Health Systems Research Initiative Call 6: Providing evidence to strengthen health systems in low and middle income countries
On this page:
- Background and scope
- Research impact
- Geographical scope
- Research capacity building
- Example questions
- How to apply
Innovative proposals are sought from across the public health, social and biomedical sciences to the sixth annual call for the Health Systems Research Initiative. Up to £5 million is available for funding foundation and full proposals under this call.
The Department of International Development (DFID), the Economic and Social Research Council (ESRC), the Medical Research Council (MRC) and Wellcome jointly fund the Health Systems Research Initiative. All funders are committed to funding world-class research with high potential for impact on policy and practice.
Launched in 2013, this programme will generate world-class and cutting-edge research that addresses key questions on strengthening and improving health systems in developing countries. Following an excellent response to this programme from the research community, funding has now been secured for an annual call under this initiative until 2021.
The programme’s aims are to fund methodologically rigorous, high-quality research that will:
- generate evidence on how to strengthen and improve health systems for people living in low and middle income countries (LMIC). This may include addressing the structure and dynamics of health systems as a whole, improving the long-term resilience of the health system, in addition to generating positive improvements to systems as currently structured.
- use a health systems approach to inform the delivery of evidence-based interventions or structural changes. Proposals must demonstrate how interventions relate to and affect wider elements of a health system such as governance, financing, health workforce, information systems, service delivery.
- expand the knowledge base in understanding the structure and dynamics of health systems and provide evidence that is of direct relevance to decision makers and practitioners in the field.
There are two different types of grant available:
Research grants, which are larger stand-alone research projects. Proposals are expected to address clearly defined challenges faced by health systems, either within a system or in considering external influences on a system. Proposals must situate this clearly-defined challenge within an understanding of the broader health system linkages and describe how and why findings from the project have the potential to improve the health of people living in low and middle income countries.
Foundation grants, which are smaller (up to £200,000) and shorter (up to two years). Proposals can be either:
- exploratory, for example, looking into existing health systems and investigating the underlying causes beneath perceived problems
- to conduct pilot work to build the necessary knowledge and methodological base to support a future full proposal.
Projects with principal investigators (PIs) from LMIC are strongly encouraged and all proposals must include co-investigators from the LMIC in which the research is taking place. Principal investigators can be based in the UK or any LMIC.
Outline and full research grant timeline
|Outline grant call opens||
|Outline grant call deadline||Call closed|
|Invitation to submit full proposals||April 2019|
|Deadline for full proposals (invite only)||12 June 2019|
|PI response to reviewers’ comments||September 2019|
|Full stage panel meeting||October 2019|
Applications for research grants will be subject to a two-stage review process. Only those successful at the outline stage will be invited to submit a full application and final funding decisions will be made in October 2019. The duration of a research grant is usually up to three years, with a maximum duration of five years. As a guide, applicants should note there is approximately £4 million available for research grants under this call. Funders would like to fund five to 10 projects of varying sizes.
Foundation grant timeline
|Foundation call opens on Je-S||5 March 2019|
|Foundation call deadline||30 May 2019|
|Foundation call panel meeting||October 2019|
Applications for foundation grants will be reviewed at the October 2019 panel meeting following which funding decisions will be announced. The duration of foundation grants can be up to a maximum of 24 months, with a maximum budget of £200,000 each. A foundation grant is expected to be more exploratory than a full research grant and could be either:
- to explore possible health system innovations, under researched areas or creative approaches that have the potential to be developed further. This could include research to identify problems (real or perceived) as well as any underlying causes of such beliefs in existing health systems.
- to conduct preliminary studies needed before a full research grant proposal can be designed. This could include work to evaluate existing interventions, pilot and feasibility work to inform plans for future research, or conducting preliminary research to conceptualise broader research questions on the health system.
Recipients of foundation grants will not automatically progress to full-scale research projects after their grant has ended. They will be expected to apply for a full-scale research project through the standard competitive process.
For decades health systems in developing countries have come under sustained pressure from interlocking social, political and economic influences, ranging from rapid globalisation, evolving disease burdens, natural disasters, conflict, fragile governments and governance systems, weak institutions and poor accountability, all of which create and exacerbate widespread social, economic and health inequalities.
The growing recognition that the challenges confronting health systems in developing countries require a research response that transcends disciplinary boundaries highlights the urgent need for research to foster genuine interdisciplinary collaborations across all areas of social science, biomedical science and other disciplines.
The funders welcome multidisciplinary and collaborative applications, including those driven by social science questions. Applicants should also ensure they embed research within relevant theoretical frameworks, as evidenced by references, to strengthen applications. Teams should also ensure engagement of researchers with strong health systems expertise and demonstrate knowledge of, and potential contribution to, relevant health systems empirical literature.
Recognising that health systems are complex and multidimensional, this scheme welcomes research that identifies and addresses a range of health systems topics including but not limited to questions of governance, structure, institutions, social policy, health workforce, financing, private sector, civil society, information systems, products and technologies, service delivery and so on.
Research funded through this call could:
- engage with the contextual dynamics that shape and/or undermine effective health systems in developing countries
- offer practical solutions to implement health care improvements
- illustrate how the research findings can contribute to increasing knowledge and to the discourse for addressing other health challenges.
