| Population | Inclusion |
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| Exclusion |
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| Intervention | Inclusion |
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| Comparators | Inclusion |
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| Outcomes | Inclusion |
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| Study Design | Inclusion |
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| Other Criteria | Inclusion |
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| Exclusion |
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Figure 1
Modified Research Capacity Development for Impact framework [22].
Domain definitions are as follows: skills and confidence building—research capacity skills and confidence of individuals and groups, includes traditional research methodology and scientific writing skills, along with “boundary‑spanning skills,” such as relationship building; co‑production—research that is produced within the context where it will be useful and engages the “right” people in the research process; equity—reduction of health research capacity disparities between and within groups as a program output or outcome; may be related to program structures, such as the promotion of recruitment/retention of marginalized groups; linkages and collaboration—building connections among researchers and groups to co‑conduct research, including between diverse disciplines; actionable dissemination—sharing project results in ways that address the translational gap, communicate directly with target audiences, or call to action; sustainability and leadership—leadership development among participants and groups, especially leadership that calls for sustaining and expanding newly gained skills (e.g., undertaking new projects, participants of the program becoming leaders or mentors themselves, etc.), and program sustainability over time; infrastructures—development of structures to support research capacity including mentorship/supervision and project management structures, long‑term collaborative partnerships, research grant/funding arrangements, structures to help with governance and ethics, and/or organized information exchange events (e.g., virtual conferences); and ownership and responsibility—promoting individual or group engagement in research that is “owned” and transitioned to being a core component of the one’s work or organizational fabric (e.g., an organization specifically allocating time for clinicians to do research). The framework domains function across three structural levels (individuals, organizations, and health and social care systems) and are surrounded by two environmental factors (policy and context) that inform and are informed by each domain.
Figure 2
PRISMA flow diagram [25].
*Indicates number of publications identified via hand‑searching.
HRCS, health research capacity strengthening; LMIC, low‑ and middle‑income country.
Table 1
Program characteristics (n = 28)a.
| CITATION | HRCS PROGRAM OBJECTIVE(S) (PROGRAM SIZE)b | LMIC PARTICIPANTS’ COUNTRY OR REGION | CLINICIAN TYPE(S) | VIRTUAL COMPONENT(S) OF THE HRCS PROGRAM (FULLY VIRTUAL OR HYBRID) | EVALUATION DESIGN |
|---|---|---|---|---|---|
| Abawi 2016 [42] | To train healthcare professionals in sexual and reproductive health research (175) | 59 countries in Africa, Asia, and North America | Midwives, nurses, and physicians | Online course, e‑mentorship, and online discussion group (fully virtual) | Non‑randomized |
| Aggarwal 2011 [9] | To compare impact and accessibility of online distance or on‑site training courses for scientists engaged in biomedical research (58) | India | Physicians | Online course (hybrid) | Randomized controlled trial |
| Atkins 2016 [43]c | To build postgraduate students’ health research capacity through online research work‑in‑progress meetings (NR) | India, Malawi, and Nicaragua | Junior researchers | Online course (fully virtual) | None |
| Barchi 2013 [44] | To train ethics committee members and researchers and evaluate the effectiveness of internet‑based learning (72) | Botswana | Ethics committee members | Online course and e‑mentorship (hybrid) | Randomized controlled trial |
| Bloomfield 2016 [45] | To enhance infrastructure and training necessary for early career researchers to conduct innovative and locally relevant non‑communicable disease research (563) | Argentina, Bangladesh, China, Guatemala, India, Kenya, Mexico, Peru, South Africa, and Tunisia | Junior researchers, and physicians | Online course, e‑mentorship, and online discussion group (hybrid) | None |
| Braunschweiger 2007 [18] | To train researchers on human subjects’ protection and responsible research conduct (>600,000) | 26 countries in the Caribbean and South America | NR | Online course (fully virtual) | None |
| Byrnes 2019 [46] | To improve research capacity for non‑communicable diseases in Asian LMICs (48) | India, Malaysia, and Sri Lanka | NR | Online course and online repository (hybrid) | Mixed methods |
| CORDIS 2015 [47]c | To build capacity in health systems and services research in sub‑Saharan African universities (300) | South Africa and Uganda | Junior faculty | Online course, online discussion group, and online repository (hybrid) | Quantitative descriptive |
| Da Silva 2019 [48]d | To improve mental health research capacity of medical doctors, clinical nurses, and psychologists via collaborative hubs (5) | Argentina, Brazil, Ethiopia, Ghana, and Nepal | Clinical psychologists, nurses, and physicians | Online learning‑by‑doing and online discussion group (hybrid) | Qualitative |
