North-South Collaboration Research Articles

Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

BackgroundCancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service.Objectives, methods and outcomesOver the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to a resource-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme.ConclusionDevelopment of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment.

Research capacity development in a South African higher education institution through a north-south collaboration

One of the constraints that prevent institutions in developing countries from engaging in effective and essential research is a lack of research capacity. This study reports on a north-south collaboration between a group of Flemish universities and a higher education institution in South Africa with the specific goal of improving productivity, quality and capacity amongst researchers. A collaborative project with multiple sub-projects was established in 2003, and extended over two consecutive five-year phases. Document analysis was conducted of annual reports, monitoring and evaluation reports, curriculum vitae of participating members, and progress reports of students and supervisors during this time. The findings of this study illustrate the extent to which research capacity objectives can be achieved through a north-south partnership. Members of the collaboration were able to develop intra- and inter-disciplinary partnerships that resulted in maximising the capacity- building efforts, enhancing both individual and institutional research capacity. Keywords: International partnerships; professional development; student development; staff development.

Educating for Global Leadership: A North-South Collaboration.

This chapter examines two global education programs in higher education, one in the global North and the other in the global South to explore the shift from command to community in leadership.

University–industry interaction on cleaner production. The case of the Cleaner Production Center at the University of Cienfuegos in Cuba, a country in transition

Universities are key stakeholders in teaching, researching and supporting the implementation of cleaner production activities. This case study discusses the experience of establishing and operating the Cleaner Production Center at the University of Cienfuegos (Cuba).Establishing, starting-up and running the center during its first four years of activity was supported by two projects targeted to inter-university cooperation. The collaboration allowed to establish a master program on cleaner production which acts as a bridge between the university, and the production industry and the services sector in the province of Cienfuegos. Currently 32 students from the first two promotions graduated and the program of two other promotions is ongoing. The master thesis research works are defined improving the environmental performance of the companies or organizations the student originate from. This results in a measurable improvement of the air and surface water quality in Cienfuegos city. An estimated yearly reduction of the emission of 60,000 ton of carbon dioxide equivalents and of 400 MWh at a cement plant have been realized.Research activities currently target the pollution inventory of Cienfuegos, energy production from local biomass, and establishing indicators for sustainable development for Cienfuegos. The inter-university collaboration resulted in several publications in international peer reviewed journals.The successful inter-university North–South collaboration between Cuba and Belgium, targeted at capacity building, transfer of experience and expertise, proved to be most crucial during these first years the center was active. It allowed generating the necessary funds which are often difficult to raise in developing countries. Therefore this is a unique case of building academic experience on cleaner production.

Stock-outs, uncertainty and improvisation in access to healthcare in war-torn Northern Uganda

Stock-outs, also known as shortages or complete absence of a particular inventory, in public health facilities have become a hallmark in Uganda's health system making the notions of persistent doubt in access to healthcare – uncertainty, and doing more with less – ‘improvisation’, very pronounced. The situation becomes more critical in post-conflict areas with an over whelming burden of preexisting and conflict-related ailments amidst weak health systems. Particularly in the war-torn Northern Uganda, the intersection between the effects of violent conflict and shortage of medications is striking. There are problems getting the right type of medications to the right people at the right time, causing persistent shortages and uncertainty in access to healthcare. With reference to patients on Antiretroviral Therapy (ART), we present temporal trends in access to healthcare in the context of medication shortages in conflict-affected areas. We examine uncertainties in access to care, and how patients, medical practitioners, and the state – the key actors in the domain of supplying and utilizing medicines, respond. Our observation is that, while improvisation is a feature of biomedicine and facilitates problem solving in daily life, it is largely contextual. Given the rapidly evolving contexts and social and professional sensitivities that characterize war affected areas, there is a need for deliberate healthcare programs tailored to the unique needs of people and to the shaping of appropriate policies in post-conflict settings, which call for more North-South collaboration on equal terms.

SDH-NET: a South-North-South collaboration to build sustainable research capacities on social determinants of health in low- and middle-income countries.

