Gaps in Indirect Cost Funding for Research in Low-and Middle-Income

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Kulanga, Gibson E. Kapanda, John A. Bartlett, Charles Muiruri, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8879897/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Introduction: Research in low- and middle-income countries (LMICs) faces limited investment from both in-country governments and philanthropies. Although research grants cover costs directly associated with specific research projects, they often exclude indirect costs that are essential to supporting research activities. The gap between grant funding and actual cost of conducting research at institutions of higher learning (IHL) in LMICs remains poorly understood. This study aimed to identify and evaluate the indirect costs that are often unaccounted for in grants funding. Materials and methods: We used a descriptive retrospective cross-sectional study to evaluate unaccounted costs atthree prominent medical universities in Tanzania. Data were obtained from annual Audited Final Reports and Final Financial Reports of sponsored biomedical and social and behavioral sciences projects funded between 2007 and 2017. Findings: A total of 17 projects were included in the study, of which 6 (35.3%) were biomedical and 11 (64.7%) non-biomedical. The median total amount of project funding for all biomedical research projects was US$ 544,084; interquartile range (IQR) [89,268-1,226,570]. These projects had median unaccounted costs of 34.3%, US$ 186,403 (IQR) [30,583–420,223]. The median funding for non-biomedical sponsored research projects was US$ 902,999 (IQR) [468,259–1,951,212] with unaccounted costs of 12.5%, US$ 112,875 (IQR) [58,532–243,902]. Conclusion: The study demonstrated that there were substantial unaccounted costs with sponsored research projects which can undermine financial sustainability, compromise research quality, and strain institutional resources. There is a need for IHLs in LMICs and funding agencies to work collaboratively to reduce the currently experienced research cost inequities. Indirect cost of research unaccounted costs institutions of higher learning low- and middle-income countries sponsored research Figures Figure 1 Figure 2 Key Massages Although research grants typically cover direct project costs, they often do not fully cover ancillary costs necessary to support the broader research infrastructure in low- and middle-income countries. This study offers a novel analysis of how institutions of higher learning in low- and middle-income countries incur costs while conducting sponsored research. Introduction To compete successfully for external support, institutions of higher learning (IHLs) must invest in the research enterprise – building infrastructure, recruiting competent investigators, maintaining laboratories, and data systems among others. These investments often yield both academic and economic benefits as research productivity and institutional prestige are key contributors to the institution’s global academic rankings 1 . In high-income countries (HIC), governments and philanthropies are key external funders of research in IHLs. With growth of economies in low- and middle-income countries (LMICs) such as African countries, there has been an impetus to recognize the value of research for sustainable development. As a result, in 2007 African leaders pledged to intensify government funding of research infrastructure 2 . Regrettably, this pledge has not been realized; most research in LMICs is funded by international organizations. Governments commit minimal or no portion of their budgets to research. For example, Franzen et al. 3 observed that research in LMICs is challenged with poor investment by governments and in-country philanthropies. It is estimated that almost 80% of research funding in LMICs originates from external sources 4 who invest resources on the basis of their goals and objectives. The paucity of local funding and underfunding of sponsored research from external funders challenges sustainability of the research enterprise in LMIC’s IHLs 4 , 5 . IHL-sponsored research budgets are typically consisted of components; (1) direct costs and (2) indirect costs, also known as overhead or facilities and administrative (F&A) costs. Direct costs are costs that are directly linked to the project activities such as salaries for investigators, graduate assistants, post-doctoral fellows, laboratory technicians; computers and durable equipment, and expendable commodities such as reagents, travel, communications, and clerical assistance 6 . Indirect costs cover a portion of the IHL’s infrastructure and operational costs necessary to conduct the research, not directly linked to specific project activities 7 . These include all of the basic facilities and administrative infrastructure to run an institution, such as utilities, maintenance, payroll and purchasing. Additionally, the indirect cost recovery supports the research enterprise by funding research initiatives, and research and shared facilities 8 . Although research grants cover costs directly associated with specific projects, they do not fully cover costs that cannot be directly attributed to one project 7 . Institutions conducting sponsored research may end up spending considerable unaccounted funds and resources to ensure a successful project 9 . According to Dr. Kelvin K. Drogemeier, University of Oklahoma Vice President for Research, while performing sponsored research IHLs incur a variety of significant costs, both direct and indirect, prior to and during a specific research project that they would otherwise not incur 10 – 13 . Fonn et al. 9 further highlights the role of in-kind contributions which can account to up to 42% of the total resources used in a project. These include unremunerated labor by faculty, use of physical and infrastructure resources, and unremunerated indirect costs in project implementation. These contributions are provided by faculty who devote unremunerated time that is not counted as part of the institution’s responsibilities apart from their teaching, supervisory, and administrative roles. Without these in-kind contributions, the realization of set goals and impact of such sponsored research projects would be difficult, if not impossible. Most LMIC institutions do not have policies on research costing and thus most F&A rates are based on funder discretion 14 . Consequently, these rates often vary widely - from 0% to 15% of direct costs which, in general, are considerably lower than indirect costs in IHLs in HICs 14 . Despite an increase in funding for sponsored research in LMICs in the past decade, a quantifiable relationship between the funds requested from funding agencies and the actual cost of paying for such projects at IHLs is poorly understood. To our knowledge, there has not been a comprehensive evaluation of adequacy of indirect costs at IHLs in LMICs to inform institutional policies on equitable distribution of research funding. It is within this premise that we conducted this study to identify the gaps in indirect cost funding at IHLs in LMICs by quantifying the actual costs of conducting sponsored research. Materials and methods This descriptive cross-sectional study was conducted at the Muhimbili University of Health and Allied Sciences (MUHAS), Kilimanjaro Christian Medical University College (KCMUCo) and Catholic University of Health and Allied Sciences (CUHAS) in Tanzania. These institutions have witnessed increased externally-funded research and development project activities over the past two decades. They are affiliated to renowned referral hospitals: MUHAS is affiliated with the Muhimbili National Referral Hospital; KCMUCo with the Kilimanjaro Christian Medical Centre (KCMC); and CUHAS with the Bugando Medical Centre (BMC) which serve as appropriate premises to carry out both biomedical and social and behavioral sciences (non-biomedical) research. The Audited Final Financial Reports (FFR) for externally funded research projects from