| Decroo 2018 [49] | To improve operational research capacity of clinicians through a blended online and in‑person training program (6) | India and Kenya | Physicians and physiotherapists | Online course (hybrid) | Quantitative descriptive |
| Dodani 2012 [50]e | To equip physicians with epidemiology research skills (56) | Bangladesh and Pakistan | Physicians | Online course (hybrid) | Quantitative descriptive |
| Dodani 2008 [51]e | To equip physicians with epidemiology research skills (40) | Bangladesh and Pakistan | Physicians | Online course (hybrid) | Non‑randomized |
| Heller 2015 [52]f | To improve population health by building public health capacity via e‑learning at very low cost (117) | Eastern, Southern, and Western Africa, and Indian subcontinent | Clinicians | Online course, e‑mentorship, online discussion group, and online learning‑by‑doing (fully virtual) | None |
| Heller 2009 [53]f | To develop infrastructure, administrative capacity, and course content for online public health training (117) | 23 countries in Africa, including Nigeria, Tanzania, and Uganda | Clinicians and physicians | Online course and online discussion group (fully virtual) | None |
| Loisel 2009 [54] | To enable trainees to contribute to the the field of work of disability prevention with a transdisciplinary perspective (44) | Brazil, Canada, France, the Netherlands, and the United States | Clinicians | Online course (hybrid) | None |
| Mayor 2019 [55] | To build and strengthen health research capacities in Good Clinical and Laboratory Practice of trainees (18) | Liberia | Midwives, nurses, pharmacists, physicians, and physician assistants | Online course, e‑mentorship, and online discussion group (hybrid) | None |
| McGuire 2020 [16]g | To use peer mentorship to build health research capacity among family medicine trainees (8) | Lesotho | Clinicians | Online course, e‑mentorship, and online learning by‑doing (hybrid) | Mixed methods |
| Mill 2014 [56] | To enhance nurses’ qualitative research capacity and promote involvement in HIV policy via participatory action research (25) | Barbados, Jamaica, Kenya, South Africa, and Uganda | Nurses | Online course, e‑mentorship, and online learning‑by‑doing (hybrid) | None |
| Nazer 2021 [57]g | To increase research skills and productivity among clinicians with minimal research experience in the Middle East (11) | Egypt, Jordan, Oman, Saudi Arabia, and Sudan | Clinicians | Online course and e‑mentorship (hybrid) | None |
| Okewole 2020 [58]g | To train clinicians and junior mental health researchers in academic research skills (15) | Ethiopia, Malawi, South Africa, and Zimbabwe | Clinicians and junior researchers | Online course (hybrid) | Qualitative |
| Pilowsky 2016 [59]e | To develop opportunities and capacity for mental health research in LMICs (NR) | Afghanistan, Bangladesh, Brazil, Chile, Colombia, Ecuador, Ethiopia, Ghana, Guatemala, India, Kenya, Liberia, Malawi, Nepal, Nigeria, Pakistan, Peru, South Africa, Sri Lanka, Uganda, and Zimbabwe | Clinicians | Online course, e‑mentorship, online learning‑by‑doing, and online repository (hybrid) | None |
| Protsiv 2016 [60]c | To train health systems and services research doctoral students in conducting meta‑analytic studies (19) | South Africa and Uganda | Clinicians and pharmacologists | Online course and e‑mentorship (hybrid) | Mixed methods |
| Reynolds 2008 [61]f | To develop and pilot public health online diploma course for practitioners in developing countries (38) | Democratic Republic of Congo, Ghana, India, Nigeria, Pakistan, Sudan, and Turkey | Nurses and physicians | Online course and online discussion group (fully virtual) | Quantitative descriptive |
| Sharma 2017 [62]e | To conduct policy research to reduce the treatment gap for mental disorders in South Asia (52) | Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka | Psychiatrists and mental health researchers | Online course, e‑mentorship, online discussion group, and online repository (hybrid) | None |
| Silverman 2013 [63] | To improve institutional and individual research ethics capacity of Middle Eastern countries (NR) | Egypt, Jordan, Lebanon, Libya, Sudan, Syria, and Yemen | Ethics committee members | Online course, online discussion group, and online repository (hybrid) | None |
| Thakurdesai 2018 [64] | To develop academic and research competence for academic psychiatrists and postgraduate students (NR) | India | Psychiatrists | E‑mentorship, online discussion group, and online learning‑by‑doing (fully virtual) | None |
| Wright 2005 [6]h | To build research and leadership capacity of Latin American nurses in substance abuse and health promotion, with a specific focus on drug‑demand reduction (11) | Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru | Nurses | E‑mentorship and online learning‑by‑doing (hybrid) | None |
| Wright 2015 [65]h | To build a cadre of academic health professionals with specialized knowledge and research skills in drug‑related issues (91) | Brazil, Colombia, Jamaica, Nicaragua, Chile, El Salvador, Ecuador, Peru, Costa Rica, Guatemala, Guyana, Mexico, Honduras, Panama, Trinidad and Tobago, Uruguay, Argentina, Bahamas, Barbados, Belize, Paraguay, and Suriname | Nurses, occupational therapists, physicians, pharmacists, and psychologists | E‑mentorship and online learning‑by‑doing (hybrid) | None |
[i] aTwenty‑eight articles used in the results section of the systematic review.
