A platform for implementation health research

Successfully connecting NGO practice and health research

Von Nicole Moran

It is difficult to think about research while managing programs. Whether you are a desk officer sitting in a head office or a coordinator in the field, you are mostly busy securing funding, keeping donors happy once you have secured funding and trying to ensure that you make a difference. But to ensure that you make a difference, it is necessary for programs to be informed by existing evidence and to develop, test and adapt models that are scalable and applicable in other contexts. This is where the challenge starts.

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Successfully connecting NGO practice and health research

I conducted a study on the topic and looked at enablers, barriers and supportive tools for the following key questions:

  • How can we integrate research into NGO practice?
  • How can NGOs collaborate with research institutes?
  • How can we translate evidence into NGO practice and policy?

The results are not surprising, but underline the need for NGOs, Research Institutes (RIs) and Donor Agencies to invest in a supportive environment that enables quality and needs-based research.

Integration of research into practice – the NGO Dilemma

“Operational research is not a luxury; it should be an integral part of all NGOs’ programmes.” (Zachariah / Draquez 2012)

It is obvious, NGOs face a dilemma:

    • Research is taking away funding from programs, and if there is not enough funding coming in, the first cut is on the research budget line, as the first priority of NGOs is to ensure the continuation of programs.
    • At the same time, the infrastructure for research is cost intensive and different expertise is required for each step of the research, as well as across the entire project cycle.
    • Ideally, NGOs have a driver in the organisation pushing the topic.


Summary of Findings: Barriers, Enablers, and Supportive Tools for integration of research

Collaboration of NGOs with Research Institutes – a gap to bridge


“…partnerships need nurturing: they require trust, mutual goals, close relationships, and equitable investments and rewards.” (COHRED 2012: 32)

One option is to collaborate with a Research Institute as NGOs cannot do everything themselves and may not have all the required expertise in-house. But such collaborations also have to be designed in a way that is beneficial for both sides.

  • A solid foundation has to be built for a successful and meaningful collaboration.
  • Open discussions right from the beginning are necessary to define clearly roles, responsibilities and expectations for each side.
  • Researchers have expressed concerns that there is more and more pressure to publish, making it difficult to invest time in collaborations with NGOs.

Summary of Findings: Barriers, Enablers and Supportive Tools for NGO-Research Institute Collaborations

 

Translation of research findings into practice – a complex business


“Research helps us to identify what works, and what does not work and how to understand the local context when introducing new ways of working. There is no point doing research if the findings do not get into policy and practice.” (Whitty / Kinn 2011)

The process of translating research into NGO practice and policy is complex. Several different steps have to be taken:

  • You have to identify what evidence is needed.
  • You have to find the evidence.
  • You have to evaluate the quality of the evidence.
  • You have to apply the evidence.

For each of those steps, different resources and capacities are required; at the same time, there are many competing priorities in the NGO’s daily tasks.

Ideally, all relevant and trained staff would buy into the idea, and the NGO would have protected time to collect, summarise and apply the latest evidence.

Very often, a successful translation is closely tied to the individual motivation of the NGO worker and the researcher as well as donor requirements.

Summary of Findings: Barriers, Enablers and Supportive Tools for translating research

 

How to address those challenges?

NGOs – from “doers” to “doer-thinkers”

A further shift is required in the culture of NGOs from “doer” to “thinker-doer” (Peirson et al. 2012:8). Although NGOs’ emphasis should remain on their core task – “doer”, i.e. implementing programming, however including the “thinker” part as an additional important element that allows NGOs to design and develop their programmes according to the latest evidence. It further allows NGOs to test, improve and scale up their programming, as well as to contribute to the wider knowledge base by integrating research into their work. In practice this could mean that NGOs develop an internal research strategy that guides their work and for which they could explicitly seek funding, including building expertise within their organisation and among their partners. The leadership of NGOs must acknowledge the need for evidence-informed approaches and allocate the necessary resources (finance, protected time and adequate expert staffing).

Research Institutes – from “thinker” to “thinker-doer”
As recommended for NGOs, Research Institutes could likewise consider shifting their culture from a “thinker” to a “thinker-doer” culture, which would allow them to assess the relevance of their research and include the application of research findings as an essential part of the research process.

