In the following section we discuss the challenges to implement South-led research as perceived by NetSRH members and their perceptions on North–South and South–South partnerships. The results are organised according to the structure of the thematic tree used for analysing the results (Box 1).
Perceived challenges to implement South-led research
Limited resource availability
All respondents reported being in favour of more research capacity building. While the majority of NetSRH members were trained and experienced in quantitative research, fewer were familiar with qualitative or mixed methods. A number of research topics identified by the NetSRH members at the kick-off meeting required a more in-depth understanding of users or community perceptions and barriers, for instance, the use long-term family planning methods. Challenges encountered during the writing of research protocols concerned the parts related to research methods and ethical issues but also to writing scientific papers and to research management skills such as grant writing and communication with donors. NetSRH members felt these management skills crucial for successfully implementing research projects, and were lacking among southern researchers in comparison to northern partners: “It requires a particular competency to set a common work agenda. To stick to the plan, to update the information, to remind everyone involved of his or her responsibilities” (R13). With regards to research management skills, one member formulated the differences as follows: “When you ask an institute of the south to create a project with a logical framework, with indicators, with outputs, deliverables, milestones, people are lost. They are used to writing narratives” (R11). Finally, knowing how to publish was seen as an important advantage of the North over the South: “We are not used to publish, we need to be guided” (R3). Since all NetSRH members are French speakers, challenges linked to publication might also be rooted in a lack of English writing skills.
The fact that NetSRH had no allocated funds available for implementing the elaborated research proposals of its members was considered a major constraint for conducting research. Conducting relevant country- or regional-based research requires literature reviews and/or needs assessments to enrich a research proposal, which are time and resource consuming activities. “To prepare local projects, you need a local budget, and if you don’t have the local resources to finance the preliminary phase it becomes complicated. […] Initiating its own research projects would be ideal but requires investment” (R11). Because of the lack of own funds and financial reserves, southern researchers depended to a large extent on external donors. Challenges concerning the search for funds were said to be related to a specific donor architecture and deserved so much attention in NetSRH members’ responses that they are mentioned under a separate heading below.
Internet and communication means
NetSRH members reported access to information concerning calls for research as a challenge. Accessing funds is only possible through access to information and systematic follow-up of calls for proposals in order to prepare a timely response. Problems of communication and internet connection were mentioned by nearly all respondents, constraining some of them in elaborating a research proposal in a timely manner. In addition, all NetSRH members were French-speaking, therefore access to information on grants as well as on technical matters was more difficult. “I think the language equally represents a barrier for many of the resources are available in English. If we were more open to this language, I think that would facilitate things” (R15).
Time for research
NetSRH’s members estimated the time available for research ranging from 20% to 65%. In addition to ongoing research within their institution, NetSRH members were engaged in multiple activities, for example, teaching and coaching activities, clinical work and management, including administrative tasks and budgetary follow-up. This multiple engagement has negatively affected the participant’s availability for research activities within the network. Three NetSRH research partners were attached to, or working in close collaboration with, the Ministry of Health, which caused a considerable amount of time to be spent on the collection and analysis of epidemiologic and Health Management Information System data. Respondents from all five West African research centres also stated that they spent most of the time available for research by responding to calls, mostly by northern institutions, in order to make ends meet. This financial pressure represents a day-to-day constraint in initiating South-led research. “We are submerged by the daily work” (R4). “All have the same problem they have to struggle to survive” (R8).
External funding constraints
Why is it that South-led research projects do not easily get financed? “Governmental structures in terms of research regulation and research funding are absent in our country. […] The national research institutes are abandoned” (R12). In search of funds, several NetSRH members mentioned the importance of networking, an activity for which they state not having time. Some mention “a heavy procedure” (R3) due to the fact that central authorities have made an agreement with the major external donors, which leaves little leeway for other actors: “We do not have the liberty to receive a grant, whether it is from a public or private donor. We work with NGOs and it is they who receive the budget” (R3).
South-led research seems hampered by the actual donor architecture from the start, research topics being decided upon in function of the potential interest of in-country donor agencies rather than in function of local needs. NetSRH members approached in-country donors at an early stage (before the fifteenth month, according to the project’s objectives) to share research ideas and to investigate their willingness to fund them. Two main reasons were given by respondents for the approached donors, such as UN agencies, to not fund NetSRH research proposals. First, donors and research institutes often had different agendas. Donors had funds available for interventions and operations but rarely for research activities. “Donor X made us swing to intervention rather than research. […] They want actions” (R13). Secondly, the available funds had been planned and attributed well in advance, sometimes since several years: “In the case of our research proposal, the donor was interested to finance the project, but it had to be aligned with the orientations of the institution. If the two don’t coincide, it won’t work. Even if the spokesperson of the identified donor is willing to collaborate, he or she cannot move things further” (R7).
Meeting with donors often led to adapting or replacing the initial proposal by another one for which budget was readily available. Similarly, some proposals were written by NetSRH members to respond to a local donor-initiated call after meeting with donors. Hence, they are not necessarily the South-led response to local needs.
Specific experience with networks and partnerships
Finding funds for research requires specific competences, namely one needs to be proactive and to have negotiation and persuasion capacities, as recognised by several NetSRH members: “We have to make many more efforts to identify funds at national level that need to be consumed, for example within one of the ministries, and to identify academic institutions that may attract funds with whom we can partner. There is work to be done to see if we have explored all” (R13).
Some NetSRH members felt prejudged by potential northern partners: “Maybe there are also unwritten elements that contribute to the fact that southern institutes don’t succeed in reaching a relatively important success rate. There is some kind of distrust from donors, especially external donors, concerning the southern institutes, in relation to their capacity. Perhaps the institutes of the south have not given sufficient guarantees” (R6). Meanwhile, when looking for partners, northern institutions will tend to gravitate towards the ‘better connected’ institutions, hence the increasing gap in experience between southern institutions: “If you don’t have collaboration with institutions of the north, you never have the opportunity to be involved in a large-scale project for they don’t know you” (R11).