BackgroundIt is desirable that health researchers have the ability to conduct research on health equity and contribute to the development of their national health system and policymaking processes. However, in low- and middle-income countries (LMICs), there is a limited capacity to conduct this type of research due to reasons mostly associated with the status of national (health) research systems. Building sustainable research capacity in LMICs through the triangulation of South–North-South (S-N-S) collaborative networks seems to be an effective way to maximize limited national resources to strengthen these capacities. This article describes how a collaborative project (SDH-Net), funded by the European Commission, has successfully designed a study protocol and a S-N-S collaborative network to effectively support research capacity building in LMICs, specifically in the area of social determinants of health (SDH); this project seeks to elaborate on the vital role of global collaborative networks in strengthening this practice.MethodsThe implementation of SDH-Net comprised diverse activities developed in three phases. Phase 1: national level mapping exercises were conducted to assess the needs for SDH capacity building or strengthening in local research systems. Four strategic areas were defined, namely research implementation and system performance, social appropriation of knowledge, institutional and national research infrastructure, and research skills and training/networks. Phase 2: development of tools to address the identified capacity building needs, as well as knowledge management and network strengthening activities. Phase 3: identifying lessons learned in terms of research ethics, and how policies can support the capacity building process in SDH research.ResultsThe implementation of the protocol has led the network to design innovative tools for strengthening SDH research capacities, under a successful S-N-S collaboration that included national mapping reports, a global open-access learning platform with tools and resources, ethical guidelines for research, policy recommendations, and academic contributions to the global SDH discourse.ConclusionsThe effective triangulation of S-N-S partnerships can be of high value in building sustainable research capacity in LMICs. If designed appropriately, these multicultural, multi-institutional, and multidisciplinary collaborations can enable southern and northern academics to contextualize global research according to their national realities.

Forest carbon in Amazonia: the unrecognized contribution of indigenous territories and protected natural areas

Carbon sequestration is a widely acknowledged and increasingly valued function of tropical forest ecosystems; however, until recently, the information needed to assess the carbon storage capacity of Amazonian indigenous territories (ITs) and protected natural areas (PNAs) in a global context remained either lacking or out of reach. Here, as part of a novel north–south collaboration among Amazonian indigenous and non-governmental organization (NGO) networks, scientists and policy experts, we show that the nine-nation network of nearly 3000 ITs and PNAs stores more carbon above ground than all of the Democratic Republic of the Congo and Indonesia combined, and, despite the ostensibly secure status of these cornerstones of Amazon conservation, a conservative risk assessment considering only ongoing and planned development projects puts nearly 20% of this carbon at risk, encompassing an area of tropical forest larger than that found in Colombia, Ecuador and Peru combined. International recognition of and renewed investment in these globally vital landscapes are therefore critical to ensuring their continued contribution to maintaining cultural identity, ecosystem integrity and climate stability.

PO-0648 Norwegian – Indian Collaboration Project To Improve Newborn Care

Background Norway India Partnership Initiative (NIPI) is cooperation between the Governments of Norway and India, and has a particular focus on improving newborn health by training health personnel. A former exchange program in Kolkata (2011–2013) reports reduction in neonatal mortality rate and improved newborn care. Aim This project aims to improve the care of sick and premature newborns, in line with international standards, in Rajasthan, India. The exchange of health personnel in north-south collaboration can reduce neonatal morbidity and mortality by improving basic neonatal nursing. Focus areas are KMC, nutrition and breastfeeding, developmental care, hygiene and pain management. The project intends to increase multicultural understanding within newborn health care. Method Exchange of 4 indian and 2 norwegian nurses/year for a 3 year period. Norwegian nurses will stay in JK Lone Hospital, Jaipur for 12 months and indian nurses in Oslo university hospital for 6 months. Focus for Norwegian nurses in Jaipur will be teaching doctors and nurses in evidence based newborn care through bedside training in the NICU. Interact with the indian team of doctors, nurses,and family of the sick newborn, in order to develop an understanding of the culture and society they are working in. Focus for Indian nurses in Oslo will be hands on bedside training in the NICU under surveillance of experienced personell. In depth knowledge of the focus areas. All participants are to convey their experience to their home partners after homecoming through teaching, demonstrations and reports. The goal is sustainable practice change according to evidence based care.

