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Health Systems Research Initiative Call 7: Providing evidence to strengthen health systems in low and middle income countries

  • Time remaining: 2m 1w 1d 16h 25m
  • Status: Open
  • Open date: 30 Oct 2019
  • Closing date: 21 Jan 2020 16:00 GMT
  • Type: Grants, MRC strategic

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Key dates

The Outline call for research grants is now open and will close on the 21st January 2020. The call for Foundation grants will open 27th February 2020 the guidance for this call will also be available at this time.

Webinar

A webinar will be taking place towards the end of November to help applicants understand the scheme and how applications are assessed. Details of the date, time and how to join will be published here shortly.
 

Summary

Innovative proposals are sought from across the public health, social and biomedical sciences to the seventh annual call for the Health Systems Research Initiative. Up to £4.7 million is available for funding foundation and full proposals under this call.

The Department for International Development (DFID), the Medical Research Council (MRC) and Wellcome jointly fund this call in collaboration with the Economic and Social Research Council (ESRC). 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 low- and middle-income countries (LMICs). 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 interdisciplinary research that will:

  • generate evidence on:
    • the structure and dynamics of health systems
    • how to strengthen and improve health systems for people living in LMICs through the delivery of evidence-based interventions or structural changes (for example strengthening the health workforce or drug supply)
  • provide evidence that is of direct relevance to decision makers and practitioners in the field, linking health systems with defined outcomes (e.g. health, confidence, financial protection)
  • demonstrate an appreciation of current theories and frameworks in health systems research
  • where focussed on a particular aspect of the health system, proposals must demonstrate how interventions relate to and affect wider elements of the system such as governance, financing, health workforce, information systems, service delivery, etc.

There are two different types of grant available:

Research grants, which are larger stand-alone research projects exploring big new ideas. Proposals are expected to address a clearly defined challenge faced by health systems (such as an existing problem or challenge of instituting new programmes or interventions), 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 LMICs.

Foundation grants, which are smaller and shorter. Proposals can be either:

  • exploratory, for example, retrospective, diagnostic analyses looking into existing health systems, investigating the underlying causes beneath perceived problems or to explore possible health system innovations, under-researched areas, or creative approaches that have the potential to be developed further
  • to conduct pilot work to build the necessary knowledge and methodological base to support a future full proposal, this could include work to pilot an intervention, feasibility/preliminary work to conceptualise broader research questions on the health system.
Funding is available for research only; we will not fund the routine delivery of health services.

Projects with principal investigators from LMICs are strongly encouraged and all proposals must include co-investigators from the LMIC in which the research is to take place. Principal investigators can be based in the UK or an LMIC.

Please note that there is specific guidance for both the outline grants and foundation grants. Please consult these documents to successfully develop your grant proposal and submit to the appropriate call.

Research grant timeline

Outline stage call opens

16th October 2019

Outline stage call deadline

21st January 2020

Invitation to submit full proposals

Mid - April 2020

Deadline for full proposals (invite only)

18th June 2020

PI response to reviewers’ comments

September 2020

Full stage panel meeting

October 2020

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 2020. The duration of a research grant is usually 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.

Foundation grant timeline

Foundation call opens on Je-S

27th February 2020

Foundation call deadline

28th May 2020

Foundation call panel meeting

October 2020

Applications for foundation grants will be reviewed at the October 2020 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.

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.

Background and scope

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, collaborative and multi-country/multi-site applications as well as focussed in-depth applications, including those driven by social science questions. Applicants should also ensure they embed research within relevant theoretical frameworks. 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, supply chains, 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
  • evaluate the health system at scale
  • illustrate how the research findings can contribute to increasing knowledge and to the discourse for addressing other health challenges.

Research impact

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 sustainable 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 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.

 

Geographical scope

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.

Research capacity building

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 LMIC researchers will lead to developing future scientific leadership. Good examples of capacity-building include:

  • opportunities for mutual learning among all those involved in the project, for example, about the subject of the research, the context where it is being conducted, engagement with policy-makers and managers, research management
  • co-design of research and implementation
  • working collaboratively, across countries, disciplines and across practice-research boundaries
  • field-based research methods training for less experienced 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 less experienced researchers to generate new knowledge and attain policy impact
  • building organisational capacity (for example in management, financial, communications)
  • institutional capacity-building where relevant (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 system 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.

Example questions

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.

Research grants:

  • 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 can a newly introduced process of decentralisation be adapted over time to support positive consequences for service delivery?
  • What is the relationship between health systems and new ways of working, for example, how responsive and adaptable are health systems to incorporating new delivery models, technologies, products, etc.? How can greater adaptability and innovativeness be encouraged?
  • How can a newly introduced process of decentralisation be adapted over time to support positive consequences for service delivery?
  • 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?
  • How does a named quality improvement process impact on the processes and practices of service delivery?
  • How do health system strengthening interventions become embedded in the system of focus, over time?
  • How can governance innovations within health systems be encouraged and spread over time?
  • How does the process of implementing a health system strengthening initiative itself impact on the wider system, and with what consequences for system functioning and performance?

Foundation grants:

  • How can technological innovations strengthen health system supply chains?
  • What happens at the end of externally supported health system interventions? Are they sustained?
  • How does a new approach to decentralisation impact on service delivery in a specific setting?
  • What are practical approaches to identifying opportunities for task shifting between cadres, and supporting this process?
  • 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. For example, developing a strategy to overcome barriers to MCH service uptake in poor 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 have innovations in health systems organisation and delivery been developed? Can past investment and/or capacity building be used to develop new models?
  • What can we learn from past experience about how improvements in health systems address aid dependency and its implications?

How to apply

Proposals must be submitted to Je-S by the call deadline:

  • Outline grants: Tuesday 21st January 2020
  • Foundation grants: Thursday 28th May 2020

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.

Contact

If you have any technical issues with the Je-S system please contact the Je-S help desk at JeSHelp@je-s.ukri.org

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.