Issues specific to resource-limited settings

Issues specific to resource-limited settings

The impact of kidney disease in low income regions is enormous and further research is urgently needed. The research environment in low- and middle-income countries is changing rapidly, but wide variations exist and the challenges for clinical researchers are different to high-income countries. Nephrologists with an interest in research are encouraged to involve themselves in such activities in their own region. Some of the key issues and potential solutions are presented below.

Potential solutions include

There is often a lack of well-trained and experienced research staff to support clinical research. In addition, it is also often difficult for inexperienced researchers to find a mentor, or senior expert who can guide them in specific topics or techniques.

Potential solutions include

Research training programs including degree training, re-entry grants, and career development fellowships. Research networks and working groups also help to strengthen collaboration in research, training, production of analytical reports and build consensus or protocols.

The ISN and ERA-EDTA both offer Fellowships to international applicants from resource poor regions. The American Society of Nephrology provides contact details for US institutions willing to support visiting international fellows. Researchers are encouraged to also investigate fellowships, scholarships or other sources of funding from regional nephrology societies.

The ISN strongly encourages forming local teams and developing innovative solutions tailored to local context, yet recognises that many under-resourced regions lack adequate infrastructure for research in their hospitals and laboratories. Generally speaking, hospitals are short of basic equipment and resources including lack of necessary communication facilities, electronic filing systems, laboratory equipment.

Potential solutions include

Institutional programme-based support to acquire sustainable research and training capabilities e.g. the sister-renal and transplant center programs of the ISN.

ISN Sister Renal Centers Program

Most universities and institutions do not provide adequate incentives to physicians who are attracted to research. Consequently, researchers usually provide time, energy and money to research in the time left to them outside their clinical work.

Potential solutions include

International, regional and national grants to support priority research and knowledge management activities

In addition, the ISN encourages professionals to engage in advocacy and establish regular communication with local administrators/governments. This may foster local support for addressing kidney diseases by investing in research that is locally relevant and sustainable.

See Funding topic of this toolkit for the possible funding sources.