Editorial

The Africa Platform of the Ghent University Association and its journal Afrika Focus have always tried to focus on academic expertise in Africa and on academic north-south collaboration. Through its annual conference and its journal the Africa Platform offers a forum in which African academics and northern scholars working on Africa can forge new and often interdisciplinary collaboration. Most of this research on Africa is highly relevant to the development of African societies, as became clear at the last symposium of 1 This editorial was written just a few days before Nelson Mandela passed away on 5 December 2013. We have lost a great man. Hamba Kahle Madiba. [5 ] the Africa Platform, entitled ‘Africa: (post-development)?’ This special issue of Afrika Focus contains a number of articles that were presented at that symposium, which took place on 7 December 2012. In his article ‘Performance, poverty and urban development: Kigali’s motari and the special city’ Rollason describes the con ict between motorcycle taxis in Kigali and the city authorities. Urban development of Kigali is at stake here as these motari do not seem to match the image of the city the government wants to present. The article by Debusscher ‘Gender equality in European Union development policy: incorporating women’s voices or con rming hierarchies?’ is highly critical of the gender mainstreaming approach of the EU in its development aid towards sub-Saharan Africa. The EU seems to be more con- cerned with reaching its policy goals rather than challenging existing power structures in Africa. Both of these articles raise awareness on the level of a particular development-re- lated issue, and they have the potential to lead to concrete recommendations for national or EU development policies. The three remaining articles in this issue do not t in with the development-topic. Mulamba’s article ‘Luba folklore and women’s ethno-gendered discourse of wifehood in “Cintu Wa Bujitu”’, throws light on the socialization function of the Lubà folk song, a folkloric tradition that seems to perpetuate gender inequalities. Naphulo’s linguistic article (‘Teacher and learner beliefs and expectations about English language teaching at a Mozambican university’) critically analyses English language teaching in tertiary in- stitutions. The conclusion is that cultural backgrounds and beliefs need to be considered in order to enable effective teaching. The nal article of this issue (‘Arbuscular mycorrhizal fungi associated with shade trees and Coffea arabica L. in a coffee-based agroforestry system in Bonga, Southwestern Ethiopia’) examines coffee production and describes how a certain type of fungi could be used as a (natural) alternative to chemical fertilizers, so as to enhance coffee production in the forest areas of Ethiopia. All three of these articles indicate that traditional knowledge – be it linguistic, cultural or botanic – always plays an important role when trying to gain insight into African societies or when trying to improve practices and policies related to education, health care or agriculture. This is an idea that should as a mat- ter of course be a consideration when designing research in an African context. We like to remind the reader that in addition to fully- edged articles, Afrika Focus also publishes reports of doctoral research or eld work. In this issue we offer you four reports of PhDs defended at Ghent University. All four of these PhD degress were ob- tained by African scholars, thus testifying to the vibrant research collaboration that exists between African institutions and this Western European university. These current reports belong to the domains of Biology and Marine Biology, Linguistics and Health Care.

Youth at the margins: Introducing a new research initiative in an ongoing south-north collaboration in the context of international diaconia

Abstract This article holds up the development of an expanding South-North collaboration between researchers from South Africa and the Nordic European countries of Finland, Sweden and Norway as an example of what can also be recognised as a new-found intentional initiative by the International Society for the Research and Study of Diaconia and Christian Social Practice (ReDi) to develop the field of International Diaconia, and, more specifically, of the establishment of particular relationships (South-North and East-South) within this development. The discussion starts by pointing out how this collaboration found its initial expression in a research initiative that was known as the WRIGP project (an acronym for 'Welfare and Religion in a Global Perspective'). It proceeds by indicating how the collaboration will be continued and expanded upon in a newly conceptualised collaborative initiative referred to as the YOMA project (an acronym for 'Youth at the Margins'). Within this framework, the article specifi...

COMPARE Forum: The idea of North-South and South-South collaboration

The idea of having a Compare Forum focusing on the above title was first discussed with one of the Editors of Compare during a PhD defence in Oslo in 2011. The PhD dissertation itself was linked to...

Creation of a therapeutic digestive endoscopy suite in Senegal: renovation, training and university certification. Results of a Belgian–Senegalese inter-university project

Therapeutic digestive endoscopy did not exist in sub-Saharan Africa before 2005. However, the prevalence of digestive diseases that could potentially benefit from basic endoscopic treatment is very high in this region. Portal hypertension with variceal bleeding and severe dysphagia associated with benign or malignant upper gastrointestinal tract diseases are prominent in these countries. The aim of the Project described in this report was to create a digestive endoscopy facility in Dakar (Senegal, West Africa), that would also provide local training in therapeutic endoscopy to doctors and nurses and facilitate regional autonomy with the opening of a University Certification in Gastroenterology. It took about 10 years to achieve these targets - 5 years to prepare realistic aims that took into account local needs, available local resources, and funding, and 4 years for the Project itself (2005-2009). At the present time, Senegalese colleagues and nurses are autonomous for basic therapeutic procedures in the upper and lower gastrointestinal tract. Two years after the end of funding, the rate of therapeutic activity has increased from 0% in 2005 to 12 % of digestive endoscopic activity in 2011. Key points of success were preparation, confidence of medical personnel, university involvement, shared funding, local multidisciplinary training, and facilitation of autonomy. Belgian healthcare workers were present on-site in Dakar for a total of about 6 months over the 4-year Project period, with an annual budget of less than € 80000. The Project has enabled an efficient North-South collaboration with a minimal budget, which has changed the healthcare provision of digestive endoscopy in Senegal, and has also provided autonomy, and facilitated the development of South-South cooperation.

North-South collaboration: a success story

North-South collaboration: a success story

Famine in the Presence of the Genomic Data Feast

While human genome analysis has extraordinary potential, it will not be realized in Africa without development of human resources and increased North-South collaboration.

