Evaluation of the National Institute for Health and Care Research’s (NIHR) Global Health Research (GHR) Portfolio, First Phase (2016/17-2020/21) - Interim Report

Abbreviations list AMR Antimicrobial Resistance BA Bibliometric Analysis BMJ British Medical Journal CA Contribution Analysis CADA Cohort Academic Development Award CEI Community Engagement and Involvement CEPI Coalition for Epidemic Preparedness Innovation DFID Department for International Development DHSC Department for Health and Social Care ECR Early Career Researcher EDCTP European and Developing Countries Clinical Trials Partnership EF Evaluation Framework EID Emerging Infectious Disease EQ Evaluation Question EPSRC Engineering and Physical Sciences Research Council ESRC Economic and Social Research Council FAF Financial Assurance Funds FCDO Foreign, Commonwealth and Development Office FGD Focus Group Discussion GACD Global Alliance for Chronic Diseases GARDP Global Antibiotic Research and Development Partnership GCC Grand Challenges Canada GECO Global Effort on COVID-19 GESI Gender, Equality and Social Inclusion GHR Global Health Research GRP Global Research Professorships HPSR Health Policy and Systems Research ISAG Independent Scientific Advisory Group JGHTI Joint Global Health Trials Initiative KII Key Informant Interview LMIC Low- and Middle-Income Countries MEL Monitoring, Evaluation and Learning MNH Maternal and Neonatal Health MRC Medical Research Council NCD Non-Communicable Disease NHS National Health Service NIHR National Institute for Health and Care Research NIHRCC National Institute for Health and Care Research Coordinating Centre OECD DAC Organisation for Economic Co-operation and Development's Development Assistance Committee ODA Official Development Assistance PI Principal Investigator PPI Patient and Public Involvement RCS Research Capacity Strengthening RIGHT Research and Innovation for Global Health Transformation RSTMH Royal Society of Tropical Medicine and Hygiene R&D Research & Development SDG Sustainable Development Goals SMT Senior Management Team SNA Social Network Analysis SORT IT Structured Operational Research and Training Initiative SRE Science Research & Evidence SSSD Severe Stigmatising Skin Disease HEI Higher Education Institution ELHRA Enhancing Learning and Research for Humanitarian Assistance HMG Research Governance Framework COVAX COVID-19 Vaccines Global Access TDR Special Programme for Research and Training in Tropical Diseases NAO National Audit Office TB Tuberculosis ToC Theory of Change TOR Terms of Reference UKCDR UK Collaborative on Development Research UKRI UK Research and Innovation UNDP United Nations Development Programme UNICEF United Nations Children's Fund VfM Value for Money WHO World Health Organisation Authorship and Disclaimer Authorship The lead authors of this report are Paula Quigley, Korina Cox, Sarah Hanka, Charlotte Mitchell, Seema Khan, Liam Shah, Jamie Smith, Marta Barba Prieto, and Panos Deoudes. Lead authors acknowledge contributions from Valentina Uccioli, Valeria Miglio, ABH Partners, Access Health International, PopTrends and Aurum Institute. Disclaimer This evaluation is funded by the National Institute for Health Research (NIHR) under its Policy Research Programme (PRP) (Grant Reference Number NIHR203816). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care (DHSC). This report has been prepared by Ecorys for DHSC, for services specified in the Terms of Reference and contract of engagement. There are no conflicts of interest. Executive Summary Background The Department for Health and Social Care (DHSC) and National Institute for Health and Care Research (NIHR) established the Global Health Research (GHR) portfolio following the 2015 UK Aid Strategy. Its purpose is to support applied health research and training in low- and middle-income countries (LMICs), addressing unmet needs and strengthening research capabilities. An initial budget of £429.5m was allocated for the first phase of the portfolio (2016/17 – 2020/21), complementing other Official Development Assistance (ODA) research funders and evolving over time to include 30 programmes that NIHR or external partners manage. The portfolio is diverse in terms of its health focus, geographical scope, and funding size and emphasises the NIHR’s operating principles of impact, excellence, effectiveness, inclusion, and collaboration, as well as strengthening research capacity, equitable partnerships and community engagement and involvement (CEI). It has grown to encompass 17 thematic areas, operate in over 50 LMICs, and has funded 616 awards in the first phase. The GHR Portfolio's Theory of Change (ToC) outlines the NIHR’s ambition to improve global health outcomes. It recognises that it may take 3-10 years for research outputs to influence policy, practice, and behaviour changes and 10-25 years for these changes to lead to strengthened health systems and increased capacity for health promotion and disease prevention. The Evaluation The DHSC commissioned Ecorys through the NIHR in December 2021 to undertake