Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 https://doi.org/10.1186/s12961-020-00568-y RESEARCH Open Access Capacity building for implementation research: a methodology for advancing health research and practice Phyllis Dako-Gyeke1, Emmanuel Asampong1* , Edwin Afari2, Pascal Launois3, Mercy Ackumey1, Kwabena Opoku-Mensah1, Samuel Dery4, Patricia Akweongo5, Justice Nonvignon5 and Moses Aikins5 Abstract Background: Implementation research is increasingly being recognised as an important discipline seeking to maximise the benefits of evidence-based interventions. Although capacity-building efforts are ongoing, there has been limited attention on the contextual and health system peculiarities in low- and middle-income countries. Moreover, given the challenges encountered during the implementation of health interventions, the field of implementation research requires a creative attempt to build expertise for health researchers and practitioners simultaneously. With support from the Special Programme for Research and Training in Tropical Diseases, we have developed an implementation research short course that targets both researchers and practitioners. This paper seeks to explain the course development processes and report on training evaluations, highlighting its relevance for inter-institutional and inter-regional capacity strengthening. Methods: The development of the implementation research course curriculum was categorised into four phases, namely the formation of a core curriculum development team, course content development, internal reviews and pilot, and external reviews and evaluations. Five modules were developed covering Introduction to implementation research, Methods in implementation research, Ethics and quality management in implementation research, Community and stakeholder engagement, and Dissemination in implementation research. Course evaluations were conducted using developed tools measuring participants’ reactions and learning. Results: From 2016 to 2018, the IR curriculum has been used to train a total of 165 researchers and practitioners predominantly from African countries, the majority of whom are males (57%) and researchers/academics (79.4%). Participants generally gave positive ratings (e.g. integration of concepts) for their reactions to the training. Under ‘learnings’, participants indicated improvement in their knowledge in areas such as identification of implementation research problems and questions. (Continued on next page) * Correspondence: easampong@ug.edu.gh 1Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Geneva, Switzerland Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 2 of 10 (Continued from previous page) Conclusion: The approach for training both researchers and practitioners offers a dynamic opportunity for the acquisition and sharing of knowledge for both categories of learners. This approach was crucial in demonstrating a key characteristic of implementation research (e.g. multidisciplinary) practically evident during the training sessions. Using such a model to effectively train participants from various low- and middle-income countries shows the opportunities this training curriculum offers as a capacity-building tool. Keywords: Implementation research, capacity-building, LMICs, Africa, practitioners capacity of practitioners must be strengthened alongside Contributions to the literature that of health researchers to produce collaborative effort  Identified processes used in developing an implementation for the ultimate adoption and adaptation of health interventions. research (IR) training module for low- and middle-income There are considerable difficulties to overcome here. countries using a multi-disciplinary team. Although the health service sector has the potential to  The contribution of a stepwise approach to developing, be a context for carrying out high-quality IR, there is a piloting and rolling out IR training to health researchers and lack of a clear set of research competencies that is practitioners emphasising the best approaches to ensuring coupled with the slow pace of capacity development successful health interventions. [10–12]. In order to address this, there should be a  The realisation of the usefulness of IR capacity-building and training model that initiates partnerships between practi- knowledge-sharing that takes place when researchers and tioners who might have little research skills and re- searchers who may lack practice experiences [13, 14]. practitioners sit together in training. Both categories of professionals should be granted the opportunity to continuously reflect on the realities of Background health research through a team-based approach and play Implementation research (IR) is a growing field promoting roles to ensure the successful implementation of health a successful response to the complexities encountered interventions [15]. when implementing evidence-based health interventions. Under its strategic focus, the WHO’s Special The discipline of IR is increasingly recognised as an im- Programme for Research and Training in Tropical Dis- portant academic function for maximising the health ben- eases (TDR) promotes capacity-building in good health efits of interventions. Consequently, there are several research practices globally [16, 17]. Through these ef- capacity-building