Reducing the scarcity in mental health research from low and middle income countries: A success story from Sri Lanka

There is an enormous inequity in global health as well as research. Less than 10% of research funds are spent on the diseases that account for 90% of the global disease burden. This case study of north–south, south–south collaborations in Sri Lanka is a classic example of the issues faced by mental health researchers in low and middle income countries (LMICs). In this paper, work carried out by the Institute of Psychiatry (IoP), King's College London and the Institute for Research and Development (IRD) partnership since 1997 in Sri Lanka is presented to show an example of a successful private research institution based in a LMIC as a product of south–south and north–south collaboration in mental health research. The evidence of scarcity of mental health research and resources is overwhelmingly abundant in the context of Sri Lanka. IRD-IoP partnership showcases a successful north–south partnership with equality and efficiency. It has moved beyond start-up phase and has become a sustainable initiative in terms of funding, collaboration, research output and policy impact. International funding agencies, academics, and other bodies need to address sustaining such initiatives as priorities in reducing scarcity and inequity in mental health research in developing countries.

North-south collaboration on research and advocacy to reduce armed violence

Armed violence is a global problem, yet disproportionately impacts certain nations. In recent years, approximately 90% of all direct conflict deaths occurred in low-income countries in Asia, Africa and Latin...

E-Learning and North-South collaboration: the experience of two public health schools in France and Benin

Distance learning (e-learning) can facilitate access to training. Yet few public health E-learning experiments have been reported; institutes in developing countries experience difficulties in establishing on-line curricula, while developed countries struggle with adapting existing curricula to realities on the ground. In 2005, two schools of public health, one in France and one in Benin, began collaborating through contact sessions organised for Nancy University distance-learning students. This experience gave rise to a partnership aimed at developing training materials for e-Learning for African students. The distance-learning public health course at Nancy teaches public health professionals through a module entitled "Health and Development." The module is specifically tailored for professionals from developing countries. To promote student-teacher exchanges, clarify content and supervise dissertations, contact sessions are organized in centres proximate and accessible to African students. The Benin Institute's main feature is residential team learning; distance-learning courses are currently being prepared. The two collaborating institutions have developed a joint distance-learning module geared toward developing countries. The collaboration provides for the development, diffusion, and joint delivery of teaching modules featuring issues that are familiar to African staff, gives the French Institute credibility in assessing research work produced, and enables modules on specific African issues and approaches to be put online. While E-learning is a viable educational option for public health professionals, periodic contact can be advantageous. Our analysis showed that the benefit of the collaboration between the two institutions is mutual; the French Institute extends its geographical, cultural and contextual reach and expands its pool of teaching staff. The Benin Institute benefits from the technical partnership and expertise, which allow it to offer distance learning for Africa-specific contexts and applications.

South–South research collaboration of countries in the Southern African Development Community (SADC)

This study investigates South–South collaboration in research, and specifically collaboration among the 15 countries of the Southern African Development Community (SADC) as well as between the SADC and the rest of Africa. It was found that only 3% of SADC papers during 2005–2008 were jointly authored by researchers from two or more SADC countries (intra-regional collaboration), and only 5% of SADC papers were jointly authored with researchers from African countries outside the SADC (continental collaboration). In contrast, 47% of SADC papers were co-authored with scientists from high-income countries. The few instances of intra-regional and continental collaboration in the SADC are largely the product of North–South collaboration. Authors from high-income countries are included in 60% of intra-regional co-authored papers and in 59% of continental co-authored papers. Moreover, between 2005 and 2008, South Africa produced 81% of all SADC papers and 78% of all intra-regional co-authored papers. This implies that there is a highly unbalanced and unequal partnership that can best be described as a variant of North–South collaboration with the scientific giant in the South taking on the role of the ‘political North’. As a consequence, guidelines for successful North–South collaborations should be extended to include South–South collaborations that comprise highly unequal partners, as is the case between South Africa and the other SADC countries.

E-taxonomy: an affordable tool to fill the biodiversity knowledge gap

As part of a recent North-South collaboration a plant diversity inventory of Angola was compiled virtually exclusively using web-based resources. Here we report on the feasibility and cost of conducting this work and test the hypothesis that existing and new internet resources enable and simplify taxonomic work and support filling gaps in biodiversity knowledge.

Mother and Child Contaminants and Dietary Impacts on the Body Burden of Contaminants: Contribution of North-South Research Collaboration to Maternal and Child Global Health

Mother and Child Contaminants and Dietary Impacts on the Body Burden of Contaminants: Contribution of North-South Research Collaboration to Maternal and Child Global Health