Conducting Research in LMICs: Challenges and Opportunities

Thursday 27 June, 15:00 – 18:00

This event was organised by UCL’s Institute of Healthcare Engineering’s Global Delivery Group. If you’d like to join our delivery group then please message us at healthcare-eng@ucl.ac.uk

Opening Remarks

The event was opened by Dr. Patty Kostkova and Prof. Ifat Yasin, chairs of the IHE’s Global Delivery Group.

Research Funding Streams and ISPF

Hour talk delivered by Helen Hopkins, the Strategic Research Coordinator at Global Health.

Helen’s slides are available here, and summarised below.

Hopkins started with a definition of Global Research: the “systematic investigation, study, or inquiry conducted on a worldwide scale, encompassing diverse geographic regions, populations, and cultural contexts.” Crucially, this type of research involves “collaboration and data collection from various countries or international entities.”

At UCL, our Official Development Assistance (ODA) Funding is made according to the list below. This funding can only be used in countries on the ODA list and must meet the criteria of catering to a vulnerable population.

[See more: https://www.oecd.org/en/topics/finance-for-sustainable-development.html ]

All active calls, including deadlines can easily be seen here: https://airtable.com/appSad7rFnqQ1WVDh/shrvowTeb8eQI7SZn/tblWCUEDV1QxFwFbo?backgroundColor=blue&viewControls=on

To note, International Science Partnerships Fund (ISPF) will be ending in March 2025 so there might be a good opportunity to get funding as ISPF try to spend the money before the end of the funding.

Like ISPF Funding, a lot of funding is politically intertwined but NIHR Global funding normally isn’t so isn’t likely to close with the change of a government.

Hopkins also announced the UCL Research Progression Award, targeted specifically for research projects addressing the challenges faced in LMICs. “The call is open to early and mid-career academics to provide this cohort with support to gain a greater level of autonomy in their own research. Professorial staff are not eligible to apply to this call.”

Projects are expected to cost up to £60K and may take place during the period 1^st October 2024 to 31^st July 2025 – but all spending must be completed on or before 31^st March 2025. Deadline 15^th August 2024. More details are found here.

Helen can be found at the Research Coordination Office and manages funds and applications to them.

Global Health Research in LMICs 101: Panel Event

This first panel featured the following academics to share their insights and experiences working in LMIC:

• David Osrin, Wellcome Trust Senior Research Fellow in Clinical Science, UCL Professor of Global Health, and Honorary Consultant at Great Ormond Street Hospital for Children.
• Maryam Bandukda, Research Fellow in Storytelling and Impact Research, and Post Graduate Teaching Assistant in MSc Human-Computer Interaction.
• Ifat Yasin, Professor of Auditory Perception and Technology and Vice Dean (Equality, Diversity and Inclusion) in UCL Engineering.
• Tiina Pasanen, Freelance Consultant specialised in Monitoring, Evaluation and Learning (MEL) methods.

Questions from the audience spanned across a range of topics, here’s an overview of some discussions that were had:

First, we looked at how to “give back" to those who contribute to your research.

A lot of the time, the partnership starts in the Global North, maybe in a University like UCL but a lot of the time ideas and research questions are also taken from people in LMIC’s and so although the partnership may have started in a place like UCL, the help we get from LMIC’s to conduct the whole project is unsurmountable.

The consensus was to look at long-term training options, something that could last after the research is done, for example, looking at the possibility of offering fellowships or ways to bring those people here to do workshops to give back to the communities. It was highlighted that when you’re doing participatory research and “your idea goes commercial,” think about who really “came up with that idea” - sometimes contracts will state that participants will not financially gain from the research output. Consider whether you think this is fair.

Another way is through co-authoring papers with members of the community to appreciate their contributions. Even if the members of the community can’t read English, it’s always nice seeing their name on papers.

Second, the audience asked for advice about general “good practice.”

When starting, it’s good to go to any public data office who can serve as a starting point and direct you elsewhere. They can tell you if you need to go through a formal procedure.

The general advice was to be adaptive when you’re on the ground. Being on Microsoft Team calls to build rapport is one thing, but once you arrive at the location, be willing to change things up and be a quick learner.

