Strengthening research capacity through regional partners: the HRP Alliance at the World Health Organization

Background Improvements in health cannot occur without cutting-edge research informing the design and implementation of health programmes and policies, highlighting the need for qualified and capable researchers and institutions in countries where disease burden is high and resources are limited. Main body Research capacity strengthening efforts in low- and middle-income countries have included provision of training scholarships for postgraduate degrees, often in high-income countries, internships at research universities/centres, short courses, as well as involvement with research groups for hands-on experience, among others. The HRP Alliance provides opportunities for developing local research capacity in sexual and reproductive health and rights through institutions based in low- and middle-income countries linked with ongoing and past collaborative studies. It is a network of HRP research partner institutions, World Health Organization (WHO) country and regional offices, WHO special programmes and partnerships, and WHO collaborating centres. Conclusion It is through the HRP Alliance that HRP seeks to improve population health by strengthening local research capacity in sexual and reproductive health across the globe, with focus in low- and middle-income countries, in alignment with WHO’s quest of promoting healthier populations.


Résumé
Introduction: Il ne peut y avoir d'amélioration en matière de santé sans une recherche de pointe qui éclaire la conception et la mise en oeuvre des programmes et des politiques de santé, en soulignant la nécessité de disposer de chercheurs et d'institutions qualifiés et compétents dans les pays où la charge de morbidité est élevée et où les ressources sont limitées. (

Resumen
Introducción: Las mejoras en la salud no pueden suceder sin investigaciones de vanguardia que informen sobre el diseño y la implementación de programas y políticas de salud y que pongan énfasis en la necesidad de contar con investigadores e instituciones capaces y competentes en los países donde la carga de morbilidad es alta y los recursos son limitados.
Conclusión: A través de la Alianza HRP, el HRP busca mejorar la salud de la población con el fortalecimiento de la capacidad de investigación local en SDSR en todo el mundo, centrado en los países de ingresos bajos y medianos, y alineado con la misión de la OMS de promover poblaciones más saludables.
Palabras clave: Fortalecimiento de la capacidad de Investigación, Investigación, Salud sexual y reproductiva, Países de ingresos bajos y medianos Background Improvements in health cannot occur without cuttingedge research informing the design and implementation of health programmes and policies. Evidence generated in-country is necessary to shape and add relevance to national research and policy agendas [1][2][3]. This highlights the need for qualified and capable researchers and institutions in countries where disease burden is high and resources are limited. The inverse relationship between sexual and reproductive health and rights (SRHR)-related disease burden and availability of research capacity is recognised and different efforts have been undertaken to strengthen capacity in low-andmiddle-income countries (LMIC) over the last few decades [4].

Main body
Research capacity strengthening (RCS) efforts in LMICs have included provision of training scholarships for postgraduate degrees, often in high-income countries, internships at research universities/centres, short courses, as well as involvement with research groups for hands-on experience, among others [5][6][7]. These efforts have resulted in producing researchers for LMICs but have not always significantly built the capacity of LMIC institutions to conduct their own research to identify solutions or monitor uptake and use of evidence for better SRHR outcomes [6]. Sustainable RCS should develop the capacity of target institutions in countries in need so they can successfully train competent researchers, and respond to local, regional, and global agendas [5,6]. While currently there are well-established research institutes in LMICs that can train and conduct high quality research, there are still gaps with regards to strengthening the research capacity of junior researchers. Ensuring equitable and fair authorship is also critical to developing local RCS [8][9][10].

The HRP Alliance
The HRP Alliance, created in 2016 as part of the UNDP/ UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) [11], provides opportunities for developing local research capacity through institutions linked with ongoing and past collaborative studies (visit website using this link https://www.who.int/reproductivehealth/hrp_alliance/en/). It is a network of HRP research partner institutions, WHO country and regional offices, WHO special programmes and partnerships, and WHO collaborating centres. It is through the HRP Alliance that HRP seeks to improve population health by strengthening local research capacity in SRHR across the globe, with focus in LMICs, in alignment with WHO's quest of promoting healthier populations [12]. (See Table 1). Despite the recent creation of the HRP Alliance, HRP has been leading RCS efforts for several decades. In the past, this has been done through long-term institutional development grants which focused mostly on individual institutional strengthening and support of local research projects. The focus now, through the HRP Alliance, lies on building a regional critical mass of researchers supported by institutions located in the regions, illustrating a true horizontal collaboration among researchers.
At the core of the HRP Alliance are regional RCS "hubs," selected through an open competitive process that considers experience in SRHR RCS and capacity to provide regional leadership in RCS. These hubs, based in Brazil, Burkina Faso, Ghana, Kenya, Pakistan, Thailand, and Viet Nam, 1 are entrusted with providing RCS support to institutions in their regions. While the HRP Alliance is still in its nascent stages, support is provided primarily through: Table 1 The HRP Alliancevision, mission, strategy, goals and core values

Vision
The HRP Alliance aims to improve sexual and reproductive health and rights (SRHR) globally by strengthening research capacity.

Mission
To support institutions to develop high quality research capacity in SRHR. Strategy By linking research capacity strengthening (RCS) with HRP research and knowledge transfer, the HRP Alliance capitalizes and reinforces existing collaborations. It provides support for institutions to position themselves in the global SRHR research and knowledge transfer arena. This is provided through long-term institutional grants to research institutions selected as regional RCS hubs supporting other institutions in their respective regions. Workshops and trainings on SRHR, research methodologies and biostatistics, systematic review and meta-analysis, qualitative research methods, implementation research, monitoring and evaluation, protocol development and manuscript writing (Fig. 1); Post-graduate education specific to SRHR research (through masters and/or doctoral degrees) (Fig. 2); Tailored support to country research institutions in the development and implementation of research studies and the production of scientific publications; Leadership in knowledge transfer activities that contribute to ensuring the implementation of WHO recommendations for policy and practice; Collaborative grant proposals among several hubs or institutions supported by the hubs using the HRP Alliance network to leverage experience and expertise; Enabled collaborations among HRP Alliance fellows for specific research projects; Response to health emergencies through SRHR research to improve rapid health system response and local research capacity.  Since inception, the HRP Alliance has trained over 700 participants from LMICs through 30 workshops and courses and is supporting over 60 researchers obtain a master's or doctoral degree, some of whom have been involved in the local implementation of HRP multi-country studies [13][14][15][16][17] and in secondary analyses. The HRP Alliance supports the use of group authorship for multi-country studies, local leadership in secondary and country-specific analyses, and the establishment of authorship rules and roles prior to project start-up. Over 20 research groups from Latin America have been funded by the HRP Alliance to provide the evidence base to respond to the Zika virus epidemic in 2016-2017 [18] and the mass migration crisis in the Americas in 2019-2020. The HRP Alliance also swiftly responds to the needs arising from health and humanitarian emergencies according to the specific needs for RCS and research. In the upcoming years, the HRP Alliance will support junior researchers through a tailored mentorship programme for women and postdoctoral fellowships as well as support additional research to study the SRHR of migrants in the Eastern Mediterranean region.

Conclusion
The HRP Alliance model for RCS is one among many, but it holds the unique characteristic of allowing for the development and building of research capacity of individuals and institutions through the engagement and leadership of research institutions located in LMICs. This model has the potential, by supporting RCS activities through institutions located in the regions of interest, to prevent future brain drain of qualified researchers by building capacity and offering viable opportunities for implementing research in their home countries. This paper serves as a blueprint of what the HRP Alliance has set out to do and to be held accountable to its mandate.