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"id":"51f3280f-016d-43bc-826a-1fe1b011242c", "related_activity_context":"ID: GB-GOV-10-HPSR_Project_1\nTitle: NIHR Global Health Policy and Systems Research Projects: Call 1\nDescription: The UK Department of Health and Social Care (DHSC) funds outstanding global health research through the National Institute for Health and Care Research (NIHR). The NIHR Global Health Policy and Systems Research (Global HPSR) programme funds health policy and systems research that is directly and primarily of benefit to people in low- and middle-income countries (LMICs), to improve access to appropriate and affordable health services aligned with the aims of Universal Health Coverage and Sustainable Development Goal 3. Global HPSR Projects Call 1 supports applied health policy and systems research projects. UK and LMIC universities and research institutes were invited to submit applications including either a sole LMIC Lead Applicant, or two Joint Lead Applicants from either a LMIC or the UK, at least one of whom must be employed by a LMIC institution.. To support applied Health Policy and Systems Research Projects which:\n1) Will support new entrants to global health policy and systems research through smaller scale awards.\n2) Have clearly defined questions which specifically target an identified health policy and/or system(s) challenge or evidence gap and set out how the outcome of the research will benefit vulnerable populations in LMICs.\n3) Address priorities identified by and relevant to local stakeholders and policymakers, and deliver evidence and outcomes that will inform policy or change practice, for example informing local, regional or national strategies.\n4) Have plans to involve relevant communities and stakeholders to ensure that research objectives address their needs.\n5) Include research capacity development plans for LMIC partners that are proportionate and relevant to delivery of the proposed activities and include appropriate project management and financial/administrative support.\n6) Support career development for research leaders of the future, e.g. through supporting less experienced researchers in LMICs to lead/jointly lead on the research proposal with effective mentoring and support from appropriate Co-Applicants.\n \n ID: GB-GOV-10-HPSR_Project_1_157653\nTitle: NIHR HPSR-PA - Harnessing routinely collected data for timely healthcare decisions in lower- and middle-income countries amidst pandemics.\nDescription: The emergent and re-emergent of global pandemics present significant challenges in lower- and-middle-income countries (LMICs) where health systems have limited capacity for timely identification and monitoring of the potential impact of pandemics. This project aims to strengthen health systems in LMICs via digitalisation to improve preparedness and responsiveness to pandemics. \n\nIt has three interrelated workstreams: \n\n1. An assessment of current capacity to use routinely collected data for healthcare decisions, including an illustrative analysis to showcase use of data to inform policy/practice.\n2. Co-development and implementation of digital health and data analytics/visualisation tools and processes to facilitate data access and use for timely decisions.\n3. Ploting and evaluating feasibility/process of digitalisation of healthcare data. \n\nThe project is jointly led by two partners in Kenya and the UK: the Tropical Institute of Community Health and Development in Africa (TICH) in Kenya and Keele University - UK, in collaboration with the Kenyan Ministry of Health and the University of Sunderland - UK. It is a three-year project, starting in November 2024, being implemented in two counties of western Kenya: Kisumu and Siaya. Findings will inform the development of appropriate data digitalisation and visualisation/analytics tools to enhance evidence-based decision making for improved performance of the health systems with feedback loops at all levels. Potential impact extends beyond the study setting in Kenya to other LMICs.. The project has 3 objectives: \n\n1. Establish current capacity to use data/evidence for healthcare decisions, using Covid-19 and maternal, newborn and child health (MNCH) care/outcomes for illustration. \n2. Develop digital health and intelligent data analytics/visualisation tools to facilitate and enhance data access/interpretation.\n3. Pilot and assess feasibility of digitalisation of healthcare data for timely MNCH decisions. \n\n\n \n ID: GB-GOV-10-HPSR_Project_1_157754\nTitle: NIHR HPSR-PA - Does consolidated procurement influence affordable access to medicines? An Indonesian experiment\nDescription: Governments in many lower-income countries have recently set up health insurance systems aiming to provide affordable treatment for all citizens. These schemes are expensive, so governments try to impose procurement systems that reduce costs of the medicines and services covered. The World Health Organisation recommends a consolidated tender system where suppliers bid to provide large quantities of medicines at low prices. While this system appears effective, no independent academic studies have systematically evaluated its impact on medicine prices, availability, or governance. This project aims to fill that gap.\n\nIndonesia, the world's 4th most populous country, launched a national health insurance scheme in 2014 and adopted the WHO-recommended procurement system. Prices for medicines provided to insured patients fell significantly. However, in 2023, changes to procurement laws replaced this system with an Amazon-style platform, requiring thousands of health facilities to negotiate prices individually with hundreds of sellers. This fragmented the market and reduced transparency. This fragmented the market and reduced transparency. Later, the government re-introduced consolidated tenders for some medicines, but not others. The changes create a natural experiment: by comparing medicine availability and prices before and after the changes, we see which system works best. We have collected procurement and price data from the public system since 2016 and will gather additional data from hospitals and health centers in 13 districts across nine provinces. Interviews with buyers, sellers, pharmacists, and doctors will explore how these changes have influenced procurement practices. Using machine learning, we will analyse patterns of potential malpractice and examine the political and economic drivers of these reforms.