initiatives focusing either on mentor- forts, the WHO-TDR initiated the establishment of Re- ship, the development of key competencies and reporting gional Training Centres in all WHO Regions (The guidelines, or on training on ethical issues [1–6]. Although African Regional Training Centre in Ghana for the Afri- these attempts are noteworthy, several have been devel- can Region, Astana Medical University in Kazakhstan for oped for high-income settings, with very limited attention the European Region, Research Institute for Tropical to the contextual and health system peculiarities in low- Medicine in Philippines for the Western Pacific Region, and middle-income (LMICs) countries [7]. Evidently, suc- Institut Pasteur de Tunis in Tunisia for The Eastern cessful transfer of evidence-based interventions into prac- Mediterranean Region, Centro Internacional de Entrena- tice is dependent on contextual factors [8]. Moreover, IR miento e Investigaciones Médicas (CIDEIM) in Colombia is multidisciplinary in nature and pivots around leads for the Americas, Universitas Gadjah Mada in Indonesia given by practitioners regarding the challenges encoun- for the South East Asian Region). TDR supports this net- tered during implementation. Although many areas of sci- work of Regional Training Centres (RTCs), one of which ence (e.g. basic research) do not require engagement from has been selected on a competitive basis to conduct and stakeholders, IR necessarily calls for engagement with disseminate training courses in IR. In October 2014, the practitioners [9]. This attempt is not only to enhance University of Ghana School of Public Health (UGSPH) practitioner readiness but also to maximise the likelihood was selected as the WHO-TDR African Regional Training that research informs practice and for the needs of practi- Centre to lead capacity-building in the area of IR. In this tioners related to required evidence, available resources regard, in 2015, UGSPH began the development of an IR and means for sustainability to be taken into consideration training model, which targets both health researchers and [9]. Consequently, this growing the field requires a cre- practitioners within LMIC contexts. This paper aims at ative attempt to ensure the building of expertise for both demonstrating the Principles of IR (PIR) curriculum and health researchers and practitioners. It also means that the course development processes. We also use feedback from Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 3 of 10 course evaluations to highlight its relevance, not only for Phase two: course content development inter-institutional capacity-building but also for inter- The second phase consisted of sets of activities, which regional networking and capacity strengthening. focused on the development of course content. Initial suggestions by the team regarding the scope of the short course were submitted to TDR for inputs and confirm- Methods and processes ation, following which five modules were defined (i.e. The development of the PIR curriculum followed a lo- concepts, methods, ethics, stakeholder engagement and gical and systematic method that informed selected sets dissemination). After this scoping process, a series of of activities. Key learnings from Thomas et al. [18] meetings, consultations, research, discussions and pre- guided us through sets of activities, which we have iso- sentations were held between March and September lated into four different phases as shown in Fig. 1. 2015. These processes were uniquely strategized to focus These phases were informed by a needs assessment con- on institutional capacity-building for all WHO/TDR ducted through various searches (desk-top reviews, read- RTCs. Consequently, from July 2015 to September 2015, ing reports) and consultations (talking to faculty and fellows from the various RTCs with TDR sponsorship Departmental Heads) seeking to identify existing institu- came to Ghana and were involved in content develop- tionalised IR capacity-building efforts within LMICs. ment with mentorship from UGSPH faculty. Two fel- Among the very few that were identified in the sub-region lows from the Research Institute for was the MSc Applied Health Social Science programme Tropical Medicine, Philippines, were assigned Module currently run by the Department of Social and Behavioral 2; one fellow from Universitas Gadjah Mada in Sciences, UGSPH, with a core focus on IR. Indonesia and two fellows from Institut Pasteur de Tunis in Tunisia worked on Modules 1 and 5, respectively. A Phase one: formation of core curriculum development fellow from Astana Medical University, Kazakhstan, was team assigned to work on Module 3. Finally, two fellows from The course development commenced with the formation the CIDEIM in Colombia were assigned Module 4. This of a core team mandated to lead the processes (Appendix mentoring mechanism included assignment of modules, 2). This team comprised of faculty from the UGSPH, who discussion of learning objectives, presentations, etc. The are involved in IR in various capacities, e.g. course devel- presentations provided the opportunity for faculty to opment, teaching, grant application writing, reviewing and make inputs where necessary. Fellows also had the op- conducting IR (Table 1). This team was later expanded to portunity to contact