomedical sciences in Angola, and to examine how the partnership between the Universidade Agostinho Neto and the Instituto de Higiene e Medicina Tropical (IHMT NOVA) was established, as well as its prospects for continuity. A qualitative study was developed, relying on semi-structured interviews with a total of 17 actors involved in the programme, through a non-probability sampling process, based on convenience. Following data collection, the interviews were transcribed and fully coded. Subsequently, content analysis was carried out. The results were analysed in different groups, taking into account the role of each participant: student, lecturer at Universidade Agostinho Neto or IHMT NOVA. The results were considered positive with regard to the impact on the academic careers of its students, as IHMT NOVA provided the appropriate training and technologies that are not often found in the Global South. The PhD allowed to contribute to the reinforcement of human and material resources, including the development of scientific research in the country.

Introducing The International Centre for Genomic Medicine in Neuromuscular Diseases (ICGNMD)

The International Centre for Genomic Medicine in Neuromuscular Diseases (ICGNMD) is a £5 m, 5 year MRC Strategic award whose goal is to improve health outcomes for people with neuromuscular diseases (NMDs) globally. Activity is distributed across 14 Centres in Brazil, India, Turkey, South Africa, the United Kingdom and Zambia. The ICGNMD aims to: • deliver an international genomics research & capacity-building partnership in genomic medicine; • facilitate international NMD patient access to accurate genetic diagnoses; • assemble “trial ready” comprehensively phenotyped and genotyped cohorts of people living with NMDs and their families; and growing clinical capacity in neuromuscular diseases by training a cohort of clinical academic researchers.

Building Capacity in Monitoring Urban Liveability in Bangkok: Critical Success Factors and Reflections from a Multi-Sectoral, International Partnership.

Cities are widely recognised as important settings for promoting health. Nonetheless, making cities more liveable and supportive of health and wellbeing remains a challenge. Decision-makers’ capacity to use urban health evidence to create more liveable cities is fundamental to achieving these goals. This paper describes an international partnership designed to build capacity in using liveability indicators aligned with the UN Sustainable Development Goals (SDGs) and social determinants of health, in Bangkok, Thailand. The aim of this paper is to reflect on this partnership and outline factors critical to its success. Partners included the Bangkok Metropolitan Administration, the UN Global Compact—Cities Programme, the Victorian Government Department of Health and Human Services, the Victorian Health Promotion Foundation, and urban scholars based at an Australian university. Numerous critical success factors were identified, including having a bilingual liaison and champion, establishment of two active working groups in the Bangkok Metropolitan Administration, and incorporating a six-month hand-over period. Other successful outcomes included contextualising liveability for diverse contexts, providing opportunities for reciprocal learning and knowledge exchange, and informing a major Bangkok strategic urban planning initiative. Future partnerships should consider the strategies identified here to maximise the success and longevity of capacity-building partnerships.

Capacity-building partnerships for surgical post-graduate training in low- and middle-income countries: a scoping review of the literature with exploratory thematic synthesis.

In recent years, international surgical programmes have moved away from vertical service delivery and towards collaborative, capacity-building partnerships. The aim of this review was to provide a map of the current literature on international surgical training partnerships together with an exploration of factors influencing their implementation. Three bibliographic databases were searched for peer-reviewed reports of surgical training partnerships between organizations in high- and low or middle-income countries to July 2018. Reports were sorted in an iterative fashion into groups of similar programmes, and data were extracted to record the intervention strategies, context, financing, reported results and themes around implementation. Eighty-six reports were grouped into five types of programme: full residency training, bi-institutional twinning partnerships, diagonal/sub-specialist programmes, focused interventions or courses and programmes using remote support. Few articles were written from the perspective of the low-middle income partner. Full residency programmes and some diagonal/sub-specialist programmes report numbers trained while twinning partnerships and focused interventions tend to focus on process, partners' reactions to the programme and learning metrics. Two thematic networks emerged from the thematic synthesis. The first made explicit the mechanisms by which partnerships are expected to contribute to improved access to surgical care and a second identified the importance of in-country leadership in determining programme results. Training partnerships are assumed to improve access to surgical care by a number of routes. A candidate programme theory is proposed together with some more focused theories that could inform future research. Supporting the development of the surgical leadership in low- and middle-income countries is key.