January 1, 2007 and closed by December 31, 2017, were obtained from the appropriate offices at each institution. The FFRs contained details of specific expenditures for each project and amounts used during a specific period of funding, and cumulative amounts for each category listed in the FFR. These categories included salaries and wages, consultancies, travel, laboratory fees, equipment, supplies and materials, training-related expenses, and regulatory fees, among others. For each cost category, we collaborated with institutional departments (e.g., finance, human resources, procurement) to identify additional associated costs not typically covered by grants but essential for project implementation. For example, if a specific project needed to hire staff to work on the project, we worked with the human resources department and identified the cost of advertising for the position and costs associated with interviewing process, hiring, Social Security contributions, payroll/wage bills, relocation/subsistence allowances and orientation/induction. These costs are expected to be paid by the IHL and not the project because they are considered unallowable. We developed a cost matrix for each category and applied it to both biomedical and non-biomedical projects. For the purpose of this study, biomedical researches were taken as those focusing on the biological and physiological aspects of health and disease while behavioral sciences (non-biomedical) researches were those dwelling on capacity building or those studying human behavior, motivations, and decision-making processes to understand social and psychological factors that influence health and well-being. For credibility, we worked closely with the respective heads of departments that perform these activities to develop the assigned associated costs from previous experience and current activity costs. For biomedical projects, both equipment and human resource components were considered in estimating the unaccounted indirect costs while for non-biomedical projects the main component was human resource. Data analysis was performed using Stata Version 15 (StataCorp LP, Texas). Descriptive statistics (median/mean and standard deviation/interquartile range) and graphs were used to summarize the collected numerical data. Comparisons between biomedical and non-biomedical externally-funded research funds for unaccounted costs and indirect cost rates were summarized using graphs. Ethics Committee approvals were obtained from the KCMUCo Ethical Review Board, the MUHAS Research Ethics Committee, and the CUHAS Research Ethics Committee. Results Seventeen projects were investigated, of which 6 (35.3%) were biomedical and 11 (64.7%) non-biomedical. Of the six biomedical sponsored research projects, three were conducted at KCMUCo, two at MUHAS, and one at CUHAS. Of the 11 non-biomedical research projects, two were conducted at KCMUCo, four at MUHAS, and five at CUHAS. The median total amount of project funding for all biomedical donor-funded research projects was United States Dollars (USD) 544,084; interquartile range (IQR) 89,268-1,226,570. The median (IQR) amount of direct costs being USD 480,600 (76,851-1,190,008) while the median (IQR) for indirect costs was USD 63,484 (12,417 − 117,562). The median (IQR) of unaccounted costs was USD 186,403 (30,583–420,223) and the average unaccounted cost rate on total project cost (unaccounted costs/total project costs) for biomedical donor-funded research projects was 34.3%. The results are shown in Table 1 . Table 1 Biomedical Project Costs Project ID Direct costs (USD) Indirect costs (USD) Total project costs (USD) Unaccounted costs (USD) (personnel + equipment) KB-1 50,876 3,617 54,493 18,669 KB-2 1,205,055 118,887 1,323,943 453,583 MB-1 3,068,685 414,402 3,483,087 1,193,306 KB-3 820,867 113,586 934,453 320,144 MB-2 140,333 13,381 153,714 52,662 CB-1 55,690 12,096 67,786 23,223 Median (IQR) 480,600 (76,851-1,190,008) 63,484 (12,417 − 117,562) 544,084 (89,268-1.226,570) 186,403 (30,583 − 420,223) Unaccounted cost rate 34.3% Note : ID = Identity; USD = United States Dollar; IQR = Interquartile Range The median (IQR) total amount of project funding for non-biomedical donor-funded research projects was USD 902,999 (468,259–1,951,212). The median (IQR) amount of direct costs was USD 790,959 (425,699–1,543,345) while the median (IQR) for indirect costs was USD 24,144 (0–137,301). The median (IQR) for unaccounted costs (unfunded by the funder) was USD 112,875 (58,532–243,902) with the average rate on total project cost of 12.5% (Table 2 ). Table 2 Behavioral and Social Sciences (Non-Biomedical) Project Costs Project ID Direct costs (USD) Indirect costs (USD) Total project costs (USD) Unaccounted-for costs (USD) (Personnel) MNB-1 527,777 - 527,777 65,972 KNB-1 8,837,056 574,015 9,411,071 1,176,384 MNB-2 212,205 1,484 213,689 26,711 KNB-2 1,813,911 137,301 1,951,212 243,902 MNB-3 1,543,345 - 1,543,345 192,918 MNB-4 36,859 24,144 61,003 7,625 CNB-1 790,959 112,040 902,999 112,875 CNB-2 746,511 - 746,511 93,314 CNB-3 425,699 42,560 468,259 58,532 CNB-4 1,310,563 - 1,310,563 163,820 CNB-5 1,313,630 898,590 2,212,220 276,528 Median (IQR) 970,959 (425,699-1,543,345) 24,144 (0-137,301) 902,999 (468,259-1,951,212 112,875 (58,532 − 243,902) Unaccounted costs rate 12.5% Note : ID = Identity; USD = United States Dollar; IQR = Interquartile Range In summary, we note that (i) the larger the sponsored research fund size, the higher the unaccounted cost amount; and (ii) though the median total costs for non-biomedical donor-funded projects were more than 1.4 times higher than those for non-biomedical projects, the median of unaccounted costs for biomedical donor-funded projects was 1.7 times higher than the median of non-biomedical projects (USD 186,403 vs. 112,875). The corresponding unaccounted rate was 34.3% vs. 12.5% of total budgets respectively. Figure 1 shows the comparison of the proportion of total unaccounted costs to total direct costs for biomedical and non-biomedical sponsored research projects according to study institution. It can be observed that the proportion of total unaccounted costs for biomedical research is considerably higher than for non-biomedical sponsored research (range: 38.2–41.7% vs. 12.6–15.4%). KCMUCo = Kilimanjaro Christian Medical University College; MUHAS = Muhimbili University of Health and Allied Sciences; CUHAS = Catholic University of Health and Allied Sciences Figure 1: Comparison of proportion of hidden costs to total amount of direct costs by type of project according to study institution Figure 2 shows the proportion of indirect costs to total direct costs, that is, indirect cost rate (ICR) according to study institution by type of sponsored research. It can be observed that the proportion of indirect cost to total direct costs for biomedical research are relatively higher than for non-biomedical. The average proportion of indirect costs to total direct costs for biomedical research is 15.5% (range = 11.4–21.7%) compared to non-biomedical of 7.7% (range = 1.1–15.4%). In general, the average indirect cost rates for both biomedical and non-biomedical sponsored research are small. KCMUCo = Kilimanjaro Christian Medical University College; MUHAS = Muhimbili University of Health and Allied Sciences; CUHAS = Catholic University of Health and Allied Sciences Figure 2: Proportion of indirect costs to total amount of direct costs by type of project according to study institution Discussion This study examined the costing practices of sponsored research practices in LMIC IHLs and their implications for unaccounted costs that are borne by IHLs. Our study demonstrated that the higher the amount of the sponsored project, the higher are the unaccounted costs. Also, we established that despite the median total amount of non-biomedical sponsored projects being about one-and-a-half times that of biomedical projects, the median amount of unaccounted costs for biomedical projects was more than twice compared to those of non-biomedical projects, which implies that unaccounted costs for