faculty on a one-to-one basis for as- include fellows from other RTCs, supported by WHO- sistance. This was a unique opportunity to develop a TDR. Through meetings, research and consultations, the network on IR capacity-building effort for both faculty core team determined the scope of this short course (i.e. and fellows. course objectives, core competencies, target audience, duration, course and module descriptions). Of critical im- Phase three: internal reviews and pilots portance, the team established the need to employ a peda- Activities in the first two stages led to the development of gogic approach that would allow for the training of a draft version of Modules 1–5. At this stage, the UGSPH academics and health researchers as well as public health team (Appendix 1) was paired and assigned to conduct an practitioners. internal review of the Zero draft. With the use of a Fig. 1 Course development phases Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 4 of 10 Table 1 Principles of Implementation Research (IR) curriculum content Modules Title Description Module 1 Introduction to IR Unit 1: Concepts in IR • Scope of IR and its relevance Unit 2: Needs assessment for IR ▪ IR problem and strategy identification ▪ Theories and frameworks in IR Module 2 Methods in IR Unit 1: Formulating IR problems, questions and objectives Unit 2: Common research approaches in IR ▪ Quantitative methods ▪ Qualitative methods ▪ Mixed methods Module 3 Ethics and Quality Management in IR Unit 1: Ethics in IR • Key ethical principles in public health • Ethical issues in IR Unit 2: Quality management IR • Quality assurance • Quality management, etc. Module 4 Stakeholder and Community Engagement in IR Unit 1: Stakeholder engagement ▪ Identifying stakeholders ▪ Stakeholder Engagement Unit 2: The community in IR ▪ What is a community? ▪ Types of communities in IR Module 5 Dissemination and Scale-Up in IR Unit 1: Dissemination ▪ Communication elements ▪ Dissemination strategies and tools Unit 2: Barriers/facilitators of scaling-up: ▪ Producing and using evidence ▪ Scaling up, types and elements ▪ References template, internal reviewers were to assess consistency in was received and an internal meeting held on 10 May learning objectives, the relevance of selected subtopics, 2017 to study and address recommendations (e.g. fine- overlaps in content, the duration assigned and other areas tuning the pedagogic approach to ensure relevance for of interest. After the internal reviews, a retreat was orga- both researchers and practitioners). Additionally, there nised on 5–7 October 2015 at Aburi, Eastern Region, was the need to include a fieldwork component to allow Ghana. This was to create a bigger forum to engage all for practical application of IR concepts. content developers (i.e. UGSPH/RTC and Fellows), exter- nal capacity-building experts and some observers (i.e. PIR course curriculum overview TDR Representatives). At this meeting, fellows made pre- The IR course curriculum is taught during organised sentations and received comments from reviewers. All workshops often taken face-to-face, usually within 4 participants then agreed on where additional work needed days. The curriculum is organised in three sessions on to be done. After all revisions were completed, the first each of the days intersected with snack and lunch pilot was conducted. breaks. Participants are trained using the five-module course developed. Each module is organised and deliv- Phase four: external reviews and evaluations ered in units. The courses are presented by different fa- Following the first pilot, the entire curriculum was sub- cilitators during the indoor session of the workshop. mitted to an anonymous external reviewer, through Participants are put into groups on a daily basis to de- WHO-TDR. In April 2017, the external reviewer’s report liver presentations on assigned activities with the aim of Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 5 of 10 building competencies for team/group work and presenta- In 2018, a more structured evaluation tool entailing tions. A day’s field work component has been incorpo- close ended and semi-structured items was designed based rated in accordance to the suggestions by the external on two criteria on Kirkpatrick’s framework for evaluation reviewer. The fieldwork component involves participants [19]. In totality, the framework assumes four criteria (reac- and facilitators visiting Health Directorates (e.g. Decision- tion, learning, behavioural changes and organisation) often making institutions, Departments/Agencies etc.), non- used in immediate and long-term training evaluations [20, governmental organisations in health, communities, and 21]. For the purposes of this paper, we report on two of any such institution that may be undertaking relevant and these criteria (reaction and learning), which were adequate applicable health intervention in real-life contexts. This is in assessing the immediate impact of the PIR course on a carefully planned activity, undertaken after the modules health practitioners and researchers. We use data from on Introduction, Methods, Ethics and Community en- the structured tool to report on participants’ ‘reaction’ to gagement have been delivered within the classroom set- the training programme. The evaluation questions in- ting, to help participants