Section outline

  • Although much of what is in this section of the course is relevant to all mentor and mentee relationships, there may be some special issues in low- to middle-income settings:

    Mentoring traditions

    • There may not be a strong tradition of mentoring
    • Much of the evidence base has come from high-income countries were cultural settings may be different

    Leadership

    • Mentorship is inarguably crucial for nurturing future global health leaders
    • The colonial mindset must be changed to reduce the inequities in global health leadership

    In the paper Strengthening Mentoring in Low- and Middle-Income Countries to Advance Global Health Research: An Overview, the authors define 'Mentorship is the professional relationship by which the mentor, “an experienced and highly regarded, emphatic person,” guides a more junior colleague, the mentee, in developing and reassessing his/her ideas, learning and development, and substantially furthers his/her personal and professional growth'

    and they state 'Many LMIC institutions do not yet have a strong tradition of mentoring, mentoring programs are very uncommon, very few LMIC scientists have received mentorship training, and institutions lack the resources and capacities needed to institutionalize mentoring programs and processes. Also, existing evidence, best practices, and norms for successful mentoring are not fit to LMICs but instead are highly biased toward the environments and resources of high-income countries, where opportunities abound and a diverse array of professionals with different backgrounds are trained, prepared, supported, and often rewarded to serve as mentors.'

    The authors conclude: 'The advancement of global health research demands sustained career development opportunities for LMIC scientists that can only be attained via the implementation and dissemination of culturally compatible mentoring practices. Institutional resources and local academic and cultural factors should guide the phased implementation of tailored mentoring activities and programs for each setting, with planned, periodic evaluation of progress. Low- and middle-income country institutions also need to support existing mentors and train additional ones, while mentees can contribute to prevent overburdening the few trained mentors available, by playing an active role in the operational efforts of mentoring programs via progressing and peer mentoring. We hope this special issue will become part of the foundation of LMIC-specific mentoring approaches around the globe.' And of course this will be similar in other areas, nit just global health research.

    Mentoring for leadership.
    In the paper A new path to mentorship for emerging global health leaders in low-income and middle-income countries, the authors say 'Evidence strongly suggests that mentorship is inarguably crucial for nurturing future global health leaders. This can be particularly challenging when there are considerably fewer leaders from LMICs due to the existing inequities in global health leadership...Current narratives on equitable partnerships mostly include academics and practitioners based in HICs who have focused on assuming responsibility for mentoring their LMIC partners...To truly shift power, LMIC collaborators must take ownership and identify context specific and nuanced skill sets needed for mentors and mentees. This is one of the few sustainable approaches to end dependency on HICs for training of our global health professionals and scientists...
     
    The major challenge to shift the local power imbalance is that power structures within global health have (un)intentionally produced leaders in LMICs with a similar colonial mindset to that seen in HICs, which reinforces power being concentrated in few hands, including mentorship of future leaders. For example, current leaders who attract the most funding gain control over international grants that results in substantial power over their institutions. This is compounded by complex systems that have created barriers such as hierarchy, bureaucracy, and capacity, limiting mentorship opportunities.
     
    A large-scale study of thousands of scientists around the world found that “mentees achieved the highest impact when they displayed intellectual independence from their mentors and did their best work when they break from their mentors’ research topics”. For mentees in LMICs to achieve such an impact, the process will have to entail allowing them to follow an independent track with structured pathways in place. Mentorship hence becomes a pivotal part of the larger succession planning in global health.
     
    We conclude that there is a dire need to mentor investigators in LMICs to reduce inequities in global health leadership. If left as is, we will continue to perpetuate the same cycle of inequities, where privileged mentees become global health leaders driving the development of a cadre of professionals who are stuck in the same role, and unable to advance their career to contribute to the field meaningfully.'
     
    The authors offer a number of recommendations to strengthen mentorship for emerging leaders in LMICs - relating to the institutions, the mentees themselves, funders and journals, and national bioethics committees. You can see the details in the paper here or as a pdf file below.
     
    A further paper titled Human-centred mentorship in global health research: are we ready to give what it takes? offers a related perspective. 'Human-centred approach is characterised by ‘valuing empathy and relationship building between the mentor and the mentee built on equitable sharing of power and shedding of privilege within hierarchical structures’. A summary of the key points is as follows:

    • Human-centred mentoring has been suggested as a sustainable strategy to nurture emerging leaders in low-income and middle-income countries for equitable and diverse representation in global health.

    • Building on the argument that investigators in these countries need to take responsibility, we take a deeper dive into the challenges of implementing this approach aimed at developing independent leaders.

    • The current global health environment where power is concentrated with few individuals hinders any progress towards institutional level changes to promote such practices. Moreover, such an environment also prematurely rewards mentees who may be resistant to this alternative form of mentoring.

    • A transformative mentorship relationship which is anchored in trust, respect, meaningful relationships and problem sharing with due responsibilities for both mentors and mentees can help create willingness in mentees to be trained as individuals ready to take on an independent path.

    Guidelines for mentors include Imparting values and promoting a culture of human-centred mentorship; Strengthening relationships; Systems approach; Ensuring recognition; Do take care of yourself.
     
    Guidelines for mentees include: Choosing a mentor; Familiarisation with the research culture; Continuous learning, constructive feedback and teamwork is the key; Values over skills.
     
    You can read these guidelines in full in the paper here and in the pdf version below.