\n\nThe results will inform the further development of medicine procurement in Indonesia, and offer valuable lessons for other countries pursuing sustainable health coverage and will take place from January 2025 to December 2026.. The project has 4 objectives:\n\n1. Assess the impact of policy changes on medicine procurement outcomes. Analyse transaction-level data from public procurement systems and health facilities to examine changes in medicine prices, availability, and quality following Indonesia’s transition from a consolidated procurement system to a decentralised marketplace model.\n2. Enhance data systems for medicine procurement. Analyse existing national and facility-level data systems to identify inefficiencies and opportunities for improvement. Integrate new data sources to create a comprehensive database on medicine procurement.\n3. Understand the Political Economy of Procurement Policy to identify which interest groups most influence medicine procurement policy choices, through what mechanisms and to achieve what goals.\n4. Contribute to the Global Evidence on Medicine Procurement. Share findings through national and international forums, publications, and seminars to inform global discussions on effective medicine procurement practices.\n\n \n ID: GB-GOV-10-HPSR_Project_1_158115\nTitle: NIHR-HSPR-PA- Using participatory research to develop and implement a rural primary depression care model in India\nDescription: This project involves the development and roll out of a care model for depression in a rural setting in India. To achieve this, the project uses a 'participatory' approach i.e., involving members of the rural community; the doctors, nurses and village-level health workers who deliver routine primary care services; and the district and state health department officials to discuss their perspectives and beliefs on how such a model should be (e.g., its components, modes of delivery, expectations out of the care received). The project aims to check if this model will be effective to identify persons with depression in the clinics, and improve their mental health outcomes.\n\nThis project is being implemented by Sangath, a mental health non-profit with 27 years of experience in India and twelve years of presence in the state of Madhya Pradesh in central India. \n\nA rural district in Madhya Pradesh has been selected for the project activities. Specifically, the depression care model will be implemented in nine primary care clinics with their catchment areas (villages), and nine other clinics will serve as the 'control group', which will receive routine health system support to deliver depression care. This will allow us to compare the effectiveness of the care model between these groups of clinics, on the percentage of people identified with depression, initiated on treatment, and those who improved their mental health outcomes (reduced depression severity) after receiving treatment. The project will be implemented from August 2025 to July 2028.\n\nNearly 50 million people live with depression in India. There are very few depression care models in India that have focused on adequate integration of depression care into rural primary care clinics, where most healthcare is delivered. Efforts so far have had limited engagement of the rural community, doctors and nurses, and local health systems, to identify local needs and perceptions towards such a care model. Developing and implementing a care model for depression by involving these stakeholders will ensure the model is adopted and used by the persons who are identified (or living) with depression, and potentially scaled up across the district to serve the rural population's mental health needs.\n. This project has 3 objectives:\n1. To gather the perspectives of rural community members, care providers and health systems officials on suitable care models for people to seek care for depression, receive 'screening' tests (to identify depression), start treatments, and follow-up back at the clinic.\n2. The insights will be used to conduct a workshop with various community representatives. This workshop will define the care model, its activities and stages and the expected changes as a result of the model. The model will be piloted with the community to make potential refinements and changes. The expected outcome will include a 'final' model that will be ready to be delivered.\n3. This final model will be implemented and evaluated in nine rural primary care clinics in Madhya Pradesh in central India, against a control group of similar clinics. The two main parameters of evaluation of model effectiveness include: identifying cases of depression - to check if the percentage of people identified with depression is higher in the intervention group, and patient mental health outcomes - to check if the patients who receive treatment show lesser severity of their symptoms of depression in the intervention group compared to control group, at 3 months follow up time point.\n\n \n ID: GB-GOV-10-HPSR_Project_1_158137\nTitle: NIHR HPSR-PA - Regulating physician dual practice for universal health coverage in Mozambique and South Africa\nDescription: Doctors in lower- and middle-income countries (LMICs) often work simultaneously in public and private clinical services, a phenomenon known as ‘dual practice’. Although such practice is credited with increasing doctors’ income and retention in the public sector, it is also accused of compromising availability of services in public hospitals. Regulating the practice is a complex health system issue, and little evidence exists on the effectiveness of regulatory options.