connect the understanding and cluded items for measuring both the content of modules knowledge acquired in the classroom with the pragmatic as well as the entire workshop quality. The assessment application of the practice of public health on the ground. tool consisted of nine-items on a 5-point Likert ordinal Generally, the content of the curriculum was struc- scale compiled by adapting questions from the Kirkpatrick tured with the objective of building/strengthening IR model-based survey. Modal scores were determined for capacity among health researchers and practitioners each of the items. For ‘learnings’, we used information within LMICs. Specifically, the course focuses on enhan- from the semi-structured section of the questionnaire, cing competencies in IR conceptualisation, design, suc- which focuses on the knowledge and skills acquired dur- cessful execution of IR studies, stakeholder engagement, ing this training. dissemination and scale-up of the IR strategies. Expected outcomes of the IR curriculum are to strengthen cap- Results acity of practitioners and researchers; to solve imple- The PIR course was developed to provide competencies mentation problems observed in real-life situations, in the conceptualisation and design of IR studies, appli- recognise key ethical issues and maximise engagement cation of ethical principles, engagement of appropriate of key stakeholders at all processes of IR execution and stakeholders as well as dissemination and scale-up. Thus dissemination of findings for better uptake. far, the PIR workshop has been organised at least once in four countries (Ghana, Mozambique, Colombia and Overview of courses run Jamaica). The results present the demographic charac- From 2016 to 2018, qualified applicants were invited to teristics of trainees as well as participants’ evaluations of participate in workshops for the PIR training. The the effectiveness of the IR curriculum. course used varied teaching techniques (e.g. practical ac- tivities, lectures, class discussions, site visits, group work, Demographic characteristics of participants etc.). All learning sessions were followed by participant From 2016 to 2018, the PIR curriculum has been used evaluations. Module and workshop evaluations were to train 165 participants across the world. The majority employed in evaluating the curriculum. Data collection of the participants were men (57%), researchers/aca- was carried out after each module in the case for ‘mod- demics (79.4%) and with Masters Level of education ule evaluation’ and after the workshop for ‘workshop (50.3%). At the inception of the training programme in evaluation’. Participation in the evaluation was voluntary 2016, 17 men and 18 women were enrolled; the number and questionnaires were made non-identifiable to ensure increased to 30 men and 31 women in 2017 and made confidentiality. room for more researchers/academics and practitioners/ PIR courses taken in 2016 and 2017 (i.e. pilot stages of policy-makers to participate in the PIR course. Further- the curriculum development) were assessed using open- more, with four different workshops organised in 2018, ended questions exploring participants’ perceptions on the course recorded the highest attendance (n = 69) in a sequence of topics presented in the modules, time allo- single year. Overall, more researchers and practitioners cation for presentations and activities as well as know- from African countries have been trained compared to ledge/skills acquired. Again, questions eliciting general other non-African countries (Table 2). comments and recommendations for improving the training material were obtained from trainees. The aim Participants’ reactions to PIR training was to enable participants to provide detailed feedback Using a 5-point Likert scale, participants’ reactions to on content and mode of delivery. Responses from these the PIR training in 2018 were assessed. The majority of evaluations served as the basis for improving the cur- the participants had positive reactions to the course riculum developed. (Table 3). Items evaluated included that the facilitator Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 6 of 10 Table 2 Demographic characteristics of Principles of Implementation Research (PIR) participants PIR participants (n = 165) Years Total 2016 (n = 35) 2017 (n = 61) 2018 (n = 69) Gender Men 17 30 47 94 (57.0%) Women 18 31 22 71 (43.0%) Position Practitioners/Policy-makers 1 18 15 34 (20.6%) Researchers/Academics 34 43 54 131 (79.4%) Educational Qualification Bachelor – 2 17 19 (11.5%) Masters 28 26 29 83 (50.3%) PhD 7 33 23 63 (38.2%) Nationality Ghana 11 25 39 75 (45.5%) Mozambique – 2 24 26 (15.8%) Jamaica – 11 – 11 (6.7%) Nigeria 4 3 1 8 (4.8%) Colombia 2 9 – 11 (6.7%) Sierra Leone 3 3 – 6 (3.6%) Mali 2 1 – 3 (1.8%) Malawi 2 – – 2 (1.2%) Kenya 2 – – 2 (1.2%) Rwanda 2 – 1 3 (1.8%) Other African nationalities 4 3 4 11 (6.7%) Others 3 4 – 7 (4.2%) provided an opportunity for practice and contribution to Evaluation of overall course delivery discussions, the facilitator integrated the concepts, time We also evaluated the reaction to the extent to which allocation, understanding of the course and content use- PIR course objectives and participants’ expectations for fulness. Participants’ reaction to PIR training was excel- enrolment were met. Each of