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

T3 -实践证据T4 -实践政策/人口国家卫生研究系统（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、机构和活动;它应包括为鼓励利用研究成果而采用的机制”（Sadana & Pang，2003）NHRS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;和4）生产和使用研究。能力良好的国家人权机构对解决国家卫生挑战至关重要（COHRED，1990年）;然而，在许多低收入和中等收入国家，国家人权机构的能力有限（Kirigia等人，2016; Ralaidovy等人，2020年），以及如何最好地支持NHRS加强知识尚未开发。本研究旨在了解国家卫生研究系统内研究机构/大学（子系统）的研究功能/作用，并以“非洲发展卓越领导力、培训和科学”（DELTAS非洲）计划为案例研究，探讨加强卫生研究系统的方法。这项研究将使用现实主义的评估方法，以了解如何加强卫生研究系统的工作，为谁和在什么情况下。本研究将解决四个问题：1。在国家卫生研究体系中，大学的研究职能是什么？2.“加强卫生研究系统”理论（在非洲三角洲方案下）在多大程度上是合理的？3. DELTAS非洲项目如何与环境相互作用，以产生预期和非预期的卫生研究系统成果？4.这些证据对政策和实践有何影响？将采用一种多案例研究设计，对三角洲技术援助非洲方案第二阶段供资的三个有目的地选定的联合体（包括牵头机构和伙伴机构）进行评价。将采用现实主义的评估方法来了解如何加强卫生研究系统的概念化，检查正在实施的干预措施，触发的机制，卫生研究系统加强实现的成果，以及如何以及为什么这些不同的方案背景。该研究预计将提供一个更广泛的框架，在此框架内，卫生研究系统的评估，以及相关的研究能力加强工作可以结合和实施。此外，这项研究将建立证据和合理化的复杂性意识的评估方法的应用，在卫生研究系统的加强。

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.