A partnership to build scientific capacity of Rwanda's future conservationists: The Memoirs Program.

The future of primates depends on conservationists in primate range countries having the education and opportunities needed to facilitate conservation efforts. However, most primates are found in countries where conservation is underfunded. Rwanda is home to 14 primate species, with three being listed as endangered on the International Union for Conservation of Nature (IUCN) Red List. Their remaining native habitats are scarce, highly fragmented, and surrounded by high human densities. Lacking education opportunities and the loss of qualified individuals following decades of political instability created a need for well-trained conservationists to tackle conservation challenges in Rwanda. The Memoirs Program, a science capacity-building partnership between Dian Fossey Gorilla Fund (DFGF), University of Rwanda (UR), the Rwanda Development Board, and Cleveland Metroparks Zoo, aims to train the next generation of Rwandan conservationists. Annually, the Memoirs Program provides 10-12 top students from the UR Conservation Biology undergraduate program the opportunity to conduct senior research projects (Memoirs) at DFGF addressing conservation issues in and around Rwanda's protected areas. Students receive one-on-one supervision by DFGF scientists and affiliates to supplement UR mentorship, along with targeted teaching modules that reinforce and complement UR curricula. In continuation of the Memoirs Program, participants are offered professional development, employment opportunities, and support to publish their research in peer-reviewed journals. Since inception of the Program in 2003, 123 students have participated with 83% being employed or pursuing higher education degrees in conservation-related fields in Rwanda and the region. Pre- and post-training comparison of oral presentation skills, one of the teaching modules, involving 22 students demonstrated increased post-training performance. The Memoirs Program represents an effective partnership between the government, an international conservation non-governmental organization, and a public higher-learning institution in a developing country to support high-performing students to become tomorrow's conservation leaders. This model could be replicated within Rwanda and in other regions of the world.

Research Capacity Strengthening in American Samoa: Fa'avaeina le Fa'atelega o le Tomai Sa'ili'ili i Amerika Samoa.

Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN’s blueprint for achieving global health equity. The UN Permanent Forum on Indigenous Issues endorses the SDG and underscores the need for global partnerships that respect local leadership and culture. Innovations that weave or integrate Indigenous and Western knowledges are emphasised. These recommendations guided the INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE). INSPIRE is led by investigators from American Samoa and supported by US co-investigators. In project year one, INSPIRE queried: What weaving approaches are feasible for promoting community access to INSPIRE’s research hub and for training Indigenous researchers? Weaving procedures involved interlacing Samoan and Western knowledges. Cultural tailoring strategies were used to customise communications. Formative evaluation suggests the feasibility of INSPIRE’s efforts. Evidential tailoring provided information on American Samoa (A.S.) social determinants of health; trainees indicated increased research commitment. Linguistic and sociocultural relevance tailoring were positively received; trainees reported increased interest in research praxis and initiated an A.S. research capacity-strengthening model. Social work assured knowledge parity in development/delivery of the training curriculum and culturally safe discussions on social determinants of health, territorial status and Samoan survivance. Findings are context-specific yet offer considerations for capacity-strengthening partnerships seeking to advance health equity.

Taking a systems approach to explore the impacts and outcomes of a research and evaluation capacity building partnership: a protocol

IntroductionPartnership models that bring researchers, policymakers and service providers closer together are gaining traction as a strategy to improve public health practice. Yet, there is little evidence of how these...

