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EDUCATION AND DEBATE: Anthony Costello and Alimuddin Zumla Moving to research partnerships in developing countries BMJ 2000; 321: 827-829 [Full text]

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Nature of research influences co-operative partnerships

Helen Smith   (17 November 2000)

Nature of research influences co-operative partnerships 17 November 2000
Helen Smith, Research Assistant Liverpool School of Tropical Medicine Send response to journal: Re: Nature of research influences co-operative partnerships	It was encouraging to read Costello and Zumla’s article advocating the need for truly co-operative research partnerships in developing countries.1 We believe the research area and topic will influence the way research is conducted and ‘partnerships’ are nurtured. In particular, we believe that research projects that investigate or test approaches to deliver care (often called "implementation research") encourage partnerships in a way that laboratory science does not. This is because such research requires an understanding of how things work, tackled by qualitative methods, with investigation of how the various participants-be they health workers or the public-relate to the service provided. Through ‘in-depth’ approaches, and communicating with health professionals, users of services, and community members, one is able to delve beneath proven statistical benefits and learn how these are interpreted locally, and how relevant an intervention is to a given community. There is little possibility of ‘semi-colonial’ dominance when local knowledge, influential academics, and other local stakeholders are the cornerstone of successful implementation. For example, we have been seeking change towards more evidence-based maternity care through the ‘Better Births Initiative3. We have conducted applied studies to encourage the use of obstetric procedures for which there is good evidence of benefit. Changing practice requires that all stakeholders are involved – women as users of state maternity services, health workers, and academics. Links with local experts and government health authorities, who are able to influence national policymaking, are also essential for successful implementation, and this is beginning to happen in South Africa and China.4 5 Helen Smith - Research Assistant, International Health Division, Liverpool School of Tropical Medicine, UK. Heather Brown – Obstetrician/Gynaecologist, Chris Hani Baragwanath Hospital, Johannesburg, South Africa. Justus Hofmeyr – Obstetrician/Gynaecologist, Cecilia Makiwane and Frere Hospitals, East London 5200, Eastern Cape, South Africa. Qian Xu – Associate Professor, Department of Maternal and Child Health, Shanghai Medical University, Shanghai, P.R.China. (on behalf of the Better Births Initiative) References 1 Costello A, Zumla A. Moving to research partnerships in developing countries. BMJ 2000;321:827-829. (30 September.) 2 Gulmezoglu M, Villar J, Hofmeyr J, Duley L, Belizan JM. Randomised trials of maternal and perinatal medicine; global partnerships are the way forward. Br J Obs Gynae 1998;105:1244-47. 3 http://www.liv.ac.uk/lstm/ihd98-ehc.html 4 Qian Xu, Smith H, Zhou Li, Liang Ji, Garner P. Current status of obstetric care in Shanghai and options for change [abstract]. Proceedings of the 7th World International Association for Maternal and Neonatal Health; 2000 April 2-5; CapeTown, South Africa. 5 Hofmeyr J, Brown H, Nikodem C, Garner P. Childbirth companionship implementation: a randomised trial [abstract]. Proceedings of the 7th World International Association for Maternal and Neonatal Health; 2000 April 2-5; CapeTown, South Africa.