They could invest more time in including all relevant stakeholders’ right from the beginning. This would include identifying research needs and defining the research question, as these have an important and direct impact on the later application of research findings.

The research findings have to be made available, and they have to be understandable. For example, short summaries could explain the content in a user-friendly way that is easy to grasp for both experts and laypeople (Zachariah et al. 2012a, Nutley et al. 2007:83, Vogel et al. 2013:8).

Funding Agencies - from “funders of results” to “funders of processes, results and research uptake”
There has been increasing interest on the part of donors to include research components in programming, particularly collaborations with Research Institutes are promoted. However, more lobbying of donors is required to provide the necessary financial resources and to create incentives for researchers to translate their research findings into real-world initiatives.

The funds allocated by funding agencies could also include resources to support the process of collaboration (sufficient time for the development and formalisation of a relationship, resources for workshops and meetings, etc.) rather than merely implementing the research. The Director of SciDev.Net (Perkins 2013) also recommends allocating more resources to innovating and testing approaches of collaboration between scientists and NGO practitioners.

However, apart from funding for research and the process of collaboration, NGOs must have the necessary resources to continue their programming. Otherwise, they will not have the necessary capacity to actively contribute to the process of collaboration and research.

Support for NGOs would also entail the availability of donor grants promoting the use of research and supporting the NGOs to develop mechanisms that improve the use of research findings in their work.

Where to invest in future?

Development of efficient and cost effective models

Collaborations between NGOs and Research Institutes are necessary to bridge the gap between research and practice and to ensure the generation and application of relevant, high-quality evidence. There is a need for more opportunities for NGOs and Research Institutes to meet, learn about each other’s work and approaches, and explore possible collaborations. There are already some such initiatives. Enhancing, learning and research for humanitarian assistance (ELRHA), for example, has launched an initiative called “Research for Health in Humanitarian Crisis (R2HC)”, with the support of Departement for International Development (DFID) and the Wellcome Trust. Its goal is to increase the quantity and quality of collaborative research on public health challenges in humanitarian crises. Besides addressing the key research challenges in the humanitarian health sector, the initiative aims to deliver more insights on collaborative partnerships between the academia and the NGO world.

There is also a need to further explore and analyse the required building blocks for an enabling environment within NGOs that would allow them to be involved in the research process in an efficient, cost-effective way. Models to increase cost-effectiveness could include not only collaboration between NGOs and Research Institutes, but also between NGOs building joint knowledge networks or sharing the costs of required research.

A platform for implementation health research

To reduce the feeling of constantly re-inventing the wheel, the study showed that it is important to have a set of supportive tools to save time and resources. Many tools are available, but they are scattered and therefore not easily accessible. As a first step, I developed a web-based platform called the NGO Research Toolbox, a collection of relevant tools for research in one place.

 

But such a toolbox is not sufficient; there is a need to provide space to share, learn and collaborate, to create a platform for implementation research. Such an interactive platform could, for example, provide space

-        To share practical experiences in the field or findings from studies conducted by NGOs, Research Institutes or academics.

-        To learn from good-practice examples as well as from interventions that were not so successful, and to provide access to supportive tools and information about training opportunities to build the research capacity of NGO staff.

-        To collaborate with others, to find partners (e.g., other NGOs, Research Institutes, etc.), to learn from existing partnerships.

 

Research Gate for Practitioners
Since 2008, the research community has maintained Research Gate, a scientific social network for researchers to present their research findings, exchange ideas and collaborate. As of today, Research Gate has 7 million users and over 80 million uploaded publications.

My vision is to have a research gate for practitioners, a platform driven by practitioners that at the same time has strong connections to academia. Ideally, this would be a combination of a web-based exchange supported by face-to-face interaction in workshops and roundtables. The aim would be for the platform to become a relevant and effective tool to further promote NGOs’ important role in research, and to facilitate links between practice, policy and health research.

What would such a platform look like?

