Global health framework

DOI: 10.1186/s12961-019-0451-0

Abstract

Efforts to measure research impact have historically concentrated on high-income countries. However, a growing body of health and medical research has emerged from low- and middle-income countries (LMICs), driven by local needs, international aid, and established research funders. The Framework to Assess the Impact of Translational health research (FAIT) is designed to measure research impact, combining three methods: Payback, economic assessment, and case study narrative. Though FAIT has been effective in Australian research initiatives, its application in LMICs has not occurred. This paper explores the feasibility and utility of applying FAIT in an LMIC context and provides recommendations for its implementation.

Introduction

The world of medical and health research is expanding its geographical influence, stretching into the corners of low- and middle-income countries (LMICs). With increasing attention to the health disparities and lack of access to medical resources in these regions, the global health community has begun to turn the wheel of change through research led initiatives. However, one question that remains pressing is: What impact does this research create within these vulnerable nations?

To measure the elusive impact of health research, the Framework to Assess the Impact of Translational health research (FAIT) proposes a combined approach. As observed in a study published in Health Research Policy and Systems, FAIT integrates Payback, economic assessment, and case study narrative, making it a potentially robust tool to gauge the ripple effects of health research (Dodd et al., 2019). But can such a framework designed presumably with high-income countries in mind find its place within the particularities of LMICs? This paper delves into the adaptability and applicability of FAIT in LMIC environments based on data and narratives from in-country studies, while providing essential context and recommendations for its prospective use.

Understanding FAIT and Its Legacy in High-Income Countries

Health research impact warrants the accountability of investments and the tangible benefits produced by scientific inquiry. FAIT is an offspring of numerous frameworks designed to achieve this. Endeavors like the Research Excellence Framework (REF) in the United Kingdom and the Science and Technology for America’s Reinvestment: Measuring the Effects of Research on Innovation, Competitiveness, and Science (STAR METRICS) in the United States have steered the legacy of research impact assessment in high-income countries (Woolf, 2008; Chalmers et al., 2014).

The Venture into LMICs

Notwithstanding the effectiveness of such frameworks in developed nations, our understanding of their influence in LMICs, where economic, social, and infrastructure disparities present unique challenges, is slim. Dodd and colleagues (2019) attempted to retrospectively apply FAIT to two LMIC studies to not only establish evidence of impact but also to assess its utility in such a context.

Their findings portrayed an intricate picture. FAIT enabled a clearer articulation of impact pathways in domains such as capacity-building and policy development. It shed light on underreported aspects of research impact, opening the door to a new and nuanced understanding of LMIC research benefits. What’s more, it offered comprehensive insights into economic impacts, though quantifying the return on investment proved to be a substantial challenge due to the contextual complexities unique to LMICs.

Constraints and Learning Curves

The determination of economic returns is a cornerstone of impact assessment in high-income countries, but its transposition to an LMIC context is fraught with difficulty. Data limitations, disparate health systems, and varied local economic conditions confound straightforward economic evaluations. The authors recommend simplifying economic assessments to accommodate the constraints of LMICs while retaining the ability to capture a broader picture of economic impact.

Storytelling through Case Narratives

An unexpected benefit of employing FAIT was the narrative aspect of case studies, translating technical research into approachable stories. This narrative delivered not only a channel comprehensible to laypersons but also served as a bridge between researchers, funds providers, and the larger community, reinforcing the importance of transparency and communication in generating actionable insights from health research data.

Recommendations for Optimizing FAIT in LMICs

– Prospective application and integration of impact assessment into the research process, rather than retrospective evaluation.
– Development of LMIC-specific metrics to support the Payback framework’s utility, capturing public health advancements, innovation, and socio-economic improvements.
– Streamlining the economic component to facilitate its application without diluting the essence of economic impact evaluation.

Path Forward: Blurring Geographical Lines of Impact Assessment

The research by Dodd and associates demonstrates that FAIT can transcendent the confines imposed by geography, delivering a flexible and adaptable tool for impact assessment. It carries within it the potential to become a global standard, offering a scaffold for strengthening health research’s effect across varied economic landscapes.

Conclusion

Applying FAIT to measure research impact in LMICs has been an enlightening exercise in understanding and assessing the depths of research contributions to global health. While challenges remain, especially in economic assessment, FAIT’s combined approach allows for meaningful evaluation and translates research initiatives into relatable impacts.

This novel application of FAIT holds a mirror up to the evolving needs of research impact studies, challenging the global community to consider the nuanced contexts of LMICs. The future of global health research lies not just in the hands of researchers but in the frameworks we use to measure and thereby enhance its far-reaching influence on society.

Keywords

1. Research Impact Assessment
2. Global Health Framework
3. LMIC Research Development
4. FAIT Application
5. Economic Evaluation in Health

References

1. Dodd, R. R., et al. (2019). Strengthening and measuring research impact in global health: lessons from applying the FAIT framework. Health Research Policy and Systems, 17(1), 48. https://doi.org/10.1186/s12961-019-0451-0
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