Table 3 Common perspectives among actors and associated lessons learned, by phase

Start-up

Fraught with difficulties, primarily because the incubation phase was overly ambitious and unrealistic assumptions had been made about the existing baseline capacity in Malawi for grant-making

In-depth review of the systems is needed to absorb, disburse and account for the funds and a plan to fill any gaps Sufficient time should be set aside for establishing roles, responsibilities and relationships between all the partners Consider a separate start-up phase (0 to 12–18 months) from a ‘production’ phase (12–18 to 42–48 months), with funding of the second phase contingent on effective systems in place

Reorganization

Extra support and accountability were mechanisms introduced to improve financial and project management

Make sure the structures, systems and processes are fit for the purpose of awarding grants before calling for applications

Implementation

The National Health Research Agenda (2012–2016) developed through background papers and broad consultation was ‘highly commended’ Development of a registry of research to capture protocols and ethics submissions and to track fulfilment of the research agenda remained at an early stage

Consensus building around priority setting is a crucial initial function of an R&D platform

Implementation

Contributed to enhancing mechanisms in Malawi for managing research processes and funding The award process was generally viewed as non-corrupt but consistent reports of problems with the application process remained, including difficulties with submission and poor communication about the outcome of applications HRCSI Developed supporting guidelines and tools for the various stages of the grant awarding process Post award approval, most interviewees were satisfied with their interactions with Health Research Capacity Strengthening Initiative (HRCSI), including professional staff, as well as during organized site visits

Place a higher priority on these functions early on in the development of a research and development platform

Implementation

HRCSI produced a step change in fostering research interest among young Malawians and enlarging the number of high calibre scientists in Malawi; the diversity of awards was popular, with short-term grants raising awareness and providing research exposure, and longer-term grants achieving strengthened capacity to do research

The huge appetite for more training in health research in lower-income countries is currently under-met

Implementation

An advocacy campaign succeeded in making awards to some of the smaller institutions, including those in the non-government sector

Institutions in a range of types, sizes, and functions are able to engage in research

Implementation

Research dissemination occurred through national and institutional meetings and academic media, and by sponsoring attendance at conferences (approximately half of all projects were presented); potential for disseminating research results to the general public through local radio and television media was not fully exploited New initiative with non-governmental organisations was designed to bring together policymakers, subject experts and researchers for the purpose of catalysing research uptake

Knowledge transfer and promotion of research utilization a key function which needs explicit resourcing in R&D platforms

Planning for sustainability

Interviewees voiced overwhelming support for continuation of HRCSI as a national research management centre, with the long-term vision that it could be a national hub for grant management across all sectors (starting with Education), more firmly embedded within National Council of Science and Technology (NCST)

Further strengthening of systems, processes and leadership within NCST and linkages to other sectors needed.