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Background and context
Indicators of impact (expected results)
Research in nutrition is essential to the ability to improve the nutrition situation in any country. Good research is the only tool for identifying nutrition problems and their causes, demonstrating their importance to the development of the country and the well-being of its population, formulating solutions, and evaluating progress. Local research capacity within strong and credible research institutions must have national support; without this, outside funding cannot be effective in developing sustained leadership for the solution of national nutrition problems. Therefore, seeking external funding cannot be justified without a commitment of national resources to maintain a critical level of institutional capacity in nutrition research. Outside funding nonetheless may be instrumental for setting up coordinated multicentre or transregional research efforts. The capacity of academic and research institutions in developing countries to respond to research needs in human nutrition is seriously limited. In some regions of the world, particularly in Asia and Latin America, there are well-established nutrition institutions, which nonetheless individually have gaps in available expertise.
In Africa there are few institutions with nutrition research capacity, and the available capacity often is very limited. Recognizing that much nutrition research can and should be field based, the limitations in research capacity often relate to a lack of facilities and appropriately trained individuals to conduct the needed research. Thus, nutrition institutions, particularly in Africa, should be strengthened by the development of a cadre of professionals capable of conducting independent research and of training the next generation of professionals: academics, policy makers, and researchers.
Nutrition is a multidisciplinary field. Research in nutrition should be judged by its effectiveness in addressing specific problems. Problem-focused research may draw on a number of academic disciplines, or it may rely on only one or two; it is not possible to specify in advance or to generalize about the specific disciplinary specialities that may be needed to address a given research problem in nutrition. For example, testing alternative dosages and frequencies of iron supplementation may draw on clinical research capacity. Evaluation of the nutritional effectiveness of a supplementary feeding programme will require input from a range of social scientists. Predicting the nutritional consequences of changing price policies may draw from disciplines well outside the traditional boundaries of nutrition. It is clear that there are many research needs in human nutrition, including laboratory and clinical research, but most especially in nutrition programme and policy implementation and in nutritional impact assessment. Similarly, methodological research also is needed.
Developing local research capacity in nutrition and its related fields should increase the input of local nutrition institutions into the solution of their countrys or regions nutrition problems and increase their influence over the identification of nutrition problems to be studied. Research conducted locally is likely to be more timely and cost-effective in addressing local problems than is research conducted by scientists unfamiliar with the region and its context.
The principal objective of building research capacity is to develop research centres of excellence in institutions where the research mission is closely linked to the educational and training mission of an academic department, school, or institution, or closely affiliated with academic institutions. Resources should be concentrated on a few selected academic research institutions in each region, since attaining stated goals requires a critical mass of trained professionals within an institution. These should be identified based on specific criteria that include demonstrated institutional commitment to addressing human nutrition problems and issues. It is also important that targeted institutions demonstrate a willingness and ability to act as regional centres.
The goals of developing these centres are to strengthen local capacity in developing countries to respond to nutrition research needs; to increase the proportion of research in nutrition that is conducted by national or regional research institutions; and to increase the level of input of researchers within the country in the definition of their countries research priorities. It may be appropriate to encourage the formation of research institutes or units within universities or to establish direct linkages between universities and research institutes. The approaches that are taken should permit greater flexibility in responding to research needs, and should recognize the time constraints commonly faced by full-time faculty.
Institutions should establish a limited list of urgent research priorities most relevant to national needs. To determine which nutritional needs are of highest priority, research institutions or units should develop a process of regular interaction with agencies (governmental or other) involved in nutrition-related activities. Selection of research priorities should be based on their potential to yield answers required for the solution of specific nutrition problems. That is, research should be undertaken in response to questions whose answers will be applicable immediately to nutrition activities in specific countries.
Research capacity in nutrition will be enhanced by educating future research faculty, that is, those who can conduct independent research and educate future researchers in nutrition and related disciplines within universities or in affiliated research institutions. This may be accomplished through the provision of degree training at the masters and doctoral levels for these professionals. These should be research-based academic degrees, and research conducted in the course of degree training should be based in the individuals country of origin and respond to a research need of the index country.
In the shorter term, existing academic faculty and researchers should benefit from additional education and training as appropriate to upgrade their skills and knowledge and to sensitize them to nutrition issues. This may take the form of degree training or short-term training. Another means of strengthening research capacity is actively to promote the participation of professionals from targeted centres in research, so that research capacity can be developed through hands-on experience and mentorship by more experienced researchers.
Governments have the primary responsibility to support this initiative, and should be sensitized to the importance of providing resources for this purpose. To accomplish this, the government, along with bilateral and multilateral agencies, non-governmental organizations, and private sector partners who sponsor research, should actively seek collaborators from the countries or regions where the research is planned to take place, and additional funds for training should be provided, whenever possible. Currently, the identification of in-country collaborators for externally sponsored research is often difficult and is commonly limited by the personal network of externally sponsored researchers. These difficulties may be minimized by using existing regional networks, or, for example, by establishing regional UNU secretariats or other regional bodies charged with maintaining and updating databases of agencies, academic and research institutions, and individuals involved in various areas of research and action related to nutrition. Over time, independent capacity to conduct research and train investigators will be developed in selected institutions.
Ideally, schools or departments selected for development should have a multidisciplinary orientation that approaches nutrition problems as they exist in society at large, reflecting the current understanding of nutrition as a multidisciplinary science that crosses the laboratory, clinical, and social sciences. Nonetheless, each department or school should be encouraged to develop its own areas of specialization, recognizing that no single department or school can develop sufficient depth to achieve excellence in every discipline related to nutrition.