[ii] bProgram size refers to the number of participants reported to be initially recruited.
[iii] cPublications on African Regional Capacity Development for Health Systems and Services Research (ARCADE) intervention.
[iv] dPublications on South Asian Hub for Advocacy, Research and Education on Mental Health (SHARE) hub interventions.
[v] ePublications on same intervention (unnamed).
[vi] fPublications on the People’s Open Access Education Initiative (People’s‑uni) intervention.
[vii] gPublications included from the updated March 2021 literature search which contributed new information to the results.
[viii] hPublications on International Research Capacity‑Building Program for Health and Related Professionals to Study the Drug Phenomenon in Latin America and the Caribbean.
[ix] HIV, human immunodeficiency virus; HRCS, health research capacity strengthening; LMIC, low‑ and middle‑income country; NR, not reported.
Table 2
Identified impacts of HRCS programs with illustrative quotes.
| DOMAIN (ABBREVIATION) | IMPACT THEMESa | ILLUSTRATIVE QUOTES |
|---|---|---|
| Skills and confidence building (SKILLS) | Programs demonstrated various skill‑building impacts, with many reporting on traditional research skills, such as critical appraisal, data analysis, and research dissemination, while others also discussed gains in soft skills, including tolerance, interpersonal communication, and worklife balance (LINK/COLLAB) | 2a) “The graduates are proven to have postgraduate level research and critical appraisal skills” [52] 2b) “I can say with great confidence that I have gained capacity not only in qualitative research but also in doing qualitative research across different countries and cultures” [56] |
| Some programs specifically described impacts on participant confidence, which was tied to career advancement, taking a stand on issues, and building partnerships (SUS/LEAD) | 2c) “I currently coordinate operational research activities with a lot of confidence and competency as an alumni of Peoples‑uni” [52] 2d) “Based on the program and the experience of realizing the research project, I[’ve had] growing confidence to take a stand about the problem in various professional contexts” [6] | |
| Co‑production (COPROD) | Virtual networks allowed researchers to work together on projects that were relevant to their own communities and local clinical contexts (LINK/COLLAB) | 2e) “During a discussion on instruments to measure stress, the Presumptive Stressful Life Events Scale was considered (Singh et al., 1984), [however] (...) it was realized that the scale requires revision to make it more relevant [to the network of researchers’ current cultural context]. Members of eJCIndia (...) working in academic institutions in different parts of the country volunteered to be a part of [this] multicenter project” [64] 2f) “The study (...) involved a survey of the value of the use of information technology in the implementation of guidelines to improve clinical or public health practice. None of the participants had previously performed research together, and 44 of the possible 48 members of the [virtual] Alumni group at the time participated in the data collection” [52] |
| Some programs intentionally involved key decision‑makers and institutions in the research process (LINK/COLLAB, SUS) | 2g) “To build a sustainable model of research capacity building in a region with inadequate and inequitable resources, it is imperative to involve (...) regional institutes with complementary roles and expertise. (...) Some of SHARE [South Asian Hub for Advocacy, Research and Education on Mental Health] partner institutes (...) work closely with the Ministry of Health in their respective countries. This gave an opportunity to the SHARE core team to initiate a dialog with the government agencies and decision makers and conduct training programs and dissemination programs for the relevant government bodies” [62] 2h) “The use of a PAR [participatory action research] design also incorporated the opportunity for ongoing, deliberative collaboration between nurses and decision‑makers” [56] | |
| Equity (EQ) | Some projects were explicitly designed and implemented to address systemic and individual barriers to access and participate in research, including collaborative agreements to promote power‑sharing, targeted funding or selection of participants, using flexible e‑learning strategies to reach those who may be otherwise excluded, and providing resources specifically needed in LMIC contexts (CO‑PROD, INF, SKILLS) | 2i) “Individuals eligible for support by MERETI [Middle East Research Ethics Training Initiative] include those from the World Bank‑designated LMIC categories. While individuals from HICs in the region are not eligible for funding from the program, they may participate as self‑funded students” [63] 2j) “While efforts to redress the gender imbalance at SSA institution continues, providing opportunities through e‑Learning, addressing some of the barriers that may impact the training of women, is an important achievement of ARCADE HSSR: Of a sample of 20 students (...) half had children under the age of 5 years. (...) childcare responsibilities may prevent parents from taking part in research. Particularly, travel (...) is often out of the question. Through (…) blended learning ARCADE HSSR has provided excellent courses for caregivers of children, policymakers, and others who are unable to travel distances to partake in cutting edge training” [47] |