biomedical sponsored research are considerably higher than those for non-biomedical sponsored research projects. The fact that the higher the total amount of the sponsored research, the higher the unaccounted costs could be attributed to higher indirect costs of the human resource component (for non-biomedical), including the high-tech equipment component (for biomedical projects) that are included in such projects. As expected, such projects may involve a large and diversified group of human resources for non-biomedical, leading to increased amount of unaccounted costs. Ehrenberg and Mykula 6 assert that there is a perception among principal investigators that by excluding some indirect costs, the chance of getting funds for sponsored research increases. This propensity may be directly related to the size of the budget requested for the sponsored research. Furthermore, applicants may exclude some indirect costs with the assumption that they are unallowable by the funder 14 . A US National Science Foundation report in 1991 enumerated deficiencies in the calculation and application of indirect costs of federally sponsored research in educational and other institutions, including underestimating indirect costs to make an applicant’s grant more competitive and assigning responsibility for reviewing indirect costs to inexperienced or poorly trained staff to accomplish the assignment effectively 15 . In most LMIC instances, the indirect cost rates are based on what the funder allows or are an estimated rate 14 . Due to this fact, there is a wide variation of indirect cost rates in LMICs, from 0% to 15% of direct costs 14 . As a result of these factors, the indirect costs from a grant award rarely cover the actual indirect costs 10 , 11 . Inadequate indirect costs can undermine the capacity of IHLs to conduct high-quality research, diminish their ability to maintain infrastructure, and place unnecessary financial strain on their budgets. This study also found that although the median amount for non-biomedical was higher than biomedical sponsored projects, the reverse was the case for the median amount of unaccounted costs, implying that unaccounted costs for biomedical are generally higher than for non-biomedical research projects. This could be attributed to differences inherent in biomedical vs. non-biomedical sponsored research projects. Biomedical research may involve clinical trials, which are studies using volunteers designed to answer safety and efficacy questions about interventions 15 and are characterized by longer durations, high-tech equipment, varied supplies, and larger number and more diversified human resources. Non-biomedical research in medical schools is most commonly geared toward enhancing medical education and therefore, mostly cross-sectional involving a great amount of human resource component. This implies that higher unaccounted costs in sponsored biomedical compared to non-biomedical research projects can undermine financial sustainability, compromise research quality, and strain institutional resources, especially in IHLs in LMICs where indirect cost recovery is often insufficient. These study results should be interpreted with caution. This was an exploratory attempt to highlight costs that IHLs incur by undertaking sponsored research. First, the findings may contain inherent weaknesses pertinent to the use of retrospective data due to unreliability of secondary data. Second, it was not possible to examine the external validity of the study for purposes of generalizability to other LMIC IHLs. Despite the fact that the findings from this study are specific to three IHLs in Tanzania, their implications could be relevant to other medical schools and IHLs in Tanzania, sub-Saharan Africa, and LMICs worldwide. Conclusion The study highlights the significant burden of unaccounted-for costs for sponsored projects at LMIC IHLs. This is consequential to LMIC institutions because it may be difficult to recover the full cost of a specific sponsored project. Given this deficit in cost-recovery from sponsored projects, there is a direct negative impact on their ability to sustain the research enterprise and sponsored projects may drain meager institutional resources. It is imperative for IHLs and funding agencies to cooperate in developing equitable and fair indirect cost rates. This effort is especially important when the decolonization movement in global health is highly visible and active. In summary, this study reveals a persistent gap in the understanding, application, and reimbursement of indirect costs in LMIC research institutions. Bridging this gap will require intentional and cooperative action to reduce inequities in research funding and support sustainable research capacity across LMICs. Declarations Ethics approval and consent to participate The study was reviewed and approved by the Kilimanjaro Christian Medical University College Ethical Review Board, the Muhimbili University of Health and Allied Sciences Research Ethics Committee, and the Catholic University of Health and Allied Sciences Research Ethics Committee. All participants provided written informed consent. Consent for publication All participants consented for the publication of study results. Availability of data and material The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. Competing interests None of the authors have any competing interests. Funding No funding was obtained for this study. Author contributions : ATK -Conceptualization, investigation, project administration, writing the manuscript; GEK- Formal Analysis, methodology and visualization; JAB - Validation, supervision, review and editing the manuscript; CM - Methodology, data curation and original draft preparation; and SdeJ – Supervision Acknowledgements: The authors thank all the stakeholders including study participants, leadership at MUHAS, KCMUCo, CUHAS who participated to provide inputs to develop this piece of work that advocates resources equity across the globe. References World University rankings [Internet]. 2019 [cited 2019 June 30]. 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ESSENCE on Health Research (2020) The Five Keys To Improving Research Costing and Pricing in Low-and Middle-Income Countries [Internet]. 2020 [cited 2021 Nov 12]. Available at https://www.who.int/tdr/partnerships/essence/en/ Ehrenberg, RG, & Mykula, JK. Merit pay for school superintendents? (NBER Working Paper Series No. 6976) [Electronic version]. Cambridge, MA: National Bureau of Economic Research; 1999. Association of Universities and Colleges of Canada. “Funding the Institutional Costs of Research: An International Perspective” [Internet]. 2009 [cited 2020 Sept 01]. Available from: https://www.uoguelph.ca/research/document/funding-institutional-costs-researchinternational-perspective Office of Sponsored Programs, Southern Illinois University (2019). Guidelines [Internet]. 2019 [cited 2019 June 30]. Available from: https://ospa.siu.edu/_common/documents/IDC%20Guidelines.pdf. Fonn S, Hu J, Igumbor JO, et al. Quantifying the cost of in-kind contributions to a multi-donor-funded health research capacity building programme: the case of the Consortium for Advanced Research Training in Africa. BMJ Global Health 2020;5:e002286. doi:10.1136/ bmjgh-2020-002286 Watt, C, & Higerd, T. Indirect costs and other uses of facilities data at institutions. New Directions for Institutions . 2007;135: 47–61. doi:10.1002/ir.222. Wimsatt, L, Trice, A, & Langley, D. ‘Faculty perspectives on academic work and administrative burden: Implications for the design of effective support services.’ Free Library . September 22, 2009 [cited 2010 Nov 17]. Available from: http://www.thefreelibrary.com/Faculty Perspectives on Academic Work and Administrative Burden…a0213601797. Goldman CA, Williams T, Adamson DM, Rosenblatt K. Paying for University Research Facilities and Administration. 