Objective
The purpose of this scheme is to provide funding for the best proposals to generate new knowledge to strengthen and improve health systems in LMICs. 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 governance, management, health workforce or supply chain).
- provide evidence that is of direct relevance to decision makers and practitioners in the field, linking health systems with defined outcomes (for example: health, confidence, financial protection)
- demonstrate an appreciation of current theories and frameworks in health systems research and/or other social or political science theory of relevance to health systems
- where focused 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.
Please note: Funding is available for research only. We will not fund the routine delivery of health services.
Priorities for this call
The funders welcome multidisciplinary, collaborative and multi-country or multi-site applications as well as focused 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/trade, 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 Foreign, Commonwealth & Development Office (FCDO) 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.
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 strengthening research capacity within LMICs and the UK. Grants funded through this scheme are expected to contribute to the development of equitable and sustainable global research systems.
Applicants are encouraged to start discussing priorities as early as possible, in consultation with key stakeholders within and outside of the project team (for example: researchers, data collectors, managers, practitioners, grass roots organisations, policymakers and research management offices).
The proposed approach to capacity building will be assessed as part of the review process and will help to demonstrate the equity of the partnership. Examples of capacity building include, but are not limited to:
- building leadership skills amongst early career researchers
- opportunities for mutual learning across the project team (such as through staff exchanges), for example, in the subject of the research, the context where it is being conducted, engagement with policy-makers and research management
- building capacity to working collaboratively, across disciplines and across practice-research boundaries (for example with policy-makers, managers and practitioners in the system)
- providing mentoring to improve the capacity of less experienced researchers to generate new knowledge and attain policy impact
- team members attending training courses to develop specific expertise or obtain relevant qualifications (excluding Masters and PhDs)
- opportunities for staff and associated health managers to author or co-author journal and conference papers and participate in national and international conferences
- building organisational capacity, (for example in management, finance or communications)
- formation of LMIC research networks.
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:
- What local and national contextual factors are most important in promoting and sustaining health system improvement?
- How can governance innovations that promote better performance and accountability within health systems be encouraged and spread over time?
- What influences how responsive health systems are to incorporating new delivery models, technologies, products, etc. that improve processes and outcomes? How can greater adaptability and innovativeness be encouraged?
- How can health systems better meet the needs of specific groups (women, children, people with disabilities, LGBT+) in countries emerging from fragility and conflict?
- How can community health systems become more interlinked and institutionalised?
- How can Ministries of Health engage other sectors, such as trade, education or social and legal systems, to strengthen policies that promote health and well-being in developing contexts?
- How can newly introduced and already existing or ongoing processes of decentralisation be adapted over time to support positive consequences for service delivery and population health?
- How can private sector actors within health systems be deployed to improve functioning and performance of the overall health system?
- What strategies can assist health systems in addressing declining foreign aid and promoting sustained strong performance?
- How and why has civil society action supported (or not) health policy change for system strengthening, and with what limits, in a particular context or across contexts?
In recognition of the current COVID-19 pandemic, the funders welcome proposals to research the impact of the pandemic on health systems (this does not need to focus directly on COVID-19, it could explore wider health systems research beyond containing the infection, for example knock on effects on health systems provision) and examine ways to enable health systems to respond to this or future pandemics more effectively:
- How can health systems be equipped to cope with epidemics or pandemics and how can they be strengthened post-pandemic so that other diseases are not neglected?
Please note, COVID-19 related proposals will be assessed according to the scheme specific assessment criteria in a competitive manner with wider non-COVID-19 research proposals. No specific budget is allocated.
All applicants are expected to provide an honest assessment of how the pandemic might affect the research plans.
Funding available
There is an expected £3-4m available for this call from the UK FCDO, the UK Medical Research Council (MRC), and Wellcome, in collaboration with the UK Economic and Social Research Council (ESRC).
You may request support for all research costs that are attributable to the project. For example, appropriate percentages of the investigators’ time, scientific, technical and administrative staff including statisticians, research nurses etc., consumables, items of equipment, data or sample handling and archiving and travel.
UK research will be funded at 74% of the full economic cost. Research incurred by overseas research organisations and investigators is eligible to be funded at 100% of full economic cost.
Regulation, ethical review and liability may vary across different countries. Principal Investigators and proposed sponsors should ensure that they have adequately understood the feasibility and costs of participation of proposed international centres.
For example, insurance arrangements will vary between countries and the sponsor (usually the host institution) is responsible for ensuring adequate arrangements are in place at each site.
Research grants should, as far as it is practicable, be fully developed and costed before they are allowed to start.
However, we recognise that preliminary work is often needed in order for applicants to develop innovative partnerships and proposals.
In this instance applicants are directed to the foundation grant call which will open in January 2021.
Foundation grants are smaller and shorter, and can either be exploratory, stand alone studies, or pilot/feasibility work expected to lead to a larger research project in future. See ‘additional information’ below for further details.
If you would like to discuss whether your research fits the remit, please contact HSRI@mrc.ukri.org.