\n\nWe base this proposal on our previous research in Mozambique and South Africa and investigate physician dual practice within the context of urban and rural public hospitals. Our research questions focus on assessing the impact of current regulation in the two countries, as well as on identifying regulatory options to help achieve Universal Health Coverage (UHC) in LMICs.\n\nFirst, a mixed-methods enquiry will help us understand the current forms of dual practice in the two countries, doctors’ distribution of time across forms of dual practice, compliance with regulation, and interactions of relevant stakeholders. In 2025, we will use a combination of interviews, analysis of hospital service data, and doctors’ diaries to develop a metrics of dual practice and construct a picture of its impact on UHC. In the second part of the project in 2026, we will use discrete choice experiments (DCE) to reveal doctors’ preferences among public sector jobs with attributes including opportunities for forms of dual practice. Finally, in 2027 we will use Agent-Based Modelling to develop a theoretical model of the interactions of doctors and hospital managers in hospital contexts. Informed by the mixed-methods enquiry and DCE conclusions, we will model the influences on doctors’ job choices among alternative hospitals and the factors shaping managers’ decisions regarding stringency of regulation.\n\nOur study includes researchers and policymakers from the National Institute of Health of Mozambique, the University of Witwatersrand of South Africa, the Nossal Institute for Global Health, Australia, and Queen Mary University of London.\n\nWe expect our project will: 1) develop health system research capacity in Mozambique and South Africa; 2) contribute to understanding the implications of different forms of regulation of human resources and health labour markets for the achievement of UHC, and; 3) engage with the development of local policies to regulate the phenomenon.. The project has 4 objectives:\n\n1. Develop a horizontal partnership to conduct health system research in Mozambique, South Africa and the UK.\n2. Conduct a mixed-methods assessment of the prevailing forms of dual practice, doctors’ time allocation between public and private service provision, the factors driving these, perceptions of their impacts and perceptions of the implementation of dual practice policies in selected hospitals in South Africa and Mozambique.\n3. Clarify doctors’ preferences and estimating trade-offs between job attributes including opportunities for dual practice through a discrete choice experiment.\n4. Apply Agent-Based Modelling to develop an understanding of how interactions between hospital managers and doctors under different dual practice regulatory policies determine service availability to public patients, using the findings from previous phases.\n \n ID: GB-GOV-10-HPSR_Project_1_158215\nTitle: NIHR HPSR-PA - Co-produced solutions for the delivery redesign of primary care for people with diabetes\nDescription: This initiative aims to refine, test, and implement a redesigned primary care model to improve healthcare outcomes for individuals with Type 2 Diabetes in Mendoza, Argentina. The model will strengthen primary care to enhance disease control, improve care quality, and increase patient confidence in the healthcare system. The results will help shape healthcare policy in Mendoza Province. They could serve as a model for effective and efficient chronic disease care in other parts of Argentina and across Latin America.\n\nThe Institute for Clinical Effectiveness and Health Policy (IECS) leads the effort in collaboration with the Quality Evidence for Health System Transformation (QuEST) initiative, which seeks to transform health systems in low- and middle-income countries (LMICs). Cayetano Heredia University - Peru and University of California San Francisco (UCSF), will be collaborators on the project as well. Local stakeholders, including the provincial Ministry of Health, healthcare professionals, and policymakers, are involved in developing practical, scalable solutions. The work will span from November 2024 to October 2027 and will be carried out in three phases. During phase I, the team will work with people involved in healthcare to fine-tune the plan based on the current list of recommendations and conduct a pilot test in 2 facilities. In phase II, the improved plan in 24 primary healthcare centres will be tested, with 12 using the new plan for 15 months. The team will look at patient records and follow patients over time to see how well the interventions work to improve disease control, enhance quality of care, and strengthen confidence in the government health system. Phase III will focus on analysing results, collaborating with policymakers to share findings, and suggesting policy changes.\n\nManaging the growing population of individuals living with chronic conditions like diabetes is a global challenge. In Argentina, a middle-income country, the increasing number of people with chronic conditions depends on a government healthcare system that is poorly equipped for long-term care. Although access to health services is high, the quality of care and system competence are inadequate for effectively detecting and managing diseases like diabetes. The proposed redesigned primary care model will better support long-term disease management and create a more resilient, efficient, and equitable healthcare system for people with diabetes, particularly in underserved areas like Mendoza. Additionally, the model has the potential to be replicated in other LMIC regions.. The project has 4 objectives:\n\n1. To assess the feasibility and acceptability of the redesigned primary care model to improve healthcare outcomes for individuals with Type 2 Diabetes in Mendoza, Argentina. \n2. To test the model’s impacts on service use patterns, system competence, user confidence and cost per visit.