  1. You can register as a user and create a profile as an organisation (an NGO or Research Institute) or an individual.
  2. As a user, you can then be active in different ways, such as:
  • Communicating with other users: asking questions, looking for a partner, learning from others;  
  • Forming groups of exchange with other users on different topics, e.g., impact study, successful collaborations; 
  • Posting and uploading information and documents that are accessible for all members, e.g., information about training opportunities, requests for collaboration, requests for information on experience of collaborations.

The platform would provide an opportunity for exchange and collaboration with academia, including both individual exchange and exchange within thematic groups.

Challenges of such a platform

The big question is, would such a platform be used? We know from our own experience that even when such a platform exists, it is not always used. Why? Lack of time? Lack of trust? To involve (potential) users, I would imagine that a mix of virtual exchange and face-to-face encounters in workshops would be the way forward.

The next question is who would maintain the platform. It will only be helpful if it is up to date, ensuring that the needs of users are met and the latest information is provided. Here, one option would be to integrate it into existing structures that are already working to bring different actors together. For example, Medicus Mundi International – Network Health for All (MMI), the network for health organisations (or Medicus Mundi Switzerland), is one such institution.

And finally, who would pay for it? Commitment and investment would be required to develop and maintain such a platform. One solution would be for it to be financed by stakeholders that understand the need for NGOs to be involved in research and the benefits of such collaboration. This could include institutional donors, but also NGOs themselves as well as social entrepreneurs.

Next steps and way forward

To move towards a platform for sharing, learning and collaboration, the following steps could be taken:

  • ­Form a group of interested NGOs to do further work on the topic
  • Further assess the needs of those NGOs in the area of research
  • Initiate joint projects (e.g., learning workshops, collaborative projects, etc.)
  • Transform such a group into a platform for implementation research.

All these steps will contribute to further promote a successful link between NGO practice and health research. Investing in such a platform would be a driver that allows the best science to meet global health challenges.

 

References

COHRED (2012): Beyond Aid: Research and innovation as key drivers for health, equity and development. Global Forum for Health Research 2012, 24-26 April, Cape Town, South Africa. 

Moran, Nicole (2014): Get evidence in NGO practice and policy, get research into practice: enablers, barriers and supportive tools for Health NGOs. Master Thesis, Swiss Tropical and Public Health Institute.

Nutley, Sandra M. / Walter, Isabel / Davies, Huw T. (2007): Using Evidence. How research can inform public services. The Policy Press: Bristol.

Peirson, L./ Ciliska, D./ Dobbins, M./ Mowat, D. (2012): Building capacity for evidence informed decision making in public health: a case study of organizational change, in: BMC Public Health, 12:137.

Perkins, Nick Ishmael (2013): Making space for science in NGO practice. Editorials; in SciDEv Net, 22 May 2013. http://www.scidev.net/global/editorials/making-space-for-science-in-ngo-practice.html

Vogel, J.P./ Oxman, A.D. / Glenton, C./ Rosenbaum, S. / Lewin, S. / Gülmezogllu, A.M. / Souza, J.P. (2013): Policymakers and other stakeholders perceptions of key considerations for health system decisions and the presentation of evidence to inform those considerations: an international survey, in: Health Research Policy and Systems, 11:19: 1-9.

Whitty, C./ Kinn S. (2011): Foreword: Lessons learning about getting research into policy and practice, in Health Research Policy and Systems 2011, 9 (suppl.1): S1.

Zachariah, R./ Draquez, B. (2012): Operational research in non-governmental organisations: necessity or luxury?, Editorial, in: Public Health Action, Vol. 2 No. 2: 31.

Zachariah, R./ Ford, N./ Maher, D./ Bissell, K./ Van den Bergh, R./ van den Boogaard, W./ Reid, T./ Castro, K.G. (2012a): Is operational research delivering the goods? The journey to
success in low-income countries, Personal View, in: The Lancet, Vol. 12: 415-421.

Nicole Moran
Nicole Moran is trained as a nurse and holds a master’s degree in Public Policy & Management and International Health.
For more than 10 years, she has worked for NGOs, mainly in the area of health and education, in the field as well as the headquarters level. Her work has included building systems, raising funds, ensuring quality and evaluating programs. Nicole developed the NGO Research Toolbox as part of her master’s thesis in international health.