title: Building reproductive health research and audit capacity and activity in the Pacific Islands (BRRACAP) study: methods, rationale and baseline results.
abstract: BACKGROUND
  Clinical research and audit in reproductive health is essential to improve reproductive health outcomes and to address the Millennium Development Goals 4 and 5. Research training, mentoring and a supportive participatory research environment have been shown to increase research activity and capacity in low to middle income countries (LMIC). This paper details the methods, rationale and baseline findings of a research program aimed at increasing clinical research activity and audit in the six Pacific Islands of Fiji, Samoa, Tonga, Vanuatu, Cook Islands and the Solomon Islands.
  
  
  METHODS
  Twenty-eight clinician participants were selected by the five Ministries of Health and the Fiji National University to undergo a research capacity building program which includes a research workshop and mentoring support to perform research and audit as teams in their country. Data on the participants' characteristics, knowledge and experiences were collected from structured interviews, questionnaires, focus groups, and an online survey. The interviews and the two focus groups were audio-recorded and all replies were analysed in a thematic framework.
  
  
  RESULTS
  The 28 participants included 9 nurses/midwives, 17 medical doctors of whom 8 were specialists in reproductive health and 2 other health workers. Most (24, 86%) were required to perform research as part of their employment and yet 17 (61%) were not confident in writing a research proposal, 13 (46%) could not use an electronic spreadsheet and the same number had not analysed quantitative data. The limited environmental enablers contributed to poor capacity with only 11 (46%) having access to a library, 10 (42%) receiving management support and 6 (25%) having access to an experienced researcher. Barriers to research that affected more than 70% of the participants were time constraints, poor coordination, no funding and a lack of skills.
  
  
  CONCLUSIONS
  Building a research capacity program appropriate for the diversity of Pacific clinicians required research evidence and collaborative effort of key stakeholders in the Pacific Islands and the region. The participants had limited research knowledge, skills and experience and would require individualized training and continuous intensive mentorship to realize their potential as clinician researchers for their services in the Pacific.
authors.affiliation: South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand. alec@pacifichealthresearch.org.nz.
authors.forename: Alec J
authors.initials: AJ
authors.lastname: Ekeroma
authors.forename: Tim
authors.initials: T
authors.lastname: Kenealy
authors.forename: Boaz
authors.initials: B
authors.lastname: Shulruf
authors.forename: Lesley M E
authors.initials: LM
authors.lastname: McCowan
authors.forename: Andrew
authors.initials: A
authors.lastname: Hill
mesh_terms: D035843:Biomedical Research / Q000193:education / Q000458:organization & administration*; D057191:Capacity Building / Q000379:methods; D004493:Education; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008611:Mentors; D010139:Pacific Islands / Q000453:epidemiology; D015397:Program Evaluation; D060728:Reproductive Health