2000. Available from: https://www.rand.org/pubs/monograph_reports/MR1135.html Association of American Universities (AAU) and the Association of Public and Land Grant Universities (APLU). Understanding the costs of federally sponsored research at universities . October 2013. Available from: https://www.ucop.edu/research-policy-analysis-coordination/policies-guidance/indirect-cost-recovery/Understanding-the-Costs-of-Federally-Sponsored-Research-at-Universities.pdf ESSENCE. Five keys to improving research costing in low- and middle-income countries. Geneva: ESSENCE, TDR/WHO. 2012a. Available from: http://whqlibdoc.who.int/hq/2012/TDR_ESSENCE_1.12_eng.pdf Office for the Protection of Human Subjects - University of Illinois. Types of research [Internet]. n.d. [cited 2021 June 22]. Available from: https://oprs.research.illinois.edu. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8879897","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":633667674,"identity":"e66d594b-3872-4c01-bd6f-c67bc64f7ea6","order_by":0,"name":"Ahaz T. 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Kapanda","email":"","orcid":"","institution":"Kilimanjaro Christian Medical University College","correspondingAuthor":false,"prefix":"","firstName":"Gibson","middleName":"E.","lastName":"Kapanda","suffix":""},{"id":633667678,"identity":"ca672e0d-d5eb-4f0b-aee2-ef2cf4c1a987","order_by":2,"name":"John A. Bartlett","email":"","orcid":"","institution":"Duke Global Health Institute- Duke University","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"A.","lastName":"Bartlett","suffix":""},{"id":633667679,"identity":"bee8eafe-75c4-4362-aeed-35906df9ae03","order_by":3,"name":"Charles Muiruri","email":"","orcid":"","institution":"Duke Global Health Institute- Duke University","correspondingAuthor":false,"prefix":"","firstName":"Charles","middleName":"","lastName":"Muiruri","suffix":""},{"id":633667684,"identity":"2f525023-2c3d-4a0d-8907-9810a8ee7e20","order_by":4,"name":"Stef Jong","email":"","orcid":"","institution":"Human Resource, European University - Business School","correspondingAuthor":false,"prefix":"","firstName":"Stef","middleName":"","lastName":"Jong","suffix":""}],"badges":[],"createdAt":"2026-02-14 12:24:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8879897/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8879897/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108389052,"identity":"0c88d7a4-7562-41c0-85ee-4f17beaba481","added_by":"auto","created_at":"2026-05-04 06:45:56","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":22618,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of proportion of hidden costs to total amount of direct costs by type of project according to study institution\u003c/p\u003e\n\u003cp\u003eKCMUCo = Kilimanjaro Christian Medical University College; MUHAS = Muhimbili University of Health and Allied Sciences; CUHAS = Catholic University of Health and Allied Sciences\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-8879897/v1/385bfa96ff2d6b6c1dc48be9.png"},{"id":108389053,"identity":"6a8dc96d-4761-465e-ba0c-d2a140e18269","added_by":"auto","created_at":"2026-05-04 06:45:56","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":22910,"visible":true,"origin":"","legend":"\u003cp\u003eProportion of indirect costs to total amount of direct costs by type of project according to study institution\u003c/p\u003e\n\u003cp\u003eKCMUCo = Kilimanjaro Christian Medical University College; MUHAS = Muhimbili University of Health and Allied Sciences; CUHAS = Catholic University of Health and Allied Sciences\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-8879897/v1/d7ff854971aad4b181f457bb.png"},{"id":108493834,"identity":"e7256add-7615-4aef-8bbb-dc48f7889ef8","added_by":"auto","created_at":"2026-05-05 10:01:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":281559,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8879897/v1/945b1c13-53f0-45d1-b5d7-e17463bd04b8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eGaps in Indirect Cost Funding for Research in Low-and Middle-Income\u003c/p\u003e","fulltext":[{"header":"Key Massages","content":"\u003cul\u003e\n \u003cli\u003eAlthough research grants typically cover direct project costs, they often do not fully cover ancillary costs necessary to support the broader research infrastructure in low- and middle-income countries.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eThis study offers a novel analysis of how institutions of higher learning in low- and middle-income countries incur costs while conducting sponsored research.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eTo compete successfully for external support, institutions of higher learning (IHLs) must invest in the research enterprise \u0026ndash; building infrastructure, recruiting competent investigators, maintaining laboratories, and data systems among others. These investments often yield both academic and economic benefits as research productivity and institutional prestige are key contributors to the institution\u0026rsquo;s global academic rankings\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn high-income countries (HIC), governments and philanthropies are key external funders of research in IHLs. With growth of economies in low- and middle-income countries (LMICs) such as African countries, there has been an impetus to recognize the value of research for sustainable development. As a result, in 2007 African leaders pledged to intensify government funding of research infrastructure\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Regrettably, this pledge has not been realized; most research in LMICs is funded by international organizations. Governments commit minimal or no portion of their budgets to research. For example, Franzen et al.\u003csup\u003e3\u003c/sup\u003e observed that research in LMICs is challenged with poor investment by governments and in-country philanthropies. It is estimated that almost 80% of research funding in LMICs originates from external sources\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e who invest resources on the basis of their goals and objectives. The paucity of local funding and underfunding of sponsored research from external funders challenges sustainability of the research enterprise in LMIC\u0026rsquo;s IHLs\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIHL-sponsored research budgets are typically consisted of components; (1) direct costs and (2) indirect costs, also known as overhead or facilities and administrative (F\u0026amp;A) costs. Direct costs are costs that are directly linked to the project activities such as salaries for investigators, graduate assistants, post-doctoral fellows, laboratory technicians; computers and durable equipment, and expendable commodities such as reagents, travel, communications, and clerical assistance\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIndirect costs cover a portion of the IHL\u0026rsquo;s infrastructure and operational costs necessary to conduct the research, not directly linked to specific project activities\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. These include all of the basic facilities and administrative infrastructure to run an institution, such as utilities, maintenance, payroll and purchasing. Additionally, the indirect cost recovery supports the research enterprise by funding research initiatives, and research and shared facilities\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAlthough research grants cover costs directly associated with specific projects, they do not fully cover costs that cannot be directly attributed to one project\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Institutions conducting sponsored research may end up spending considerable unaccounted funds and resources to ensure a successful project\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. According to Dr. Kelvin K. Drogemeier, University of Oklahoma Vice President for Research, while performing sponsored research IHLs incur a variety of significant costs, both direct and indirect, prior to and during a specific research project that they would otherwise not incur\u003csup\u003e\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eFonn et al.