| Equity was not explicitly addressed or measured in most articles and one program specifically noted an inability to impact equity (CO‑PROD, INF, SKILLS) | 2k) “Despite the best efforts to provide equitable research capacity‑building opportunities (...) [they] remained skewed to settings where the infrastructure already existed” [62] | |
| Linkages and collaboration (LINK/COLLAB) | Collaboration between researchers with diverse experiences can enhance the quality of HRCS programs and research outputs (DISS, COPROD) | 2l) “The (...) program applied team science principles by bringing together a group of investigators with diverse disciplines, management styles, local and regional global health needs, core competencies, and training program objectives working towards a common goal. By working together and leveraging on their training expertise, COE [Collaborating Centers of Excellence] training representatives closed gaps in their training programs (...) and collaborated on proposals, securing additional funding (...) to enhance their respective training programs” [45] 2m) “The solutions offered in eJCIndia group discussions lead to an improvement in the quality of studies designed and papers written by members (...) [via] knowledge pooling by members who have expertise in different fields of psychiatry and psychiatric research” [64] |
| Some programs encouraged collaboration via team mentorship that linked researchers at various career stages (SUS/LEAD) | 2n) “The SHARE capacity‑building team realized that the model based on one–one mentoring by senior researchers may not be sustainable (...) in a region where there are few trained researchers; therefore, the SHARE team endeavored to form a network of mentors at different career stages. Thus, at the end of its 5 years, SHARE has successfully brought together a bank of researchers with varied experience and areas of expertise, to provide guidance or career advice to young or early career researchers” [62] 2o) “This programme built linkages between senior researchers, junior researchers, and students. Faculty from MU [Makerere University], SU [Stellenbosch University], MA [Malawi University College of Medicine], and MUHAS [Muhimbili University of Health and Allied Sciences] attended meetings during which students worked on research protocols, thus also creating research linkages between the staff. The meetings clarified the staff’s research interests, and linked students to staff, both within institutions and between institutions. Thus, many senior researchers could assist junior researchers and students in developing their research proposals” [47] | |
| The formation of virtual research networks, including those which extend beyond initial program targets, were highlighted as important; however, the impact of such networks can be difficult to quantify as they may occur over long periods of time (SUS/LEAD) | 2p) “Formation of peer network of researchers was the pivot of success of the SHARE program” [62] 2q) “There were some research programmes on the periphery of the consortium that emerged during the project and represented collaboration between the two hubs. (...) No results are available yet from these studies” [47] | |
| Actionable dissemination (DISS) | In addition to the commonly reported metric of number of research publications by participants, some programs also reported other forms of dissemination, such as conference submissions and presentations (LEAD/SUS) | 2r) “Activities have led to the preparation of about 20 articles in three years” [64] 2s) “A total of 154 research presentations were given by trainees at national and international conferences” [64] |
| Examples of actionable dissemination included directly sharing research findings with policymakers and stakeholders, and the use of non‑traditional formats for dissemination of results, such as policy briefs | 2t) “Trainees have also had the opportunity to exchange their research findings with senior policymakers and practitioners” [46] 2u) “In order to highlight the rich, in‑depth qualitative findings, we shared findings using a wide range of non‑traditional formats for a variety of target audiences. These included lay summaries, policy briefs, and concise recommendations for decision‑makers and front‑line nurses” [56] | |
| Some HRCS programs led to trainees participating in further research, taking leadership roles in their countries, expressing interest in, or pursuing higher research degrees, and advancing their careers (COPROD, INF, DISS) | 2v) “More than 50% of ASCEND [Asian Collaboration for Excellence in Non‑Communicable Disease] trainees commenced higher research degrees during or following their participation in the ASCEND program. These included PhD, Masters, or MD programs (...) with mentoring and supervisory support provided by the international ASCEND faculty” [46] 2w) “I substantially improved my abilities for research and now I work on advanced nursing research projects with greater social impact, with my graduate students and professors. (...) I hold a leading position in the Faculty, where scientific knowledge is generated, applied, and spread; (...) services are extended to society; and management is realized, which means that ways of financing projects are looked for” [6] | |