these items were rated lent, with rated modal scores of 5 for seven out of nine with a modal score of 5, indicating that their expecta- items measuring reaction to the course and mode of de- tions were totally met. Again, satisfaction with group livery (Table 3). work, the workshop as well as whether trainees will rec- ommend the PIR course to others, were assessed. Group work sessions incorporated into training programmes Table 3 Evaluation of Facilitator by Participants’ Reaction to were also evaluated as excellent. Again, trainees were Principles of Implementation Research Short course positive with regards to overall satisfaction with the PIR Evaluated Items Researchers Implementers workshop. This therefore was an indicator of their deci- sion to recommend the PIR course to others, which was Provided opportunity 5 5 rated as excellent with a modal score of 5 (Table 4). Integrated concepts 5 5 Explained concepts 5 5 Evaluation of participants’ learning Spoke clearly 5 5 The evaluation of the learning was mainly obtained Time 5 5 through responses to open-ended questions on the Understanding 5 5 semi-structured tool, which focused on acquisition of knowledge and skills. The findings indicated that, prior Content useful 5 5 to the training, some participants did not have much un- Total average score 5 5 derstanding of what IR was but gained knowledge on Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 7 of 10 Table 4 Evaluation of overall course delivery “I now know the difference between quality assur- Course delivery Average scores ance and quality control.” (Participant 5, May 2017 PIR objectives met 5 PIR workshop) Expectation met 5 “I learnt about the importance of Ethics and quality Group work 5 management when doing implementation research.” Workshop 5 (Participant 3, May 2017 PIR workshop) Recommend PIR course to others 5 Total 5 Coupled with the theoretical knowledge acquired by par- ticipants, the workshops also provided skills. According this during the training. For instance, a participant men- to the trainees, the PIR workshop had offered them skills tioned that “I learnt and probably mastered the actual on different study designs and data collection ap- meaning of IR. Before now, it was really hazy” (Partici- proaches relevant in IR. For instance, some participant pant 3, June 2016 PIR workshop). Another participant stated: mentioned that: “This is an eye opener in my study as a student. I did not actually get the understanding of what “I have also learnt how to competently design/plan IR was but now I have in-depth understanding of IR” an IR which I previously did not have the skills to do (Participant 2, May 2017 PIR workshop). For those par- before this training.” (Participant 3, June 2016 PIR ticipants who had come across IR in their fields of prac- workshop) tice or research earlier also received a clearer explanation of what IR was, its concepts and the charac- “Module two of the PIR course was very insightful for teristics of IR. This is evident in the quotes below: me. I am a purely quantitative researcher, but I have now been introduced to qualitative and mixed “Most of the issues that I read about in the literature methods.” (Participant 4, June 2016 PIR workshop) about IR have been clarified and addressed.” (Par- ticipant 4, June 2016 PIR workshop) “I acquired knowledge and skills on overcoming bar- riers in scaling up innovations.” (Participant 20, June More importantly, participants learned about the re- 2016 PIR workshop) search pipeline and the differences between IR and other types of research and how they are each situated on the Another practical learning was on how to identify rele- health research pipeline. The distinction between IR and vant stakeholders using an analysis tool. Participants ap- other streams of research served as the basis acquired by preciated the significance of the involvement of all individuals who participated in PIR workshops. For community and stakeholders in an IR programme. One instance, some participants stated that: trainee was of the view that “The success of any interven- tion is dependent on the support and participation of the “I can now differentiate implementation research community in which the intervention is implemented, from other types of research such as operational re- thus the need to identify and prioritise ones stakeholders” search or health system research.” (Participant 18, (Participant 2, June 2016 PIR workshop). In essence, the June 2016 PIR workshop) skills required to identify and engage key stakeholders in an IR programme were also learnt. This is evident in the “I like this module [Introduction to Implementation following quote: Research]. It gives a good concept on implementation research. It actually makes the difference between IR “I have a better understanding of community mobil- and other researches. Implementation research deals isation, social mobilisation and stakeholder engage- with intervention.” (Participant 11, June 2016 PIR ment.” (Participant 1, May 2017 PIR workshop) workshop) Discussion In addition to the basic IR concepts, some participants Herein, we outlined the processes for the development also mentioned that they had gained knowledge on eth- of a training curriculum for the PIR short course with ical principles and quality control. The training gave par- the