\u003csup\u003e9\u003c/sup\u003e further highlights the role of in-kind contributions which can account to up to 42% of the total resources used in a project. These include unremunerated labor by faculty, use of physical and infrastructure resources, and unremunerated indirect costs in project implementation. These contributions are provided by faculty who devote unremunerated time that is not counted as part of the institution\u0026rsquo;s responsibilities apart from their teaching, supervisory, and administrative roles. Without these in-kind contributions, the realization of set goals and impact of such sponsored research projects would be difficult, if not impossible.\u003c/p\u003e \u003cp\u003eMost LMIC institutions do not have policies on research costing and thus most F\u0026amp;A rates are based on funder discretion\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Consequently, these rates often vary widely - from 0% to 15% of direct costs which, in general, are considerably lower than indirect costs in IHLs in HICs\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eDespite an increase in funding for sponsored research in LMICs in the past decade, a quantifiable relationship between the funds requested from funding agencies and the actual cost of paying for such projects at IHLs is poorly understood. To our knowledge, there has not been a comprehensive evaluation of adequacy of indirect costs at IHLs in LMICs to inform institutional policies on equitable distribution of research funding. It is within this premise that we conducted this study to identify the gaps in indirect cost funding at IHLs in LMICs by quantifying the actual costs of conducting sponsored research.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThis descriptive cross-sectional study was conducted at the Muhimbili University of Health and Allied Sciences (MUHAS), Kilimanjaro Christian Medical University College (KCMUCo) and Catholic University of Health and Allied Sciences (CUHAS) in Tanzania. These institutions have witnessed increased externally-funded research and development project activities over the past two decades. They are affiliated to renowned referral hospitals: MUHAS is affiliated with the Muhimbili National Referral Hospital; KCMUCo with the Kilimanjaro Christian Medical Centre (KCMC); and CUHAS with the Bugando Medical Centre (BMC) which serve as appropriate premises to carry out both biomedical and social and behavioral sciences (non-biomedical) research.\u003c/p\u003e \u003cp\u003eThe Audited Final Financial Reports (FFR) for externally funded research projects from January 1, 2007 and closed by December 31, 2017, were obtained from the appropriate offices at each institution. The FFRs contained details of specific expenditures for each project and amounts used during a specific period of funding, and cumulative amounts for each category listed in the FFR. These categories included salaries and wages, consultancies, travel, laboratory fees, equipment, supplies and materials, training-related expenses, and regulatory fees, among others. For each cost category, we collaborated with institutional departments (e.g., finance, human resources, procurement) to identify additional associated costs not typically covered by grants but essential for project implementation. For example, if a specific project needed to hire staff to work on the project, we worked with the human resources department and identified the cost of advertising for the position and costs associated with interviewing process, hiring, Social Security contributions, payroll/wage bills, relocation/subsistence allowances and orientation/induction. These costs are expected to be paid by the IHL and not the project because they are considered unallowable. We developed a cost matrix for each category and applied it to both biomedical and non-biomedical projects. For the purpose of this study, biomedical researches were taken as those focusing on the biological and physiological aspects of health and disease while behavioral sciences (non-biomedical) researches were those dwelling on capacity building or those studying human behavior, motivations, and decision-making processes to understand social and psychological factors that influence health and well-being. For credibility, we worked closely with the respective heads of departments that perform these activities to develop the assigned associated costs from previous experience and current activity costs. For biomedical projects, both equipment and human resource components were considered in estimating the unaccounted indirect costs while for non-biomedical projects the main component was human resource.\u003c/p\u003e \u003cp\u003eData analysis was performed using Stata Version 15 (StataCorp LP, Texas). Descriptive statistics (median/mean and standard deviation/interquartile range) and graphs were used to summarize the collected numerical data. Comparisons between biomedical and non-biomedical externally-funded research funds for unaccounted costs and indirect cost rates were summarized using graphs.\u003c/p\u003e \u003cp\u003eEthics Committee approvals were obtained from the KCMUCo Ethical Review Board, the MUHAS Research Ethics Committee, and the CUHAS Research Ethics Committee.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eSeventeen projects were investigated, of which 6 (35.3%) were biomedical and 11 (64.7%) non-biomedical. Of the six biomedical sponsored research projects, three were conducted at KCMUCo, two at MUHAS, and one at CUHAS. Of the 11 non-biomedical research projects, two were conducted at KCMUCo, four at MUHAS, and five at CUHAS.\u003c/p\u003e \u003cp\u003eThe median total amount of project funding for all biomedical donor-funded research projects was United States Dollars (USD) 544,084; interquartile range (IQR) 89,268-1,226,570. The median (IQR) amount of direct costs being USD 480,600 (76,851-1,190,008) while the median (IQR) for indirect costs was USD 63,484 (12,417\u0026thinsp;\u0026minus;\u0026thinsp;117,562). The median (IQR) of unaccounted costs was USD 186,403 (30,583\u0026ndash;420,223) and the average unaccounted cost rate on total project cost (unaccounted costs/total project costs) for biomedical donor-funded research projects was 34.3%. The results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBiomedical Project Costs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProject ID\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDirect costs (USD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndirect costs (USD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal project costs (USD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUnaccounted costs (USD) (personnel\u0026thinsp;+\u0026thinsp;equipment)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKB-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50,876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3,617\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54,493\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18,669\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKB-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,205,055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118,887\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,323,943\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e453,583\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMB-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3,068,685\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e414,402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3,483,087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,193,306\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKB-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e820,867\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113,586\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e934,453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e320,144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMB-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e140,333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13,381\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e153,714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52,662\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCB-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55,690\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12,096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67,786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23,223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e480,600\u003c/p\u003e \u003cp\u003e(76,851-1,190,008)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63,484\u003c/p\u003e \u003cp\u003e(12,417\u0026thinsp;\u0026minus;\u0026thinsp;117,562)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e544,084\u003c/p\u003e \u003cp\u003e(89,268-1.226,570)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e186,403\u003c/p\u003e \u003cp\u003e(30,583\u0026thinsp;\u0026minus;\u0026thinsp;420,223)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnaccounted cost rate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eNote\u003c/em\u003e: ID\u0026thinsp;=\u0026thinsp;Identity; USD\u0026thinsp;=\u0026thinsp;United States Dollar; IQR\u0026thinsp;=\u0026thinsp;Interquartile Range\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe median (IQR) total amount of project funding for non-biomedical donor-funded research projects was USD 902,999 (468,259\u0026ndash;1,951,212). The median (IQR) amount of direct costs was USD 790,959 (425,699\u0026ndash;1,543,345) while the median (IQR) for indirect costs was USD 24,144 (0\u0026ndash;137,301). The median (IQR) for unaccounted costs (unfunded by the funder) was USD 112,875 (58,532\u0026ndash;243,902) with the average rate on total project cost of 12.5% (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBehavioral and Social Sciences (Non-Biomedical) Project Costs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProject ID\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDirect costs (USD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndirect costs (USD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal project costs (USD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUnaccounted-for costs (USD) (Personnel)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNB-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e527,777\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e527,777\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65,972\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKNB-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8,837,056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e574,015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9,411,071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1,176,384\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNB-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e212,205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1,484\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e213,689\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26,711\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKNB-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,813,911\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137,301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,951,212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e243,902\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNB-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,543,345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,543,345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e192,918\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNB-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36,859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24,144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61,003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7,625\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNB-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e790,959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112,040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e902,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e112,875\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNB-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e746,511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e746,511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e93,314\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNB-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e425,699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42,560\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e468,259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58,532\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNB-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,310,563\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1,310,563\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e163,820\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNB-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1,313,630\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e898,590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2,212,220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e276,528\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e970,959\u003c/p\u003e \u003cp\u003e(425,699-1,543,345)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24,144 (0-137,301)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e902,999\u003c/p\u003e \u003cp\u003e(468,259-1,951,212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e112,875\u003c/p\u003e \u003cp\u003e(58,532\u0026thinsp;\u0026minus;\u0026thinsp;243,902)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnaccounted costs rate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eNote\u003c/em\u003e: ID\u0026thinsp;=\u0026thinsp;Identity; USD\u0026thinsp;=\u0026thinsp;United States Dollar; IQR\u0026thinsp;=\u0026thinsp;Interquartile Range\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn summary, we note that (i) the larger the sponsored research fund size, the higher the unaccounted cost amount; and (ii) though the median total costs for non-biomedical donor-funded projects were more than 1.4 times higher than those for non-biomedical projects, the median of unaccounted costs for biomedical donor-funded projects was 1.7 times higher than the median of non-biomedical projects (USD 186,403 vs. 112,875). The corresponding unaccounted rate was 34.3% vs. 12.5% of total budgets respectively.\u003c/p\u003e \u003cp\u003eFigure 1 shows the comparison of the proportion of total unaccounted costs to total direct costs for biomedical and non-biomedical sponsored research projects according to study institution. It can be observed that the proportion of total unaccounted costs for biomedical research is considerably higher than for non-biomedical sponsored research (range: 38.2\u0026ndash;41.7% vs. 12.6\u0026ndash;15.4%).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eKCMUCo\u0026thinsp;=\u0026thinsp;Kilimanjaro Christian Medical University College; MUHAS\u0026thinsp;=\u0026thinsp;Muhimbili University of Health and Allied Sciences; CUHAS\u0026thinsp;=\u0026thinsp;Catholic University of Health and Allied Sciences\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 1: Comparison of proportion of hidden costs to total amount of direct costs by type of project according to study institution\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFigure 2 shows the proportion of indirect costs to total direct costs, that is, indirect cost rate (ICR) according to study institution by type of sponsored research. It can be observed that the proportion of indirect cost to total direct costs for biomedical research are relatively higher than for non-biomedical. The average proportion of indirect costs to total direct costs for biomedical research is 15.5% (range\u0026thinsp;=\u0026thinsp;11.4\u0026ndash;21.7%) compared to non-biomedical of 7.7% (range\u0026thinsp;=\u0026thinsp;1.1\u0026ndash;15.4%). In general, the average indirect cost rates for both biomedical and non-biomedical sponsored research are small.