Many institutions whose areas of expertise reflect a traditional focus on laboratory and clinical sciences have identified the social sciences of nutrition policy and programmes as an area in which additional capacity is needed. Thus, faculty excellence should not be defined only within the traditional academic disciplines, but should include the promotion of academically rigorous, problem-focused, cross-disciplinary researchers. Every effort should be made to ensure that within a given region, the institutions selected for development build complementary areas of strength.
Institutional capacity, once developed, must be maintained. The targeted institutions and their collaborators should be linked in a communication network that allows individuals to inform each other of their activities and to seek information or assistance from each other to meet particular research or educational needs. The Internet or other electronic media can be used to maintain this communication in an informal manner. The UNU is encouraged to provide leadership to this activity. Beyond informal electronic communication, regularly scheduled meetings of regional and international networks responsible for training should be held. (Over time, it is likely that institutions may come to have both roles, that is, those of provider and recipient of education, training, and mentorship.) These meetings might be scheduled to coincide with major professional meetings, such as the International Union of Nutritional Sciences (IUNS). Both the informal communication networks and periodic meetings would facilitate the exchange of training and research materials, lessons learned, specific programmes, and so forth.
A process should be defined to identify appropriate academic research institutions to target for strengthening, and to identify the specific areas in need of research capacity. The development of an inventory of existing institutions in each region that deal with nutrition issues, and cataloguing their existing capacities, the training of their faculty and professional staff, and their research expertise is recommended as a first step. The second step would be to establish a set of objective criteria for selecting institutions for targeting within each region. These criteria should include demonstrated commitment to nutrition on the part of the larger institution (e.g., university), reflected in its track record of research performed, professional and faculty positions allocated, space provided, and ability to attract students and research funds.
To facilitate partnering of researchers in undertaking funded investigations, the inventory of institutions could be the basis for a regional database of individuals and institutions involved in various aspects of nutrition research, as mentioned previously.
Commitments should be sought from governments, local institutions, and external agencies and institutions to encourage close collaboration to accomplish these action steps
To build a new department of nutrition where none exists is a long-term process, requiring perhaps 10 to 20 years of development. But many units are already established and simply require strengthening of underemphasized areas on which they have chosen to focus. A time frame of three to five years is not unrealistic to achieve significant progress in strengthening capacity in a particular area of research and training within an existing department or school.
The first steps, developing an inventory of existing institutions and setting up a mechanism for selecting institutions for targeting, might be accomplished in a year. Obtaining commitment from research funders to promote partnering and mentorship is an ongoing process of advocacy, but one that can be started immediately.
The time frame for developing enhanced research capacity in an institution should be generated specifically for each institution, but one could establish targets for each region, based on a sense of how well developed is its research capacity and institutional base in nutrition.
Ideally, the effectiveness of the proposed investment in research capacity would be reflected in the improved nutritional status of national populations. But it is unrealistic to expect that the effects of training and research capacity-building could be separated in an evaluation from the many other confounding influences that affect nutritional status at the national level. Still, one can identify numerous possible indicators of the effectiveness of such a programme that may be linked to the desired outcome.
Intermediate indicators of the effectiveness of training to develop institutional research capacity can be measured at three levels: those of the individual, the institution, and the users of an enhanced research capacity. Appropriate benchmarks for achievement must be specified appropriately for the time frame of the evaluation. (For example, the success of an academic department as measured by the achievements of its students will take many more years than its success in building its own facultys capacity.)
The Working Group recommended that in the first year of targeted investments, a series of evaluations be undertaken of established academic research institutions. The purpose of such an evaluation would be to establish a baseline for comparison and to develop reasonable expectations for institutions at various stages of development. No fewer than three such evaluations were recommended, one per region. This need not be an expensive activity. It would involve time for developing a concrete set of evaluation tools that cover the indicators discussed briefly below. The actual evaluation could be performed by a team of three persons spending perhaps two to three weeks at an institution. A part of this activity would be to collect information from existing evaluations of training programmes so that comparable tools (questionnaires, methods, measures) might be developed.
Among the recommended indicators of success are the following:
At the individual level:» self-evaluation of the usefulness of training for professional activities;
» ongoing research;
» publications and research reports;
» active participation in networks of information exchange for research and training.
At the institutional level:» number of trained faculty and professional staff, and their level of training;
» extent to which the range of disciplines represented in the department (or school or institute) matches the self-identified goals of the department (number of disciplines alone should not be the criterion, so that depth is not sacrificed for breadth);
» amount and range of research performed in the department and by department members working in collaboration with other institutions;
» publications and research reports;
» active participation in networks of research and training.
At the institutional level, longer range:» number of graduates of the department and their level of training;
» number and proportion of graduates who are in jobs, including:- positions of influence and decision-making in the public and private sectors (local, regional, national)
- academic posts
- nutrition-related activities
- international agencies
At the level of potential users of the results of improved research capacity:» amount and proportion of outside-funded research that is conducted by national or regional institutions, alone or as lead institutions among collaborators;
» evidence of increased input into policy decisions on the part of nutrition professionals acting as advocates and providers of information (e.g., implementation of a fortification programme; provision of nutrition education in schools; implementation of targeted subsidies);
» increased number of nutrition programme and policy evaluations;
» increased use of nutrition parameters in social programme evaluations (such as poverty alleviation and community development programmes);
» evidence of the increased use of information disseminated by departmental researchers in community-level programmes;
» evidence that research results have been incorporated into the design or modification of policies and programmes relevant to nutrition in the country.
There is limited experience in the formulation of success indicators such as those suggested above. For this reason, we have proposed an evaluation to be carried out early in the course of this activity. This will allow us to test the feasibility of our measures of impact, and to develop and refine instruments and methods of measurement for them.
Chairperson: Joseph Hautvast
Rapporteur: Beatrice Rogers
Participants: Judit Katona-Apte, Lilian Marovatsanga, Jacques Berger, Rodolfo Florentino