How does health research systems strengthening work, for whom and under what circumstances? A realist evaluation

T3 -证据转化为实践T4 -政策/人口实践国家卫生研究系统（NHRS）被定义为“与研究有关的主要目的是产生可用于促进、恢复和/或维持人口健康状况的高质量知识的人员、机构和活动；它应包括为鼓励利用研究而采用的机制”（Sadana & Pang, 2003）。国家卫生服务系统与更广泛的国家研究系统和国家卫生系统重叠，包括四个主要功能：1)管理，2)融资，3)创造和维持资源；4)生产与使用研究。能力良好的国家卫生服务机构对于解决国家卫生挑战至关重要（人权与发展中心，1990年）；然而，许多低收入和中等收入国家（LMICs）的国家卫生制度能力有限（Kirigia et al., 2016; Ralaidovy et al., 2020），而且关于如何最好地支持加强国家卫生制度的知识还不发达。本研究旨在了解研究机构/大学（子系统）在国家卫生研究系统中的研究职能/作用，并以“在非洲发展卓越的领导、培训和科学”（三角洲非洲）计划为案例研究，审查加强卫生研究系统的方法。这项研究将使用现实主义评价方法来了解加强卫生研究系统是如何起作用的，为谁以及在什么情况下起作用。该研究将解决四个问题：1。在国家卫生研究体系中，大学的研究功能是什么？“卫生研究系统加强”理论（在三角洲非洲项目下）在多大程度上是可信的？3. 3 .三角洲非洲项目如何与环境相互作用，以产生预期和意外的卫生研究系统成果？这些证据对政策和实践的影响是什么？将采用多案例研究设计来评估三角洲援助非洲计划第二阶段资助的三个有目的地选择的财团（包括牵头机构和伙伴机构）。将采用现实主义评价方法来了解加强卫生研究系统是如何概念化的，检查正在实施的干预措施，触发的机制，实现的卫生研究系统加强结果以及这些结果如何以及为什么在规划背景下有所不同。预计这项研究将提供一个更广泛的框架，在这个框架内，可以将卫生研究系统的评价和相关的研究能力加强工作纳入背景并加以实施。此外，本研究将在加强卫生研究系统的背景下建立证据并使复杂性意识评价方法的应用合理化。

T3 - Evidence into Practice T4 - Practice to Policy/PopulationA national health research system (NHRS) has been defined as "the people, institutions, and activities whose primary purpose in relation to research is to generate high-quality knowledge that can be used to promote, restore, and/or maintain the health status of populations; it should include the mechanisms adopted to encourage the utilization of research" (Sadana & Pang, 2003) A NHRS overlaps both the broader national research system and the national health system and consists of four primary functions: 1) stewardship, 2) financing, 3) creating and sustaining resources; and 4) producing and using research. Well capacitated NHRS are essential to resolving national health challenges(COHRED, 1990); however, NHRS capacity is limited in many low- and middle-income countries (LMICs) (Kirigia et al., 2016; Ralaidovy et al., 2020) and knowledge as to how best to support NHRS strengthening is undeveloped. This study seeks to understand the research functions/roles of research institutions/universities (sub-system) within the national health research system and - using the 'Developing Excellence in Leadership, Training, and Science in Africa' (DELTAS Africa) Programme as a case study - examine approaches to health research system strengthening. The study will use a realist evaluation approach to understand how health research systems strengthening works, for whom and in what contexts. The study will address four questions:1. What is the research function of a university within the national health research system?2. To what extent is the 'health research systems strengthening' theory (under the DELTAS Africa programme) plausible? 3. How does the DELTAS Africa programme interact with the context to generate intended and unintended health research system outcomes?4. What is the implication of the evidence on policy and practice?A multi-case study design will be used to evaluate three purposively selected consortia (covering lead and partner institutions) funded under the DELTAS Africa Programme Phase II. Realist evaluation approach will be employed to understand how the health research system strengthening has been conceptualised, examine the interventions being implemented, the mechanisms triggered, the health research system strengthening outcomes realised and how and why these differ across programme contexts. The study is anticipated to provide a broader framework within which evaluation of health research systems, and related research capacity strengthening efforts can be contextualised and implemented. Additionally, this study will build evidence and rationalise the application of complexity-aware evaluation methodologies in the context of health research systems strengthening.