Perceptions of NetSRH members on network collaboration between South and North
The appreciation of North–South collaboration
“The ideal is to initiate our own research, for always answering to calls for proposals by northern institutes makes us an eternal second. As a consequence, we will never adequately learn how to present our own projects” (R6).
Southern NetSRH members considered the relation between northern and southern research partners asymmetric in (1) access to grants; (2) competences leading to such access (research skills but also research management skills); and (3) experience in networking and new communication technologies.
Several respondents reported a difference in access to grants between northern and southern institutions: “Not all grants are open to the institutes of the south. When a northern institute partners with a southern institute, the latter is not always the beneficiary” (R11). North–South collaboration was compared with a ‘fair trade’ concept: “Emphasis should be put on strengthening of the local capacity. […] Really trying to decentralize in a way that developing and European countries can truly be in partnership, with developing countries being the principal partner, the contractor. That gives the chance to southern institutions to receive overhead budget that may be used to strengthen local capacities” (R11).
NetSRH members presented the asymmetry as a cyclic problem: “When the funds come from the north, perhaps the northern institutes are privileged due to their position: they know better how to present and are more aware of the capacities needed to obtain the results. They give more content, so they obtain more resources than institutes of the south” (R6).
Most NetSRH members envisioned a real discussion between northern and southern partners, on the distribution of tasks within the process of producing and publishing articles: “We hope to be valued because we’re not only data collectors, but also share in the analysis and article writing. Things are improving now with partners of the north, who more and more organize postdoctoral stays. We find the funds, they invite us, and generally it is for one or two months and we write articles together. I think that is good” (R15). One respondent adds: “In the north people are quite prompt in the production. The south needs to show some productivity as well, a certain aptitude to be able to rapidly produce the papers linked to the research conducted. I think it is through these measures that we will bring back the symmetry” (R6).
Intermediate challenges and successes of NetSRH
When asked whether NetSRH succeeded, at this stage of the project, in one of its major objectives, capacity strengthening, responses were mitigated. Building strong research institutions in the South remains challenging, as confirmed by respondents in our study, of whom some demonstrated a certain determinism: “The asymmetry is there at the start, that is the problem. We cannot turn that into symmetry when we do not have the same competences” (R6). When discussing the asymmetry in competences, respondents did not necessarily refer to a South–North dichotomy. Significant differences in competences between members exist despite, or precisely due to, an increase in multi-country projects in which more experienced southern research centres are selected as partners in large projects and are consequently more advantaged both financially and in terms of capacity strengthening. This also showed in the agenda of the annual meetings, which was made by NetSRH members in a consensual manner. While some NetSRH members wished to receive a refresher course concerning literature reviews, others were looking forward to technical sessions concerning ethics in research and more advanced training in qualitative research. The result was a meeting agenda with topics sometimes too advanced for certain members, yet not challenging enough to others.
Why common research projects between southern partners took time to develop
A perceived need for collaboration
Interestingly, not all southern network members felt, after 18 months of network activity, a true need to collaborate. Southern institutions collaborate little amongst themselves, confirmed NetSRH members: “We are rather in competition than in partnership. We have the impression that every country had to propose a protocol and that the country that was in delay in comparison to others was ‘a less good student’” (R9).
Poor communication among NetSRH members between annual meetings and the perception of competition by some members contributed negatively to the development of the South–South collaboration within NetSRH. Although there were perspectives for a potential research project in common, such collaboration has not yet taken place.
NetSRH not having a specific budget for conducting collaborative or joint research project was a limitation, and perceived so by the members.
“Working with a cross-country partner who has no future, no budget whatsoever, and for whom it takes time and resources to be able to collaborate, does not ensure anything for thereafter. So people prefer to give the priority to what will give them a return the earliest possible” (R11).
Another reason given by NetSRH members was the difference in epidemiological contexts of each country. The “difficulty to find a unique donor or a transnational donor in every country” (R8) is an additional constraint. There are also differences in professional culture; there had been some prejudices between North and West African NetSRH members in the beginning of the project.
What role do southern NetSRH research partners envision for their northern allies?
Although critical in their appreciation of capacity transfer through North–South networking, several respondents did consider partnerships with the North as important, sometimes even more important than investing in South–South networks. One respondent described two clear advantages: “We need a cooperation with the north, not only to maintain a research quality standard which is relatively higher, but also to have the opportunity to access funds that are much more substantial and sustainable” (R13).
With regards to having a southern instead of the traditional northern partner as the contracting party, hence entitled on overhead budget, a NetSRH member stated that:
“This will not be evident. The institutions of the north will always try to keep the monopoly. It is not in their interest for southern institutions to become independent” (R11).
While some respondents considered the coordination of a multi-country research project as a role for the ITM as sole northern partner, others attributed the weak collaboration between southern NetSRH partners precisely to the presence of a northern partner, and to the latter being the network lead: “Perhaps people tend to turn to the ITM because it is the coordinating center” (R6). However, as the same respondent adds: “The northern partner coordinating the network does not justify a lack of direct collaboration between institutes of the south” (R6).
According to NetSRH members, research capacity building should not only take place between North and South, yet increasingly between southern partners: “It is important that with regards to contextualization of different questions socio-anthropologic aspects linked to our context, things are done through south-south collaboration or even at national level with other researchers” (R13). Northern researchers do have a role to play as well though, for “their vision on these questions is perhaps a bit more neutral than the vision of national researchers” (R13).