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eKCMUCo\u0026thinsp;=\u0026thinsp;Kilimanjaro Christian Medical University College; MUHAS\u0026thinsp;=\u0026thinsp;Muhimbili University of Health and Allied Sciences; CUHAS\u0026thinsp;=\u0026thinsp;Catholic University of Health and Allied Sciences\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 2: Proportion of indirect costs to total amount of direct costs by type of project according to study institution\u003c/b\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined the costing practices of sponsored research practices in LMIC IHLs and their implications for unaccounted costs that are borne by IHLs. Our study demonstrated that the higher the amount of the sponsored project, the higher are the unaccounted costs. Also, we established that despite the median total amount of non-biomedical sponsored projects being about one-and-a-half times that of biomedical projects, the median amount of unaccounted costs for biomedical projects was more than twice compared to those of non-biomedical projects, which implies that unaccounted costs for biomedical sponsored research are considerably higher than those for non-biomedical sponsored research projects.\u003c/p\u003e \u003cp\u003eThe fact that the higher the total amount of the sponsored research, the higher the unaccounted costs could be attributed to higher indirect costs of the human resource component (for non-biomedical), including the high-tech equipment component (for biomedical projects) that are included in such projects. As expected, such projects may involve a large and diversified group of human resources for non-biomedical, leading to increased amount of unaccounted costs. Ehrenberg and Mykula\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e assert that there is a perception among principal investigators that by excluding some indirect costs, the chance of getting funds for sponsored research increases. This propensity may be directly related to the size of the budget requested for the sponsored research. Furthermore, applicants may exclude some indirect costs with the assumption that they are unallowable by the funder\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. A US National Science Foundation report in 1991 enumerated deficiencies in the calculation and application of indirect costs of federally sponsored research in educational and other institutions, including underestimating indirect costs to make an applicant\u0026rsquo;s grant more competitive and assigning responsibility for reviewing indirect costs to inexperienced or poorly trained staff to accomplish the assignment effectively\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. In most LMIC instances, the indirect cost rates are based on what the funder allows or are an estimated rate\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Due to this fact, there is a wide variation of indirect cost rates in LMICs, from 0% to 15% of direct costs\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. As a result of these factors, the indirect costs from a grant award rarely cover the actual indirect costs\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Inadequate indirect costs can undermine the capacity of IHLs to conduct high-quality research, diminish their ability to maintain infrastructure, and place unnecessary financial strain on their budgets.\u003c/p\u003e \u003cp\u003eThis study also found that although the median amount for non-biomedical was higher than biomedical sponsored projects, the reverse was the case for the median amount of unaccounted costs, implying that unaccounted costs for biomedical are generally higher than for non-biomedical research projects. This could be attributed to differences inherent in biomedical vs. non-biomedical sponsored research projects. Biomedical research may involve clinical trials, which are studies using volunteers designed to answer safety and efficacy questions about interventions\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e and are characterized by longer durations, high-tech equipment, varied supplies, and larger number and more diversified human resources. Non-biomedical research in medical schools is most commonly geared toward enhancing medical education and therefore, mostly cross-sectional involving a great amount of human resource component. This implies that higher unaccounted costs in sponsored biomedical compared to non-biomedical research projects can undermine financial sustainability, compromise research quality, and strain institutional resources, especially in IHLs in LMICs where indirect cost recovery is often insufficient.\u003c/p\u003e \u003cp\u003eThese study results should be interpreted with caution. This was an exploratory attempt to highlight costs that IHLs incur by undertaking sponsored research. First, the findings may contain inherent weaknesses pertinent to the use of retrospective data due to unreliability of secondary data. Second, it was not possible to examine the external validity of the study for purposes of generalizability to other LMIC IHLs. Despite the fact that the findings from this study are specific to three IHLs in Tanzania, their implications could be relevant to other medical schools and IHLs in Tanzania, sub-Saharan Africa, and LMICs worldwide.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study highlights the significant burden of unaccounted-for costs for sponsored projects at LMIC IHLs. This is consequential to LMIC institutions because it may be difficult to recover the full cost of a specific sponsored project. Given this deficit in cost-recovery from sponsored projects, there is a direct negative impact on their ability to sustain the research enterprise and sponsored projects may drain meager institutional resources.\u003c/p\u003e \u003cp\u003eIt is imperative for IHLs and funding agencies to cooperate in developing equitable and fair indirect cost rates. This effort is especially important when the decolonization movement in global health is highly visible and active. In summary, this study reveals a persistent gap in the understanding, application, and reimbursement of indirect costs in LMIC research institutions. Bridging this gap will require intentional and cooperative action to reduce inequities in research funding and support sustainable research capacity across LMICs.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was reviewed and approved by the Kilimanjaro Christian Medical University College Ethical Review Board, the Muhimbili University of Health and Allied Sciences Research Ethics Committee, and the Catholic University of Health and Allied Sciences Research Ethics Committee. \u0026nbsp;All participants provided written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants consented for the publication of study results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone of the authors have any competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e: ATK -Conceptualization, investigation, \u0026nbsp; project administration, \u0026nbsp;writing the manuscript; GEK- Formal Analysis, methodology and visualization; JAB - Validation, supervision, review and editing the manuscript; CM - Methodology, data curation and original draft preparation; and SdeJ – Supervision\u003c/p\u003e\n\u003cp\u003eAcknowledgements: The authors thank all the stakeholders including study participants, leadership at MUHAS, KCMUCo, CUHAS who participated to provide inputs to develop this piece of work that advocates resources equity across the globe.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eWorld University rankings [Internet]. 2019 [cited 2019 June 30]. Available from: http://roundranking.com/ranking/world-university-rankings.html#world-2019.