| Sustainability and leadership (SUS/LEAD) | The “training of trainers” model, wherein alumni or sometimes participants still within the program go on to train others in research, can support program sustainability (LINK/COLLAB) | 2x) “A number of the alumni are cascading their knowledge to others through their own local teaching and are applying for research grants themselves and with colleagues” [52] 2y) “Team members described their increased confidence in qualitative and participatory research methodologies, with many members taking on teaching and mentoring roles in their own institutions by the end of the project, a clear indicator of the sustainability of the research capacity that has developed” [56] |
| Funding and resource availability are essential for continued sustainability at all levels, with the organizational level being the most challenging to achieve | 2z) “Sustainability of the program, ASCEND was largely based on financial viability and external funding. A sense of ownership by local institutions involved in the program would be critical for sustainability (...), however, without continual funding and further strengthening of capacity of these institutions, this is potentially challenging. At [an] individual level, the benefits of the research capacity strengthening program can be maintained, adapted, and developed. But sustainability of research capacity at [the] organizational level requires system and organizational level interventions” [46] | |
| Strategies to promote sustainability included encouraging local ownership, use of virtual networks for networking connections, ensuring access to resources beyond program‑end, and actively creating regional conditions that favor long‑term sustainability (INF, OWN, LINK/COLLAB) | 2aa) “A momentous success of SHARE has been the achievement of sustainability and accessibility of training opportunities in the region (...) by developing various (...) virtual platforms for short courses, and by offering ‘classic’ lectures on mental health in open‑source formats for the global community. (...) The strength of the course was the cascade model, thereby ensuring that master trainers are trained in the region to ensure the momentum of further training” [62] 2bb) “Due to the hierarchical structure of academia in the Middle East region, junior trainees reported difficulties assuming major roles on their institution’s research ethics committee and implementing research ethics into the curriculum. To alleviate these difficulties, prior to trainee selection, we discuss with top university officials how they will promote and support trainee efforts when they return home, as well as selecting senior and junior faculty from the same institution so that junior trainees could be supported in advocating for and implementing research ethics activities” [63] | |
| Infrastructures (INF) | Infrastructure impacts included formation of research ethics governance structures, research training agreements between universities, and the production of research training manuals | 2cc) “Double Ph.D. degree training agreements were signed between SU [Stellenbosch University], MU [Makerere University] and SU and KI [Karolinska Institutet]” [47] 2dd) “An NVivo 8 resource manual was created by a Canadian RA [research assistant] and distributed to teams” [56] |
| A few programs developed guidelines for collaboration, including ones specific to authorship, as a means of promoting equity in publication (EQ) | 2ee) “We attempted to strategically design small research teams to carry out the research and to work together on the publication of findings. The Principles for Research Collaboration (...) clearly outlined the authorship guidelines and helped to ensure that LMIC team members had the same opportunities to participate in publications as the Canadian team members did” [56] 2ff) “For the process of publication, another letter of agreement between CICAD [Comisión Interamericana para el Control del Abuso de Drogas] and University of Alberta‑Faculty of Nursing was signed, detailing the nature and authorship of the manuscripts that would result from this unique experience” [65] | |
| Ownership and responsibility (OWN) | Some HRCS programs precipitated ownership and responsibility by prioritizing and developing structures for local participation of diverse actors, from junior researchers to decision‑makers (CO‑PROD) | 2gg) “The ability of more junior team members to mentor others provided evidence that the qualitative capacity was not only locally‑owned, but also sustainable following completion of the project” [56] 2hh) “The involvement of the leadership hubs, including front‑line practitioners, managers, and decision‑makers, reinforced the importance of qualitative research and helped to ensure that the capacity building was locally‑owned” [56] |
[i] aMost themes were noted during the analysis to overlap with other domains, these overlaps are denoted by noting the abbreviation of the additional domain(s) in parentheses.
[ii] HIC, high‑income country; HRCS, health research capacity strengthening; LMIC, low‑ and middle‑income country.
Figure 3
HRCS program facilitators.
Summary of identified virtual‑specific and general HRCS program facilitators.