\n3. To analyse the impact of the model on potential inequalities by sociodemographic factors. \n4. To work with local policymakers to share findings and suggest evidence-based policy changes that can improve chronic disease management within the public healthcare system.\n \n ID: GB-GOV-10-HPSR_Project_1_158314\nTitle: NIHR HPSR-PA - Co-production and piloting of socio-culturally embedded systems strengthening interventions to improve quality of care for people with mental health conditions in Somaliland\nDescription: Somaliland has a high burden of mental health conditions (MHCs), exacerbated by conflict trauma, poverty and substance abuse. The mental health system in Somaliland does not meet the needs of people with MHC. Co-design of interventions to improve the experience of people with MHC when they seek care has a proven track record of success, including in similar contexts such as Ethiopia, as illustrated by work conducted by members of our research team.\n\nOur plan incorporates various approaches and methods. We will adapt existing approaches from Ethiopia and Somaliland to empower people with MHC, their caregivers and health workers and create an enabling environment so they can actively participate in the project. We will use interviews, observation and existing service data to understand and analyse behaviour, experiences and perspectives on care seeking and provision. Following this process, we will conduct Theory of Change workshops with community members, health and social care organisation representatives, practitioners and people with MHCs and their carers. The goal will be to identify what outcomes people value that need to be achieved by mental health services. Lastly, we will co-produce and pilot an intervention package to improve person-centred care in both public and private-religious sectors. The intervention package will be evaluated using process evaluation.\n\nThe project will work with key stakeholders in Somaliland, particularly the Ministry of Health Development (MoHD), people with mental health conditions (MHC), their caregivers and health workers to co-design and pilot interventions to improve the quality of mental health care. The work will span from February 2024 to January 2028. Our research group is a multidisciplinary team comprising of members from Addis Ababa University, Amoud University, Dalarna University, Jigjiga University, Ministry of Health Development Somaliland, University of Hargeisa, The University of Edinburgh and King's College London.. The project has 3 objectives:\n\n1. To empower people with mental health conditions (MHCs) and their caregivers so they have the skills and knowledge to proactively shape the direction of future mental health research in Somaliland.\n2. To improve understanding of and respect for MHCs among health workers to increase respectful, rights-based care.\n3. To identify the major issues people with MHCs and their caregivers experience in accessing and using mental healthcare and intervene to address these issues.\n \n ID: GB-GOV-10-HPSR_Project_1_158320\nTitle: NIHR-HSPR-PA- Reimagining the health system from the world view of indigenous communities (rTribe study)\nDescription: Adivasi communities (indigenous communities in India) are known to have poor access to healthcare and poor health status, often due to social and historical reasons. Healthcare services in Adivasi settings often do not provide care in a way that is acceptable and respectful of their culture and history.\n\nThe study will apply state-of-the-art health policy & systems research methods to co-produce knowledge on improving the health system's responsiveness to Adivasi communities in Southern India. Guided by the tenets of indigenous standpoint theory, the study will take a multi-method participatory action research approach to reimagine and co-produce transformative solutions for strengthening health systems' responsiveness in two Adivasi community settings in Southern India. This project will build upon existing, long-term, trust-based collaborative relationships between the research team, Adivasi leaders, community-based organisations, and government decision-makers in two remote, forested Adivasi settings in two states in Southern India. The study team aims to improve the responsiveness of the health system to the needs and expectations of Adivasi communities in these two settings and use the knowledge to build a model of practice that can achieve this in other settings.\n\nThe study will be undertaken by Deva Soliga Cultural and Development Trust (India), Institute of Public Health Bangalore (India), the M S Swaminathan Research Foundation (India) and the University of Melbourne (Australia) between September 2025 and August 2028.. The project has 3 objectives:\n1. To characterise how Adivasi communities perceive, interact, and relate to the health system in their specific social and historical context in two Adivasi settings in Southern India.\n2. To describe other health systems actors' understandings and perspectives about what constrains health systems actors ability to, and what will enable them to, deliver culturally responsive care to the Adivasi communities they serve.\n3. To co-produce a health system responsiveness practice model with the Adivasi communities, healthcare providers and decision-makers to enhance health system responsiveness for Adivasi communities.\n\n \n ID: GB-GOV-10-HPSR_Project_1_158330\nTitle: NIHR-HSPR-PA- Strengthening the Brazilian health system to better address racial and or ethnic health inequities\nDescription: This project will produce evidence on different health system factors and policies that exacerbate or reduce racial health inequalities in Brazil. It specifically aims to comprehensively measure racial health inequalities across Brazil, including changes over time and between geographical areas. It will strengthen the capacity of researchers working on racial health inequalities in Brazil and promote their institutions and networks to increase the prominence of their work and deliver change.