Applicants must identify the potential impacts of their research on policy and practice and outline clear relevance to decision makers and practitioners. Projects should identify and address the key barriers to implementation and uptake of evidence-based interventions at local and national levels, paving the way for their successful adoption into routine practice with improved access and use by the populations in need. A central component of this research programme is to build evidence on and within health systems. We would also encourage the exploration of assumptions, and of broader conceptual and structural matters such as power and economic organisation which have longer term impact.
Solutions to strengthening health systems in developing countries must be rooted in, and acceptable to, the institutions, communities, and societies where they will operate. As such, non-academic stakeholders, including potential users of the research, are expected to be included and involved in the design and delivery of projects. Indeed, proposals should demonstrate strong engagement with in-country stakeholders and decision makers from the project inception stage and include appropriate budget for such activities.
Researchers are encouraged to be innovative in the kinds of user engagement, knowledge exchange, communications and research uptake activities they plan to undertake during and beyond the period of research funding. It is important that applicants appreciate that outreach and engagement activities in themselves do not constitute impact. Applicants may find it helpful to refer to the UKRI guidance on developing an impact strategy: UKRI excellence with impact toolkit and DFID’s Research Uptake Guidance.
Priority will be given to research that benefits the most vulnerable populations and/or those in poorly resourced settings. Whilst the funders recognise that many of the world’s poor live in middle-income countries, it is a specific objective of this programme to increase the body of research that is specifically relevant to low-income countries, whether through research in those countries or the ability to demonstrate the relevance of experience from middle-income countries to low-income countries. Applicants must illustrate how the proposed study will contribute to strengthening low-income country health systems.
For a full list of the countries that fall under the categories of low and middle income countries please refer to the OECD DAC list of ODA recipients. Research teams should include, or be led by, LMIC researchers while research questions and budgets should also reflect a focus on local contexts.
All countries of focus need to be adequately justified and a local need identified. The relevance of all countries involved in any multi-country study must also be justified.
All funders are committed to supporting capacity building in research. Capacity-building elements should be set out in relation to the core intellectual agenda of the research proposal and not treated separately; the focus should be on the quality and impact of the research, and how increasing research capacity contributes to this.
If the principal investigator (PI) is based in the UK, there must be clear partnership with, and scientific leadership from, co-investigators (Co-Is) based in the countries where the project will take place.
Proposals should demonstrate how capacity building for junior UK and developing country staff will lead to developing future scientific leadership. Good examples of capacity-building include:
- co-design of research and implementation
- field-based research methods training for developing country partner staff
- opportunities for staff to author/co-author journal and conference papers and participate in national and international conferences
- providing mentoring to improve the capacity of Southern researchers to generate new knowledge and attain policy impact
- building organisational capacity (for example in management, financial, communications)
- institutional capacity-building (such as the incentive structures, the political and regulatory context and the resource base in which research is undertaken and used by policymakers).
UK investigators should demonstrate an understanding of the national and local health systems context, and work harmoniously and effectively with local stakeholders to ensure the research programme does not undermine local research capacity. These factors will be taken into account by the commissioning panel.
We have provided below a list of example questions intended for guidance and to assist applicants’ understanding of the scope and scale of research that funders expect to see in this call. This is not an exhaustive list and therefore should not be treated as a set of indicative questions.
- How can health systems better meet the needs of specific groups in countries emerging from fragility and conflict?
- How can Ministries of Health engage other sectors, such as education or social and legal systems, to strengthen policies that promote health and well-being in developing contexts?
- How do leadership and governance issues affect the effective implementation of health systems strengthening and/or restructuring strategies?
- What is the relationship between health systems and new ways of working, for example, how responsive and adaptable are health systems to incorporating new technologies and products?
- What is the role of private sector actors within health systems and what are the effects of different system interventions on both public and private sector actors?
- How can improvements in health systems address aid dependency and its implications?
- Feasibility work to identify the health system changes to improve delivery of key health interventions to underserved populations. For example, family planning, integrated provision of services, a package of measures for prevention and treatment of chronic conditions, quality improvements using various approaches.
- Understanding inequality: developing a strategy to overcome barriers to MCH service uptake in urban communities.
- Preliminary work to address how the range of healthcare providers (government, for-profit, not-for-profit) affect health service access for different groups in society. How can this information be used to strengthen the health system and improve the health of different groups?
- Developing an innovative approach to community-based models of care in health systems to respond to evolving demographic, economic and disease profiles.
- How to capture user perspectives to understand the implications of task shifting practices for community health worker performance in relation to quality of care.
- How have innovations in health systems organisation and delivery been developed? Can past investment and/or capacity building be used to develop new models?
- Engaging with stakeholders: what are the knowledge gaps in policy and how can these be addressed to implement and deliver robust models of innovative health systems?
Proposals must be submitted to Je-S by the call deadline:
- Outline grants: Thursday 14 February 2019
- Research grants (invite only): Wednesday 12 June 2019
- Foundation grants: Thursday 27 June 2019
Full details on how to apply to this scheme can be found in the scheme specific guidance.
Proposals can only be accepted by electronic submission through the Je-S system.
If you have any technical issues with the Je-S system please contact the Je-S help desk at JeSHelp@rcuk.ac.uk
Guidance on this system can be found in the Je-S handbook.
Please contact HSRI@mrc.ukri.org with queries about applying to this funding scheme or scheme eligibility.