Post-doctoral research fellowship as a health policy and systems research capacity development intervention: a case of the CHESAI initiative

BACKGROUND: Building capacity in health policy and systems research (HPSR), especially in low- and middle-income countries, remains a challenge. Various approaches have been suggested and implemented by scholars and institutions using various forms of capacity building to address challenges regarding HPSR development. The Collaboration for Health Systems Analysis and Innovation (CHESAI) – a collaborative effort between the Universities of Cape Town and the Western Cape Schools of Public Health – has employed a non-research based post-doctoral research fellowship (PDRF) as a way of building African capacity in the field of HPSR by recruiting four post-docs. In this paper, we (the four post-docs) explore whether a PDRF is a useful approach for capacity building for the field of HPSR using our CHESAI PDRF experiences. METHODS: We used personal reflections of our written narratives providing detailed information regarding our engagement with CHESAI. The narratives were based on a question guide around our experiences through various activities and their impacts on our professional development. The data analysis process was highly iterative in nature, involving repeated meetings among the four post-docs to reflect, discuss and create themes that evolved from the discussions. RESULTS: The CHESAI PDRF provided multiple spaces for our engagement and capacity development in the field of HPSR. These spaces provided us with a wide range of learning experiences, including teaching and research, policy networking, skills for academic writing, engaging practitioners, co-production and community dialogue. Our reflections suggest that institutions providing PDRF such as this are valuable if they provide environments endowed with adequate resources, good leadership and spaces for innovation. Further, the PDRFs need to be grounded in a community of HPSR practice, and provide opportunities for the post-docs to gain an in-depth understanding of the broader theoretical and methodological underpinnings of the field. CONCLUSION: The study concludes that PDRF is a useful approach to capacity building in HPSR, but it needs be embedded in a community of practice for fellows to benefit. More academic institutions in Africa need to adopt innovative and flexible support for emerging leaders, researchers and practitioners to strengthen our health systemsIS

Social Assistance in Developing Countries Database Version 5.0

The Social Assistance in Developing Countries Database is a user-friendly tool that provides summary information on social assistance interventions in developing countries. It provides a summary of the evidence available on the effectiveness of social assistance interventions in developing countries. It focuses on programmes seeking to combine the reduction and mitigation of poverty, with strengthening and facilitating household investments capable of preventing poverty and securing development in the longer term. The inclusion of programmes is on the basis of the availability of information on design features, evaluation, size, scope, or significance. Version 5 of the database updates information on existing programmes and incorporates information on pilot social assistance programmes in Latin America, Asia and Africa. It also adopts a new typology that distinguishes between social assistance programmes providing pure income transfers; programmes that provide transfers plus interventions aimed at human, financial, or physical asset accumulation; and integrated poverty reduction programmes. This new typology has, in our view, several advantages. It is a more flexible, and more accurate, template with which to identify key programme features. It provides a good entry point into the conceptual underpinnings of social assistance programmes

The targeting effectiveness of social transfers

Many methodologies exist for dividing a population into those who are classified as eligible for social transfers and those who are ineligible. Popular targeting mechanisms include means tests, proxy means tests, categorical, geographic, community-based and self-selection. This paper reviews empirical evidence from a range of social protection programmes on the accuracy of these mechanisms, in terms of minimising four targeting errors: inclusion and exclusion, by eligibility and by poverty. This paper also reviews available evidence on the various costs associated with targeting, not only administrative but also private, social, psycho-social, incentive-based and political costs. Comparisons are difficult, but all mechanisms generate targeting errors and costs. Given the inevitability of trade-offs, there is no ‘best’ mechanism for targeting social transfers. The key determinant of relative accuracy and cost-effectiveness in each case is how well the targeting mechanism is designed and implemented