aim of enhancing IR capacity. Our approach of pro- ticipants an understanding on ethical considerations, viding training for both implementers/practitioners and quality control in IR, their significance as well as the dis- researchers concurrently enhanced the incorporation of tinction between these concepts. For instance, partici- an intersectoral and interinstitutional collaboration. The pants said: overall result from the assessment of participants who Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 8 of 10 took the developed PIR course indicated (1) consistency Implications for interregional/institutional capacity- of the developed PIR course with stated lesson objec- building tives, (2) relevance of the course content to both practi- The curriculum focused on sustainable outcomes for in- tioners and researchers, and (3) consistency in sequence terregional and interinstitutional capacity-building and and linkages of PIR modules. dissemination of the IR Concept. This was first evident in In disseminating the course development procedure, it the approach of including fellows from various RTCs in is therefore essential to highlight key learnings revealed various LMICs (Colombia, Indonesia, Tunisia and through the development and utilisation of this PIR Philippines). Secondly, the initial opportunities to run the curriculum. course were in these countries. We used this opportunity to further identify relevant case studies that will allow the course to be run globally in LMICs. Adoption of the cor- Learnings from a collaborative training model responding expected changes in IR design and practices as The multidisciplinary nature of IR was evident through well as training of researchers/practitioners have become the use of the collaborative training model, which in- the primary responsibility of universities and health insti- novatively included both practitioners and researchers in tutions across cultures [31–34]. Since health practitioners, training sessions. To achieve this aim, an elaborative lecturers and researchers come from different back- consultative approach was utilised in enhancing interest grounds and traditional research trainings [35], it is neces- during the development stage as well as to ensure par- sary to create more internal awareness and capacity in the ticipation by these specific stakeholders [22, 23]. Despite institutes. The curriculum development process and its its usefulness, there were a few challenges that are note- implementation are means of capacity-building in the in- worthy. During several sessions, we observed gaps in stitutions. The knowledge obtained on concepts of IR, re- knowledge. Whereas researchers were a more advanced search methods, ethics, quality assurance, communication in their thinking of research principles, there was the and community engagement will enhance healthcare de- need to spend more time with practitioners to enable livery and good clinical outcomes. them to better appreciate IR concepts. On the other hand, practitioners had depth of knowledge on the prac- Limitation of the curriculum tical challenges that are encountered in the field, espe- The processes for curriculum development were intensive cially their understanding of how contexts impact the and the outcome has impacted positively on participants’ implementation processes. Consequently, there were knowledge and skills. Participants generally gave positive concerns with content in terms of how much to offer ratings (e.g. integration of concepts) for their reactions to within the sessions and time in terms of total training the training. Under ‘learnings’, participants indicated im- duration. In addressing these issues, we introduced a provement in their knowledge in areas such as identifica- fieldwork component, combined some modules and re- tion of IR problems and questions. However, there a few duced the number of days for training from 5 to 4 days. limitations. First, there is a language barrier, since all ma- All these were targeted to enhance learning and facilitate terials are in English language. In instances where training the transfer of knowledge of the PIR in real life situa- has taken place in Spanish- and Portuguese-speaking tions [24–26]. These help to overcome the potential of countries, it has been difficult for us to determine if in- inert knowledge problems experienced in cases where deed learning has taken place. Second, since we use only expected transfer does not take place due to factors such Neglected Tropical Diseases as examples in all the training as low turnover of stakeholders and challenges in em- sessions, some participants are limited in their under- bedding new programmes into existing systems [24, 27]. standing of IR concepts, especially individuals who work One of the spin-offs from this process was the in- in other disease and public health areas. creased opportunities for fellows from the different RTCs to interact and to share professional experiences. Conclusion Stakeholders were invited to comment, either in a writ- In this IR curriculum, we adopted an approach for train- ten format or through small workshops, on the drafted ing both researchers and implementers, which offers a curriculum frameworks and the detailed content. Some dynamic opportunity for the acquisition and sharing of stakeholders with particular expertise were invited to knowledge for both categories of learners. This approach give guest lectures to students during the pilot. An im- was crucial in demonstrating the ability to make a key portant result from this enhanced process of interaction characteristic of IR (e.g. multidisciplinary) practically evi- was the strengthening of an emerging IR training net- dent during the training sessions. Using such a model to work as previous findings on the relevance of social net- effectively train participants from various LMICs shows working and multi-stakeholder engagements in project the opportunities this training curriculum offers as a success also indicated [23, 28–30]. capacity-building tool. Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 9 of 10 Appendix 1 Reviewers of drafted curriculum and modules assigned  Module 1: PDG and FA  Module 2: EA1 and AY  Module 3: MA and JN  Module 4: EA2 and OM  Module 5: AA and PA Appendix 2 Table 5 Stakeholder engagements Stakeholders Functions and contributions Institutions Stakeholders inside training Curriculum developers Designing curriculum UGSPH, RTCs, etc. Subject lectures Teaching/participate in review University Heads of Department Managing/monitoring Students Evaluating training Stakeholders outside training Researchers Consulting the content/participating in teaching UGSPH, RTCs Policy-makers Participating in curriculum design MOH, GHS Health project managers (rural/ Participating in training needs assessment/curriculum design MOH, GHS urban) Training managers at ministerial Control/approvalParticipating in teaching material development UGSPH, RTCs level Control Researchers/fellows Participating in training needs assessmentConsulting/participating in training course design, UGSPH, RTCs signing training contracts INGO, LNGO Consulting/participating in training course design, signing training contracts WHO, TDR Sponsor linking Linking, coordinating activities Patients Participating in research activities GHS Graduate students Monitor/evaluating training courses Universities GHS Ghana Health Service, INGO international non-governmental organisations, LNGO local non-governmental organisation, MOH Ministry of Health, RTCs regional training centres, TDR Research and Training in Tropical Diseases, UGSPH University of Ghana School of Public Health Supplementary information Authors’ contributions Supplementary information accompanies this paper at https://doi.org/10. All authors have made substantial contributions to the development of the 1186/s12961-020-00568-y. manuscript. PDG and EA conceived the initial idea. PDG drafted the manuscript. SD analysed the evaluations. PDG, EA, PL, JN and MA were Additional file 1. involved in editing and reviewing the manuscript. EA incorporated and finalised all comments from authors. All authors performed significant editing of the manuscript, read and approved the final manuscript. Abbreviations CIDEIM: Centro Internacional de Entrenamiento e Investigaciones Médicas; Funding IR: Implementation research; LMICs: Low- and middle-income countries; This process received financial support from TDR, the Special Programme for PIR: Principles of implementation research; RTCs: Regional Training Centres; Research and Training in Tropical Diseases co-sponsored by UNICEF, UNDP, TDR: Research and Training in Tropical Diseases; UGSPH: University of Ghana the World Bank and WHO. TDR is able to conduct its work thanks to the School of Public Health commitment and support from a variety of funders. We also like to acknow- ledge all long-term core contributors from national governments and inter- Acknowledgements national institutions as well as designated funding for specific projects within We highly appreciate the support of all those who were part of this exercise TDR current priorities. For the full list of TDR donors, please visit their website from the beginning of this process. We appreciate the fellows (Joy Lorenzo, at: https://www.who.int/tdr/about/funding/en/ Carol Malacad, Trisasi Lestarl, Hind Bouguerra, Kharroubi Ghassen, Amangal Akanov, Alexander Cossio- Duque and Luisa Rubiano Counsuelo) from the other RTCs who spent time Availability of data and materials in Ghana assisting with the course development and all who have partici- All relevant data are within the paper. The evaluation forms are also available pated in the Implementation Research short-course trainings. on request. Dako-Gyeke et al. Health Research Policy and Systems (2020) 18:53 Page 10 of 10 Ethics approval and consent to participate 16. Ogundahunsi OA, Vahedi M, Kamau EM, Aslanyan G, Terry RF, Zicker F, et al. Not applicable. Strengthening research capacity—TDR’s evolving experience in low- and middle-income countries. PLoS Negl Trop Dis. 2015;9(1):e3380. 17. Maure C, Halpaap BMM, Vahedi M, Yamaka S, Launois P, Kaser M. Research Consent for publication capacity strengthening in low and middle income countries - an evaluation Not applicable. of the WHO/TDR Career Development Fellowship Programme. PLoS Negl Trop Dis. 2016;10(5):e0004631. 18. Thomas PA, Kern DE, Hughes MT, Chen BY. Curriculum Development for Competing interests Medical Education: A Six-Step Approach. Baltimore: JHU Press; 2015. The authors declare that they have no competing interest, including 19. 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