\n\nThe research will use multiple methods. The project team will carefully quantify the differences in health outcomes between racial groups and identify the impact of policies. In addition, interviews will be conducted with stakeholders to understand the roles of different policies and health system factors. The project team will also conduct experiments with health professionals to explore implicit bias and treatment decisions.\n\nThis work will be carried out in Brazil by the Institute of Health Policy Studies (IEPS) in Sao Paulo in collaboration with Imperial College London in the UK. It will be carried out between May 2025 and April 2028.\n\nRacial and/or ethnic health inequalities are large, unjust, preventable, and remediable. Health systems can exacerbate these inequalities by reflecting discrimination in wider society or by actively addressing these inequalities. Specific actions are needed to strengthen policies, financing, and clinical services to reduce racial health inequalities. Brazil is a key setting for this research as it has significant health inequalities across racial groups and high-quality healthcare datasets. There are also important policies related to the health of the Black population that need to be evaluated, as well as effective civil society movements and engaged policymakers requesting evidence to inform their agendas. . The project has 7 objectives:\n1. Co-produce indicators to document the magnitude and evolution of racial inequalities in healthcare access, quality, and health outcomes in Brazil.\n2. Identify the contributory role of health system factors in explaining racial inequalities including political, civil society, managerial, economic, and health-system factors (for example financing arrangements and differential treatment by health professionals).\n3. Evaluate race-related policies like the National Health Policy for Black People, affirmative action policies (educational quotas) and welfare policies (Bolsa Familia), understanding health system and health inequalities impacts.\n4. Engage stakeholders in the research project and dissemination and or advocacy activities and produce policy briefs and online training courses/seminars to raise awareness.\n5. Strengthen research capacity, especially for Black researchers to investigate racial inequalities in health.\n6. Build capacity among key stakeholders to use research results and influence policy development related to race and health equity.\n7. Build research capacity in mixed-methods approaches and apply these to integrate qualitative and quantitative research for a more robust and comprehensive understanding of race, health systems, and health in Brazil.\n \n ID: GB-GOV-10-HPSR_Project_1_158384\nTitle: NIHR HPSR-PA - Building system capacity to deliver youth-targeted mental health services in Vietnam and Cambodia\nDescription: Rising rates of mental illness are an urgent global health problem. As mental health problems often start in youth, intervening early is crucial in mitigating long-term personal and economic costs. In countries such as Vietnam and Cambodia, there is appetite for delivering early mental health interventions but there are also system-level limitations, especially outside major cities. The question is, how can we build capacity in mental health care systems in Vietnam and Cambodia to co-develop and implement a feasible, acceptable, beneficial and sustainable youth-targeted mental health intervention?\n\nThis three year project (Nov 2024-Oct 2027) builds on previous work of the interdisciplinary team members (from Queen Mary University of London, the Royal University of Phnom Penh, and Vietnam National University), and includes a multi-level framework for conceptualising systems strengthening, and has 4 overlapping phases. Phase 1 will identify and map youth-targeted interventions and services in Vietnam and Cambodia. In Phase 2, we will use this knowledge to identify 40 people in each country who work with young people and train them on youth mental health, increasing their mental health literacy. This capacity building will end with the co-design of the youth targeted intervention. In Phase 3, the intervention will be implemented by the trainees in schools and community centres in Kampong Chhnang and Siem Reap in Cambodia and Khanh Hoa and Thai Binh in Vietnam. We will deliver this intervention to 175 young people in each country, with another 175 being allocated to a wait-list control condition. Data will be collected on the mental health literacy of trainees (in Phase 2) as well as the observation of their delivery in Phase 3. Using mixed methods, we will evaluate the feasibility, acceptability, and potential range of effects on reductions in anxiety and depression symptoms and other relevant secondary outcomes e.g., well-being among youth. Finally, in Phase 4, we will co-develop mechanisms for embedding, scaling up and strengthening youth mental health systems including considering intersectoral communication and referral pathways.\n\nOur project will lead to an increased ability to address youth mental health in Cambodia and Vietnam through an increased number of youth mental health services providers and through a strengthened and integrated system of provision. . The project has 3 objectives:\n\n1. Train potential service providers across different sectors (health, education, social) on mental health literacy and then co-design and co-adapt with them and youth an intervention for youth (aged ~14-19) that we developed and pilot-tested in previous projects.\n2. Measure the feasibility, acceptability and potential effects of these interventions in promoting good mental health.\n3. Co-design referral pathways for the scale-up of these interventions.