Also, make sure, if you’re working as a multi-country network, that it's not just you travelling everywhere but everyone visiting each other. Keep roles and responsibilities clearly defined throughout and, “although its institutional, it’s also about personal relationship.” Maintain good relations with the communities you work with.

And something that kept coming up in discussions is making sure that you always bring the research back to the community. It’s not just a case of collecting the data but also understanding it - you need to feedback and showcase your data. Respondents appreciated it when researchers did this. A lot of the panel have found that this has helped solidify relationships and build trust for any future projects.

Tiina put this into practice during her time in Ghana and the response was that this was the first time someone had gone back to explain the research to the community. Maryam also recalled how a few years ago she went back to relay the findings of a project to the community and even today she still gets calls about the project. There is interest in knowing what happens afterwards.

But even before all this, engaging with the community before data collection can lead to more responsive data.

Third, how do we get more policymakers interested in research that is still not completed?

Here, the panel gave an insight into the difficult situation of getting policymakers to listen -  “there’s always values, people’s beliefs, and politics.” “Sometimes they already made decisions and your research is to justify it.” It was also advised that “you need to speak their language,” in this regard.

And lastly, do we emphasise collaboration with community partners in our grant applications?

Interestingly, we’re seeing more and more of this cross collaboration being recognised in grant applications. We shouldn’t be feedbacking and having good relationships with our community partners just for funding though, but also to be able to help the community we’re taking from. Learning happens both ways, after all.

Another thing to note is that funders say they want high risk but they only mean this when it’s a small amount of risk! One example given is that of Afghanistan. Nominated as high risk, the NIHR accepted them as high risk but these partners still have not been paid yet because of global geopolitics.

Experiences from Latin America, Africa, South-East Asia: Panel Event

The second panel of the afternoon featured the following panel:

• Punaf Yadaf, Associate Professor of Humanitarian Studies and Co-director of the Centre for Gender and Disaster at the Institute for Risk and Disaster Reduction.
• Monica Lakhanpaul, Professor of Integrated Community Child Health at UCL Great Ormond Street Institute of Child Health and Honorary Consultant Paediatrician at Whittington Health NHS.
• Delmiro Fernandez-Reyes, Professor of Biomedical Computing at UCL Department of Computer Science. Focused on furthering research on LMICs global challenges.
• Michelle Heys, UCL and NIHR Professor of Global Child Health and a Community Paediatrician looking after children and young people with cerebral palsy and learning disabilities in Newham, East London.
• Patty Kostkova, Professor in Digital Health and the Director of UCL IRDR Centre for Digital Public Health in Emergencies.

A number of interesting points were raised as these individuals gave insights into their global research experiences. The following is an overview of some of the major talking points.

It’s important to be mindful and not take advantage of different cultures and their customs. One researcher noted how people can be extremely accommodating and hospitable to researchers and this, in the past, has led to exploitation. Think also about the language we use, the term “research” has a big negative history behind it in the context of imperialism. There is also mistrust when contracts, forms etc. are in English and literacy rates in that country might be low. Get rid of the mindset that we are going out to countries for our own research, we should be going out there to help with their interests.

Funding was also another big thing of note amongst the speakers. Punam noted that although we might have grant funding by the time you pay your overheads, you barely have any money left. Our UCL finance system is also a barrier when paying people for their time and data. But then so are the funding rules in the country you’re working in and working with different currencies.

There was a big discussion centring on ethical clearance, since different countries have different standards and paperwork. One researcher suggested that the native researchers should make the ethics forms, which can then be passed on to UCL researchers for analysing. There’s a lower chance of the approvers saying no when it’s been internationally approved. However, this can become problematic due to UCL requiring these forms to be English, which means you need to send a lot of copies back and forth to check that all parties are happy with agreements and translations. On the other hand, other countries may have a number of different ethics boards that you need to get through and this can be expensive.

There was also a discussion around research priorities – is this something that the community actually needs or wants?

And lastly, we can’t devalue how innovative LMIC’s actually are. Sometimes the work the local community is carrying out is far more innovative than the work we do in the UK or in the NHS.

Based on the high turnout and engaging conversations, the event was a major success. We hope to create more opportunities like these for researchers to connect and share their experiences to help one another.