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Building reproductive health research and audit capacity and activity in the pacific islands (BRRACAP) study: methods, rationale and baseline results

Alec J Ekeroma1*, Tim Kenealy1, Boaz Shulruf2, Lesley ME McCowan3 and Andrew Hill1

Author Affiliations

1 South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand

2 Office of Medical Education, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

3 Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand

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BMC Medical Education 2014, 14:121  doi:10.1186/1472-6920-14-121

Published: 19 June 2014



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.


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.


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.


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.

Pacific countries; Clinician researchers; Research capacity building; Research skills; Barriers and enablers of research