\n \n ID: GB-GOV-10-HPSR_Project_1_158451\nTitle: NIHR HPSR-PA - Improving the core functions of primary care in sub-Saharan Africa\nDescription: The Primary Care Assessment Tool (PCAT) has the potential to measure all the core functions of primary care in the manner suggested by the World Health Organization (WHO) and to enable improvement in the quality of care. The question is how best to create a PCAT for general use in sub-Saharan Africa (SSA), a region with a critical need for improved healthcare, so that countries can measure and monitor the core primary care functions and drive improvement in the quality of care. The vital role of a comprehensive primary care system within any healthcare infrastructure cannot be overstated. It functions as the initial point of contact for individuals within the healthcare system, providing an enduring continuum of care and a broad range of services. This need is acutely felt in SSA, a region grappling with many health-related challenges. The WHO has delineated fundamental primary care functions, including first-contact accessibility, continuity, comprehensiveness, coordination, and a people-centric approach. However, evaluating these core functions presents a formidable challenge, particularly in low to middle-income nations with restricted access to data and health information systems.\n\nTo rectify this, the PCAT has been developed and implemented in various countries, demonstrating its potential to measure all core functions of primary care. This study aims to adapt a PCAT for widespread use in 11 countries in SSA. This would allow countries to track and monitor their primary care functions and improve the quality of care provided. The proposed PCAT will be multilingual and available in digital and paper formats, ensuring its accessibility and usability throughout the region. Local and regional stakeholders will engage with the PCAT findings and plan interventions to improve the quality of primary care. The findings are expected to inform improvements in the core functions of primary care in African healthcare systems. The PCAT is anticipated to become a widely used tool for primary care researchers and health information systems to gauge primary care performance. The evidence generated could inform WHO recommendations on measuring core primary care functions.\n\nThe proposed timeline for this study spans three years from 2024-2027. The project team comprises a central project leadership team, ten additional country-level research leads, and their respective teams. An external advisory board will guide the team in meeting the project aims.. The project has 1 objective: \n\n1. This project aims to create a version of the Primary Care Assessment Tool (PCAT) for general use in the sub-Saharan region, enabling these countries to measure their primary health cares core functions as intended by the World Health Organization (WHO). This region already has a robust academic family medicine network, the Primary Care and Family Medicine (PRIMAFAMED) network, which spans 40 departments across 25 countries. Family medicine is the clinical discipline which trains family physicians and doctors to provide comprehensive care in primary care teams.\n \n ID: GB-GOV-10-HPSR_Project_1_158474\nTitle: NIHR HPSR-PA - Modelling the effects of integrating diabetic retinopathy services in the Malawi health system\nDescription: We are developing models to integrate eye screening and treatment services for people with diabetes into Malawi's health system. The research focuses on Malawi, but our goal is to create an approach that can be applied in other African countries.\n\nOur project team includes researchers from the Eye Health Research Group (EHRG) and Health Economics and Policy Unit (HEPU) at KUHeS, the International Centre for Eye Health (ICEH) at the London School of Hygiene & Tropical Medicine, the Diabetes Association of Malawi, and the Malawi Ministry of Health. The project will run for 3 years, starting in October 2024.\n\nEye disease caused by diabetes is a growing problem in Africa and across the world. Currently, 24 million adults in Africa have diabetes, and this number is expected to more than double in the next 20 years. Eye disease caused by diabetes (diabetic retinopathy) is one of the most common causes of blindness in working-age people. In Africa, one in three people with diabetes have this condition, and one in six need urgent treatment to save their sight. In Malawi, nearly half a million people with diabetes need regular eye check-ups. These check-ups help identify those who need treatment to prevent sight loss. Currently, health services for this are limited. Blindness leads to significant loss of productivity and also increases the risk of early death. The World Health Organization considers screening and treatment for diabetic eye disease to be highly cost-effective. However, these services are not yet available in most of Africa.\n\nWe will gather data on diabetic eye disease in Malawi. Using this data, we'll create a mathematical model to show how eye care services could be integrated into the health system and calculate the health benefits of these services. We'll use an existing model for long term health conditions in Malawi as a starting point. We aim to provide Malawian policy makers with evidence to support the integration of diabetic retinopathy services into the health system. Our findings will help policy makers decide which health services to prioritise. Our results will be shared through a network of 12 African countries working on diabetic eye disease, publications in scientific journals, and presentations at international scientific meetings.. The project has 5 objectives: \n\n1. To explore different ways to provide eye care services for people with diabetes in Malawi. We will analyse how cost-effective these methods are and assess how well they could work within Malawi's existing healthcare system. This will help us identify the most suitable and efficient approaches for the country.\n2. To determine how many people in Malawi are affected by diabetes-related eye problems. We will also investigate what factors make people more likely to develop these eye issues. This information will help us understand the scale of the problem and who is most at risk.