Building capacity for geospatial cancer research in Uganda: a feasibility study

Abstract Background There is a growing epidemic of cancer and other non-communicable diseases in sub-Saharan Africa. Targeted, specific, cost-effective strategies are needed to manage the growing burden of cancer. In high-resource settings, geospatial analysis has transformed cancer control through geographic targeting of interventions and policies. A similar approach could improve cancer control in sub-Saharan Africa; however, georeferenced cancer data and increased geospatial research capacity are needed. Here, we aimed to assess the feasibility of geocoding and mapping small-area cancer data from a cancer registry in Uganda. Methods We established a partnership including the Makerere University Department of Pathology, School of Public Health and College of Computing and Information Sciences, the Kampala Cancer Registry, Uganda, and the Medical College of Wisconsin, USA. The overarching goal of our multidisciplinary and multi-institutional partnership is to increase geospatial cancer research capacity at Makerere University to enhance the prioritisation and targeting of limited cancer prevention and control resources in Uganda. Findings Two medical students from the Medical College of Wisconsin, mentored by faculty at their own institution and Makerere University, worked in Kampala with registry staff to identify, enter, and quality-check geographic codes of residence for approximately 1522 cervical cancer records from 2005 to 2014. Information about district (n=1520, 99·9%) and subcounty (n=1486, 97·6%) was available for the vast majority of cases, and the parish was identifiable for a large proportion of cases (n=1242, n=81·6%), with increasing availability in more recent years. A seed grant is supporting ongoing capacity building at the Kampala Cancer Registry, including the purchase of new computing hardware and software and the implementation of a revised geographic data collection protocol to support future geospatial analysis of Kampala Cancer Registry data. Interpretation It is feasible to geocode cancer registry records in Kampala, Uganda, and to create cancer incidence maps to identify areas with higher than expected cancer burdens. This capacity building partnership is a catalyst for improving targeted prevention and control efforts to reduce the burden of cancer in Uganda. Funding Dr Elaine Kohler Summer Academy of Global Health Research, Class of 2001 Scott Sprtel Summer Research Training Fellowship, Medical College of Wisconsin Office of Global Health Research Seed Project Funding for Faculty.

Using dispute settlement partnerships for capacity building

PurposeWorld Trade Organisation grants rights to its members, and WTO Dispute Settlement Understanding (DSU) provides a rule-oriented consultative and judicial mechanism to protect these rights in cases of WTO-incompatible trade infringements. However, the DSU participation benefits come at a cost. These costs are acutely formidable for least developing countries (LDCs) which have small market size and trading stakes. No LDC has ever filed a WTO compliant, with the only exception of India-Battery dispute filed by Bangladesh against India. This paper aims to look at the experience of how Bangladesh – so far the only LDC member that has filed a formal WTO complaint – persuaded India to withdraw anti-dumping duties India had imposed on the import of acid battery from Bangladesh.Design/methodology/approachThe investigation is grounded on practically informed findings gathered through authors’ work experience and several semi-structured interviews and discussions which the authors have conducted with government representatives from Bangladesh, government and industry representatives from other developing countries, trade lawyers and officials based in Geneva and Brussels, and civil society organisations.FindingsThe discussion provides a sound indication of the participation impediments that LDCs can face at WTO DSU and the ways in which such challenges can be overcome with the help of resources available at the domestic level. It also exemplifies how domestic laws and practices can respond to international legal instruments and impact the performance of an LDC at an international adjudicatory forum.Originality/valueExcept one book chapter and a working paper, there is no literature available on this matter. This investigation is grounded on practically informed findings gathered with the help of original empirical research conducted by the authors.

Building Mental Health Research Capacity in Kenya: A South - North Collaboration.

This paper describes a mental health capacity-building partnership between the University of Nairobi (UON) and the University of Washington (UW) that was built upon a foundational 30-year HIV/AIDS research training collaboration between the two institutions. With funding from the US National Institute of Mental Health Medical Education Program Initiative (MEPI), UW and UON faculty collaborated to develop and offer a series of workshops in research methods, grant writing, and manuscript publication for UON faculty and post-graduate students committed to mental health research. UON and UW scientists provided ongoing mentorship to UON trainees through Skype and email. Three active thematic research groups emerged that focused on maternal and child mental health, gender-based violence, and HIV-related substance abuse. Challenges to conducting mental health research in Kenya included limited resources to support research activities, heavy teaching responsibilities, clinical duties, and administrative demands on senior faculty, and stigmatization of mental health conditions, treatment, and research within Kenyan society. The partnership yielded a number of accomplishments: a body of published papers and presentations at national and international meetings on Kenyan mental health topics, the institution of systematic mental health data collection in rural clinics, funded research proposals, and a mental health research resource centre. We highlight lessons learned for future mental health research capacity-building initiatives.

Constructing and Governing Partnerships for Capacity Building in Implementation Science

Constructing and Governing Partnerships for Capacity Building in Implementation Science