\u003c/li\u003e\n \u003cli\u003eAfrican Union. \u003cem\u003eAssembly of the African Union Eight Ordinary Session – Decisions and declarations\u003c/em\u003e [Internet]. Available from: https://au.int/sites/default/files/decisions/9556-assembly_en_29_30_ January_2007_auc_the_african_union_eighth_ordinary_session.pdf. Retrieved May 30, 2019\u003c/li\u003e\n \u003cli\u003eFranzen, SR, Chandler, C, \u0026amp; Lang, T. ‘Health research capacity development in low- and middle-income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature,’\u003cem\u003eBMJ \u003c/em\u003eOpen. 2017;7, p.e012332\u003c/li\u003e\n \u003cli\u003eMusiige, G., Maassen, P. ‘Faculty perceptions of the factors that influence research productivity at Makerere University” in N. Cloete, P. Maassen, and T. Bailey (eds), \u003cem\u003eKnowledge Production and Contradictory Functions in African Higher Education\u003c/em\u003e. Cape Town: African Minds; 2015.\u003c/li\u003e\n \u003cli\u003eESSENCE on Health Research (2020) \u003cem\u003eThe Five Keys To Improving Research Costing and Pricing in Low-and Middle-Income Countries \u003c/em\u003e[Internet]. 2020 [cited 2021 Nov 12]. Available at https://www.who.int/tdr/partnerships/essence/en/\u003c/li\u003e\n \u003cli\u003eEhrenberg, RG, \u0026amp; Mykula, JK. Merit pay for school superintendents? (NBER Working Paper Series No. 6976) [Electronic version]. Cambridge, MA: National Bureau of Economic Research; 1999.\u003c/li\u003e\n \u003cli\u003eAssociation of Universities and Colleges of Canada. “Funding the Institutional Costs of Research: An International Perspective” [Internet]. 2009 [cited 2020 Sept 01]. Available from: https://www.uoguelph.ca/research/document/funding-institutional-costs-researchinternational-perspective\u003c/li\u003e\n \u003cli\u003eOffice of Sponsored Programs, Southern Illinois University (2019). \u003cem\u003eGuidelines \u003c/em\u003e[Internet]. 2019 [cited 2019 June 30]. Available from: https://ospa.siu.edu/_common/documents/IDC%20Guidelines.pdf.\u003c/li\u003e\n \u003cli\u003eFonn S, Hu J, Igumbor JO, et al. Quantifying the cost of in-kind contributions to a multi-donor-funded health research capacity building programme: the case of the Consortium for Advanced Research Training in Africa. BMJ Global Health 2020;5:e002286. doi:10.1136/ bmjgh-2020-002286\u003c/li\u003e\n \u003cli\u003eWatt, C, \u0026amp; Higerd, T. Indirect costs and other uses of facilities data at institutions. \u003cem\u003eNew Directions for Institutions\u003c/em\u003e. 2007;135: 47–61. doi:10.1002/ir.222.\u003c/li\u003e\n \u003cli\u003eWimsatt, L, Trice, A, \u0026amp; Langley, D. ‘Faculty perspectives on academic work and administrative burden: Implications for the design of effective support services.’ \u003cem\u003eFree Library\u003c/em\u003e. September 22, 2009 [cited 2010 Nov 17]. Available from: http://www.thefreelibrary.com/Faculty Perspectives on Academic Work and Administrative Burden…a0213601797.\u003c/li\u003e\n \u003cli\u003eGoldman CA, Williams T, Adamson DM, Rosenblatt K. Paying for University Research Facilities and Administration. 2000. Available from: https://www.rand.org/pubs/monograph_reports/MR1135.html\u003c/li\u003e\n \u003cli\u003eAssociation of American Universities (AAU) and the Association of Public and Land Grant Universities (APLU). \u003cem\u003eUnderstanding the costs of federally sponsored research at universities\u003c/em\u003e. October 2013. Available from: https://www.ucop.edu/research-policy-analysis-coordination/policies-guidance/indirect-cost-recovery/Understanding-the-Costs-of-Federally-Sponsored-Research-at-Universities.pdf\u003c/li\u003e\n \u003cli\u003eESSENCE. \u003cem\u003eFive keys to improving research costing in low- and middle-income countries. \u003c/em\u003eGeneva: ESSENCE, TDR/WHO. 2012a. Available from: http://whqlibdoc.who.int/hq/2012/TDR_ESSENCE_1.12_eng.pdf\u003c/li\u003e\n \u003cli\u003eOffice for the Protection of Human Subjects - University of Illinois. \u003cem\u003eTypes of research\u003c/em\u003e [Internet]. n.d. [cited 2021 June 22]. Available from: https://oprs.research.illinois.edu.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"health-research-policy-and-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrps","sideBox":"Learn more about [Health Research Policy and Systems](http://health-policy-systems.biomedcentral.com/)","snPcode":"12961","submissionUrl":"https://submission.nature.com/new-submission/12961/3","title":"Health Research Policy and Systems","twitterHandle":"@HarpsJournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Indirect cost of research, unaccounted costs, institutions of higher learning, low- and middle-income countries, sponsored research","lastPublishedDoi":"10.21203/rs.3.rs-8879897/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8879897/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e Research in low- and middle-income countries (LMICs) faces limited investment from both in-country governments and philanthropies. Although research grants cover costs directly associated with specific research projects, they often exclude indirect costs that are essential to supporting research activities. The gap between grant funding and actual cost of conducting research at institutions of higher learning (IHL) in LMICs remains poorly understood. This study aimed to identify and evaluate the indirect costs that are often unaccounted for in grants funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and methods:\u003c/strong\u003e We used a descriptive retrospective cross-sectional study to evaluate unaccounted costs atthree prominent medical universities in Tanzania. Data were obtained from annual Audited Final Reports and Final Financial Reports of sponsored biomedical and social and behavioral sciences projects funded between 2007 and \u0026nbsp;2017.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFindings:\u003c/strong\u003e A total of 17 projects were included in the study, of which 6 (35.3%) were biomedical and 11 (64.7%) non-biomedical. The median total amount of project funding for all biomedical research projects was US$ 544,084; interquartile range (IQR) [89,268-1,226,570]. These projects had median unaccounted costs of 34.3%, US$ 186,403 (IQR) [30,583–420,223]. The median funding for non-biomedical sponsored research projects was US$ 902,999 (IQR) [468,259–1,951,212] with unaccounted costs of 12.5%, US$ 112,875 (IQR) [58,532–243,902].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The study demonstrated that there were substantial unaccounted costs with sponsored research projects which can undermine financial sustainability, compromise research quality, and strain institutional resources. There is a need for IHLs in LMICs and funding agencies to work collaboratively to reduce the currently experienced research cost inequities.\u003c/p\u003e","manuscriptTitle":"Gaps in Indirect Cost Funding for Research in Low-and Middle-Income","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-04 06:45:52","doi":"10.21203/rs.3.rs-8879897/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-04-23T16:08:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-17T08:27:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-17T08:26:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"Health Research Policy and Systems","date":"2026-02-14T12:11:34+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"health-research-policy-and-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrps","sideBox":"Learn more about [Health Research Policy and Systems](http://health-policy-systems.biomedcentral.com/)","snPcode":"12961","submissionUrl":"https://submission.nature.com/new-submission/12961/3","title":"Health Research Policy and Systems","twitterHandle":"@HarpsJournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"35cca422-9789-42b3-ba76-4dccaf504a5e","owner":[],"postedDate":"May 4th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T06:45:52+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-04 06:45:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8879897","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8879897","identity":"rs-8879897","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}