\n3. To review Malawi's current health policies related to diabetes care and eye health services. We will check if these policies work well together and support each other. This analysis will highlight any gaps or inconsistencies in the current approach to managing diabetes and its eye-related complications.\n4. To examine how eye care services for people with diabetes are currently provided in Malawi's healthcare system. We will look at what services are available, where they are offered, and how effectively they're meeting people's needs. This assessment will give us a clear picture of the current situation and areas for improvement.\n5. To create a plan for including eye care services within diabetes care programs and the broader healthcare system in Malawi.\n\n \n ID: GB-GOV-10-HPSR_Project_1_158619\nTitle: NIHR HPSR-PA - Capacity building in mental health services for sexual orientation and gender minorities in Malaysia\nDescription: Responding to the lack of systemic protections, public services or policies to provide people with marginalised sexual orientations, gender identities and expressions, and sex characteristics (SOGIESC minorities) with access to inclusive and high quality mental health services in this geographic context, the project takes a micro-systems approach, to enhance capacity for mental health services that are inclusive, affirming and culturally safe for key populations in Malaysia. Specifically, this is for individuals with marginalised sexual orientations, gender identities and expressions, and sex characteristics (SOGIESC minorities). This community faces high mental health risks compounded by a lack of accessibility to inclusive mental health services largely due to the local environment where SOGIESC minorities lack legal, social or political protection.\n\nLed by a team comprising researchers from Universiti Malaya, community advocate groups, People Like Us Hang Out and Justice for Sisters, and researchers from Cardiff University and University of Waikato, this project will enhance community-based capacity building in the form of training for mental health practitioners in providing affirming services for people with marginalised sexual orientations, gender identities and expressions, and sex characteristics (SOGIESC minorities). We will utilise a discursive approach to enhance, implement and validate a community-based training tools for SOGIESC-affirming mental health practitioners in Malaysia. \n\nThis three-year-project will run from 1 November 2024 to 30 October 2027 and is expected to impact the provision of inclusive health care in Malaysia by increasing the availability of mental health professionals able to deliver SOGIESC affirming mental health care to this stigmatised and minoritised group. This could have the long-term impact of improving mental health outcomes for SOGIESC minorities. In addition, by providing two graduate training posts and research skills training for junior members of the team, the project will also contribute to capacity building in Malaysia, both in the community-organisation community and in academic and research capacity. The project will be co-developed and implemented by an alliance of social science and clinical researchers, community advocacy organisations and SOGIESC affirming mental health professionals, from Malaysia, UK and New Zealand, with project activities carried out in Malaysia.. The project has 4 objectives: \n\n1. To collate and analyse data on social context, discursive practices and stakeholder perspectives in relation to mental health(care) and people with marginalised sexual orientations, gender identities and expressions, and sex characteristics (SOGIESC minorities) in Malaysia. \n2. To enhance training tools for SOGIESC affirming mental health practitioners. \n3. To Implement, evaluate, and validate the enhanced training tools for SOGIESC affirming mental health practitioners. \n4. To consolidate and disseminate findings and advocacy to engage with stakeholders.\n \n ID: GB-GOV-10-HPSR_Project_1_158782\nTitle: NIHR HPSR-PA- Systems of evidence to improve health policy in Africa \nDescription: This research aims to investigate the structure and functioning of evidence advisory systems (also called evidence ecosystems) serving to provide policy-relevant scientific evidence and advice to national government to inform health policy responses in Africa.\n\nThe research will be undertaken by Health Research Operations Kenya Limited, Makerere University School of Public Health Uganda, University of Global Health Equity Rwanda, The Malawi Liverpool Wellcome Trust Clinical Research Programme, London School of Economics & Political Science and Liverpool School of Tropical Medicine UK.\n\nThe research will take place in Kenya, Malawi, Rwanda and Uganda from March 2025 to February 2028. \n\nFor almost all aspects of health policy and planning, there is a need to inform policy decision with robust and policy appropriate evidence. It is therefore critically important for countries to build effective systems of evidence provision which can serve these needs. This is a particular challenge however for lower income settings, which may have limited capacity but which could benefit greatly from robust uses of scientific research, evidence, and innovation. The team aims to work directly with local government stakeholders to co-produce research questions, establish locally-relevant normative conceptual frameworks of analysis, and ultimately coordinate activities which may lead to institutional improvements in evidence systems in Africa.\n. The project has 4 objectives:\n\n1. Mapping national evidence advisory systems, institutional arrangements, and cultures of evidence in four case study countries: Kenya, Malawi, Rwanda, and Uganda.\n2. Developing a framework on which to judge and evaluate the structure and function of national evidence advisory systems, co-produced with key stakeholders.