Empowering Sexual Health Research in Low- and Middle-Income Countries

by Jon Scaccia October 17, 2024

Imagine trying to solve a puzzle with missing pieces. That’s what many researchers in low- and middle-income countries (LMICs) face when addressing sexual and reproductive health (SRH) issues in their communities. While SRH is a critical component of public health, especially in regions where resources are stretched thin, the capacity to conduct research that reflects the unique cultural and societal needs of these countries remains limited. Without the tools, infrastructure, and support, these researchers struggle to contribute solutions that could save lives and improve well-being.

Now, think about what happens when those pieces are finally put in place. The puzzle starts to make sense, and what was once a vague image becomes clear. This is what strengthening SRH research capacity in LMICs can do—it empowers local experts to lead the way in improving sexual health outcomes. But how do we get there? A recent scoping review, published in PLOS Global Public Health, sheds light on the strategies used to foster research in this critical area. Let’s dive into what the research reveals and why it matters.

The Missing Piece: Why SRH Research in LMICs Matters

Sexual and reproductive health touches every aspect of life—from family planning and maternal health to fighting HIV/AIDS and addressing gender-based violence. For many countries, especially those classified as LMICs, addressing SRH issues is not just about healthcare; it’s about human rights. Unfortunately, the ability to research and find tailored solutions to these problems is often stunted. Why? The disparity in access to training, funding, and infrastructure leaves researchers in LMICs playing catch-up with their counterparts in high-income countries (HICs).

The scoping review identified 24 studies that documented various efforts to bridge this gap by strengthening SRH research capacity. These efforts aim to build research skills, secure sustainable funding, and ultimately influence health policies in ways that matter to local populations. But while programs exist, they are often short-lived, leaving many wondering: How can we make these efforts stick?

What Does Strengthening Look Like?

Capacity strengthening isn’t just about throwing money at a problem or offering a one-off workshop. It’s about developing long-term systems where researchers can continue to thrive even after external support fades away. The review outlined several key strategies that worked, including:

• Training and Education: Many programs focus on providing in-person training or workshops, designed to upskill early-career researchers. These sessions cover essential topics like data analysis, research ethics, and scientific writing—skills that are crucial for producing high-quality research that can influence policy.
• Mentorship: Another important piece is mentorship, where senior researchers, often from HICs, guide less-experienced LMIC researchers through the complexities of academic publishing and grant writing. This mentorship model helps build lasting relationships and supports a continuous learning environment.
• Sustainability Challenges: While many programs show promise in the short term, sustaining them is an ongoing challenge. The review found that few programs had concrete measures to ensure their efforts would continue after funding ended. This lack of sustainability often leaves researchers stuck when support runs dry, a pattern we need to break if we want lasting progress.

A Power Shift is Needed

One of the most significant barriers to progress is the power imbalance between HICs and LMICs. In many cases, health research in LMICs is driven by the priorities of funders from HICs, which may not align with the actual needs of the communities being studied. To create meaningful change, local researchers need to take the lead, setting the research agenda based on what matters most to their people.

Here’s where things get complicated: research is expensive, and much of the funding comes from HICs. When someone controls the purse strings, they tend to call the shots. This dynamic often leaves LMIC researchers out of the decision-making process, even though they are the ones with the on-the-ground expertise.

How can we flip this script? One way is by fostering more equitable partnerships between HICs and LMICs. For instance, rather than HIC researchers leading every project, they could act as collaborators, sharing resources and knowledge while letting LMIC researchers drive the mission. This shift not only empowers local experts but also ensures that the research conducted is culturally relevant and actionable.

Real-World Impact: When Local Voices Lead

Consider this scenario: A group of women in a rural LMIC community struggles with maternal health issues. The nearest clinic is miles away, and traditional practices around childbirth make it difficult to implement Western-style interventions. Now imagine a research team led by local health workers who understand the nuances of this community, conducting studies to find sustainable, culturally sensitive solutions. They collaborate with policymakers to enact changes based on their findings, such as mobile clinics or locally trained midwives, significantly improving maternal outcomes.

This type of locally-led research can lead to more impactful, long-lasting changes that resonate with the community. It’s not just about gathering data—it’s about creating actionable steps that improve lives.

Closing the Gap: What Needs to Happen Next

The review provides a roadmap for what’s needed to strengthen SRH research capacity in LMICs, but it also highlights gaps that must be addressed. Key among them:

1. Sustainability: We need to focus on long-term strategies that enable research to continue without constant external funding. Building local institutions and securing government support are critical to this.
2. Mentorship and Training: Continued education and mentorship are essential, but they must be paired with opportunities for researchers to lead their own projects. This creates a cycle of learning and leadership that benefits the entire region.
3. Equitable Partnerships: Shifting the power dynamic between HIC and LMIC researchers is key to sustainable progress. LMIC researchers must have a seat at the table when decisions are made about funding and research priorities.
4. Increased Funding for Capacity Building: While LMIC researchers should lead, they still need resources. Increased and sustained funding for capacity building will ensure that these programs can thrive.

Where Do We Go from Here?

As we look to the future, the question isn’t just how to strengthen SRH research in LMICs but how to make those efforts last. Can we build a system where local researchers are not only empowered but also equipped to lead for years to come?

The road ahead will require more than just financial support—it will take a commitment to equity, sustainability, and the belief that those closest to the problem are best equipped to solve it.