Developing mental health research in sub-Saharan Africa: capacity building in the AFFIRM project

Abstract

BackgroundThere remains a large disparity in the quantity, quality and impact of mental health research carried out in sub-Saharan Africa, relative to both the burden and the amount of research carried out in other regions. We lack evidence on the capacity-building activities that are effective in achieving desired aims and appropriate methodologies for evaluating success.MethodsAFFIRM was an NIMH-funded hub project including a capacity-building program with three components open to participants across six countries: (a) fellowships for an M.Phil. program; (b) funding for Ph.D. students conducting research nested within AFFIRM trials; (c) short courses in specialist research skills. We present findings on progression and outputs from the M.Phil. and Ph.D. programs, self-perceived impact of short courses, qualitative data on student experience, and reflections on experiences and lessons learnt from AFFIRM consortium members.ResultsAFFIRM delivered funded research training opportunities to 25 mental health professionals, 90 researchers and five Ph.D. students across 6 countries over a period of 5 years. A number of challenges were identified and suggestions for improving the capacity-building activities explored.ConclusionsHaving protected time for research is a barrier to carrying out research activities for busy clinicians. Funders could support sustainability of capacity-building initiatives through funds for travel and study leave. Adoption of a train-the-trainers model for specialist skills training and strategies for improving the rigor of evaluation of capacity-building activities should be considered.

Lessons from the field: the conduct of randomized controlled trials in Botswana

“…The required capacity-building measures are diverse. Some efforts to build capacity in African countries experiencing a progressive rise in clinical trials include the creation of data safety monitoring boards to assist local researchers [ 20 , 21 ]. These boards contribute to capacity-building as they train nationals in data safety monitoring and research skills training for research staff.…”

'We need more big trees as well as the grass roots’: Going beyond research capacity building to develop sustainable careers in mental health research in African countries

“…More often, both fellows and senior researchers noted the lack of senior mental health researchers to provide mentorship, for fellows and faculty alike, a nding consistent with prior studies [19]. Senior researchers in LMICs faced the burden of training clinicians and researchers, conducting their own research, and, often, ful lling clinical duties, all without the administrative support provided to HIC clinician-researchers [18,28]. Beyond careers in academia, all respondents agreed that there could be a role for doctorate-level researchers in ministries of health and wanted more linkages between research and government.…”

“…While a detailed brief on each university can be found in the online appendix A, there are some important features to highlight concerning previous experience with research capacity building partnerships between the universities involved in AMARI. All four universities collaborated in AFFIRM, a research and capacity building initiative that supported MPhil fellowships, funding four PhD students nested within AFFIRM trials, and short courses in specialist research skills [16,18]. The universities in South Africa and Ethiopia were part of PRIME, a LMIC-led partnership which provided research evidence for the development, implementation and scaling up of integrated district mental healthcare plans in ve countries with 21 PhD students nested within PRIME [23].…”

“We need more big trees as well as the grass roots”: going beyond research capacity building to develop sustainable careers in mental health research in African countries

“…While a detailed brief on each university can be found in the Additional file 1: Appendix A, there are some important features to highlight concerning previous experience with research capacity building partnerships between the universities involved in AMARI. All four universities collaborated in AFFIRM, a research and capacity building initiative that supported MPhil fellowships, funding four PhD students nested within AFFIRM trials, and short courses in specialist research skills [16,18]. The universities in South Africa and Ethiopia were part of PRIME, a LMIC-led partnership which provided research evidence for the development, implementation and scaling up of integrated district mental healthcare plans in five countries with 21 PhD students nested within PRIME [25].…”