\n3. Comparing national evidence advisory systems in relation to two contrasting health policy challenges (Universal Health Care and COVID-19).\n4. Development and monitoring of action plans for national stakeholders working to improve evidence systems for health.\n\n \n ID: GB-GOV-10-HPSR_Project_1_158806\nTitle: NIHR HPSR-PA - Assessing and mitigating corruption to strengthen health systems in Lebanon and Jordan\nDescription: Corruption in the health system allows people who work in healthcare to use their power in a way that benefits themselves instead of doing what is best for patients. This makes healthcare less efficient and trustworthy and also negatively impacts health system goals including ensuring access to high quality care for all patients, irrespective of their ability to pay. When people in charge are corrupt, it also makes it harder for a country's health system to handle complex health crises. In the Middle East and North Africa (MENA) region, corruption is particularly pervasive, with many countries scoring poorly on Transparency International’s Corruption Perceptions Index. Despite evidence of the negative impacts of corruption on health systems, there is a lack of attention to this issue in the region. This research aims to address this gap by examining the nature, drivers, consequences and potential solutions to health system vulnerabilities and corruption risks in two lower-and middle-income countries (LMICs) in the MENA region: Lebanon and Jordan. Both countries are dealing with multiple problems, such as the huge influx of refugees that have affected their economy, politics and health systems. In both countries, the health sector is also heavily affected by corruption. The research will be undertaken by American University of Beirut, Jordan International Academy for Public Health (IAPH) and London School of Hygiene & Tropical Medicine (UK).\n\nThe findings of the research will be used to inform national policies and strategies to curb corruption in health systems and can be adapted for use in other settings in the MENA region and beyond. We will engage with policymakers, stakeholders, and communities from both countries to inform anti-corruption policy formulation, strategies and programs in the health sector, which will ultimately help the health system to achieve its objectives, including the goal of Universal Health Coverage. Our research will also produce an interactive monitoring and assessment tool that can help prevent, detect and respond to corruption risks in the health system during both ordinary times and in health crises. A final key benefit of our research will be to strengthen research capacity in partner countries to demand, generate, and utilise high quality policy-relevant research. The project will be implemented from 2024 to 2027.. The project has 4 objectives:\n\n1. To understand and define the specific meanings and manifestations of corruption in the health systems of Lebanon and Jordan.\n2. To identify the most important corruption risks and vulnerabilities in the health systems in Lebanon and Jordan by conducting a comprehensive assessment using a range of methods.\n3. To examine the key political factors which drive anti-corruption efforts and how these can be addressed.\n4. To co-develop actionable strategies and corresponding action plans with stakeholders from healthcare, policy, and civil society sectors in Lebanon and Jordan to mitigate identified corruption risks.\n\n \n ID: GB-GOV-10-HPSR_Project_1_158924\nTitle: NIHR-HSPR-PA- Understanding the policy and system dynamics to improve palliative care in Lao People's Democratic Republic\nDescription: Palliative care is a fundamental human right, yet accessibility of palliative care in Lao People's Democratic Republic (PDR) remains extremely limited, with only a small fraction of those in need receiving appropriate care. This project aims to improve palliative care services in Lao PDR by estimating the current and future need for palliative care, analysing the structure and performance of the health and social systems, and developing a simulation model to support better policymaking. The research study is led by the Lao Tropical and Public Health Institute (Lao TPHI) in collaboration with the Ministry of Health, Laos Cancer Center, Karunruk Palliative Care Center of Khon Kaen University, and Swiss Tropical and Public Health Institute, and the research will be conducted in Vientiane Capital, Luang Prabang, and Champasack Provinces for a 36-month period from 2025 to 2028.\n\nThe project will measure serious health-related suffering (SHS) among people living with advanced and irreversible diseases, assess how the healthcare system currently supports palliative care, and engage stakeholders to design a system dynamics model. This model will help policymakers test different strategies virtually before implementing them in the real world. The final goal will be a decision-support tool to guide the design of cost-effective strategies to reduce suffering and improve the quality of life for patients and families. The research project is essential to inform national health strategies and to address the growing burden of serious health-related suffering in Lao People's Democratic Republic.. The project has 3 objectives:\n1. To estimate the burden of serious health-related suffering for deceased and non-deceased living with an advanced and irreversible disease in Lao People's Democratic Republic and to project the future burden.\n2. To conceptualise the structure, dynamics, governance, and value chain of the social and healthcare system to provide continuum of care for patients with advanced and irreversible diseases.\n3. To create a comprehensive system dynamics model that analyses the impact of different intervention strategies to improve the quality of life and wellbeing for patients at the end of life, as well as their families and caregivers.\n", "_version_":1862221874294947840 }] } }