an evaluation of its first phase of activities (2016/17-20/21). The portfolio evaluation is delivered in four stages: inception, interim evaluation, final evaluation (due in December 2023) and a dissemination phase (due to be completed by March 2024). The evaluation utilises a theory-based approach to assess the contributions of the GHR Portfolio to the intended outputs, outcomes, and likely impact of investments. It focuses on assessing whether the portfolio is on track to deliver the expected results given the long-term nature of the research impact. The evaluation process involves testing the portfolio's ToC, including its assumptions and causal links, to determine the validity of the underlying theory using a contribution analysis (CA) approach. CA is an approach that allows recognition of the complexities of attribution, given a whole wide range of and and a are of – well a is and is to support of contribution likely is it that these activities and outputs lead to the in the theory of on the are expressed in terms of of it be that this to the to support a a on the The evaluation and are the Organisation for Economic Co-operation and Development's Development Assistance Committee evaluation and and and and impact. The to and community engagement and involvement and for The and and and an to funded a Social Network Analysis to assess and funded and a Bibliometric Analysis to research to be in the final evaluation phase. approach to programmes and awards for and the Evaluation This report the interim of the evaluation of the first phase of the GHR It for the portfolio's impact and is the GHR Portfolio addressing of health research in is unmet by in the The GHR Portfolio is addressing of health in The GHR Portfolio to by on thematic by other funders in The Ecorys analysis to that health given and to the underlying of these The Ecorys that the funding and the of and involvement of from The of the GHR Portfolio's in the of its be to involvement There is that the portfolio in health research a approach needs through UK and partners in global health research and through for from UK and LMIC Higher Education or Research thematic is that and the and of the portfolio's initial the and of engagement of LMIC and other be Involvement of and in the of the portfolio was are of increased involvement over awards to and The that a approach to addressing of health research and LMIC and other may be is the GHR Portfolio a funding to its NIHR has the GHR Portfolio to research funding and other UK and global health Early of initial a for research and NIHR funded programmes the thematic research There has been an to the GHR The the ToC and thematic and outputs has been programmes been results to this a in partnerships by programmes and awards and be to and and other and global health research the and programmes to engagement other funders and in and this process and awards has been has the GHR Portfolio been in its intended interim The GHR Portfolio has in its intended interim The GHR Portfolio to be by research outputs to policy, research capacity, equitable and The that the portfolio has funded programmes and awards that in these and a wide range of There is of the in research capacity including of There is of in strengthening the capacity and of as well as of capacity including LMIC research of capacity changes is this The portfolio has in equitable addressing to the equitable of LMIC is a that time and the of the of on CEI and CEI in awards over time and a to equitable engagement of LMIC a analysis of needs is to in this The CA that it is that portfolio outputs to and to in to a that the of the of its funded changes be the portfolio has in its is for in evaluation and addressing capacity and CEI the GHR Portfolio and its partners been to outputs in a and The GHR Portfolio has in the first phase of its and is There is of GHR Portfolio the portfolio in outputs in an This awards including to research in the of external as the COVID-19 and in The portfolio and for awards to to and the and of NIHR and its partners been by and There is on other of VfM effectiveness, and the GHR Portfolio an for its approach to partners and systems in global health research are to and in LMICs, including and including and are of is a for and to assess the to CEI is the as and not include from It is not to the awards are or to the changes that are as a of CEI the of and of for the and and for programmes be for LMIC research to the of research as well as the of equitable and well is the GHR Portfolio and The NIHR has a the Learning has been a of the GHR funded to to the by in a The portfolio has its to for and on needs and is for to be awards and including and This is for those operating in thematic or to the portfolio's and impact. that funded research and capacity strengthening activities are on track the to 3-10 The NIHR has the for impact through the GHR Portfolio it is to assess the long-term impact of the GHR is expected to in 10-25 years from the of the is of outcomes. 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