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"id":"84f8df06-76d0-4876-b033-06130e045cd5", "related_activity_context":"ID: GB-GOV-10-NIHR_GHRG4\nTitle: NIHR Global Health Research Groups: Call 4\nDescription: The NIHR's fourth Global Health Research call for Groups. UK universities and research institutes were invited to submit applications, working in equitable partnerships with researchers in low- and middle-income countries (LMICs) eligible to recieve Official Development Assistance (ODA), to develop their ambitions to deliver world-class applied global health research to address under-funded or under-researched global health areas specific to those countries. The partnerships support both identified training and capacity needs for academy research and programme support functions in low resource settings. Together these provide an important, sustainable platform for future research and resilience in those countries. \n\nGlobal Health Reseach Group funding is available to research groups either new to delivering applied health research globally or that wish to expand an existing partnership. Through this call, awards up to £3 million over a period of up to four years are available to NIHR Global Health Research Groups. \n. The project has three objectives:\n1. Adapt an existing treatment for people with severe mental illness to stop using all forms of tobacco, including smokeless tobacco, via an updated and refined intervention package consisting of treatment materials and training resources.\n2. Identify, evaluate and refine strategies to deliver Smoking cessation for people with severe mental illness in South Asia (SCIMITAR-SA) in mental health facilities, and develop a shortlist of relevant strategies for its wider rollout in Bangladesh, India and Pakistan.\n3. Deliver the intervention to people with severe mental illness via a randomised controlled trial to compare tobacco use and severe mental health between recipients and non-recipients at 6 and 12 months.\n\n \n ID: GB-GOV-10-GHRG_4_155559\nTitle: NIHR Global Health Research Group on Global Injury\nDescription: Injuries are the leading cause of death in people aged between 10-49 years. More people die from injuries than from HIV, malaria, and tuberculosis combined. For every person who dies, up to 50 people survive but become disabled. Broken bones account for most of these injuries, and disproportionately affect people living in poorer regions, such as countries in Africa. Little is known about how many individuals in Africa sustain a broken bone, what healthcare services are available to treat them, how the injury affects individuals and their families, or ways to improve their recovery.\n\nAcross three African countries (Malawi, Tanzania, and South Africa) we aim to:\n1. Develop the ability to undertake research into the care of broken bones. \n2. Determine the number of people affected by a broken bone. \n3. Describe the healthcare resources available for the treatment of broken bones and identify factors that help or hinder the delivery of services. \n4. Assess the impact of a broken bone on the life and livelihoods of those affected. \n5. Improve the recovery of patients who have experienced a broken bone. \n\nMethods: \nOur project has four themes:\n\n1. Capacity: Doctors, nurses, and healthcare workers involved in the care of patients with broken bones have limited training in how to conduct research and poor access to the basic resources to do research, making it difficult to improve the care for their patients. We will assess current levels of research training and organisation, designing educational resources to fill gaps in the current understanding and ability to undertake research.\n\n2. Mapping: We will create a network of collaborating hospitals, in our partner countries, to perform a study to determine how often different types of broken bones occur. We will look at five broken bones that the World Health Organisation (WHO) have identified to cause the most disability and describe the resources (people and equipment) available to treat these injuries and find out how patients make use of these services.\n\n3. Outcome: We will examine how patients recover from their injury and the impact on their lives and livelihoods for each of the five types of broken bones.\n\n4. Change: Through our network of collaborating hospitals, we will undertake a multi-centre study to ‘test’ if it is possible to do large-scale research studies. Our goal is to run similar studies throughout Africa to assess new treatments for patients with broken bones.\n\nThis project will help us understand the number of broken bones that occur in Africa, what treatments are available and how these injuries affect patients. It will develop research capacity and lay the foundations to attract future research funding, enabling us to work towards our vision that the care for broken bones in poor countries can be safe, accessible, and appropriate to the resources of local health systems. This project will run from September 2024 to August 2028. \n\nCommunity engagement and involvement: We have engaged with local patients and healthcare workers, whose opinions have informed our work so far. We will continue to integrate patients and community leaders to co-produce our research.\n\nDissemination: Patients, clinicians and methodologists will co-develop publications, social media, and events. We will work alongside policy makers in national government ministries and strengthen our relationship with leaders within the WHO to ensure that we disseminate our findings effectively and influence policy to drive improved patient care. . This project has 4 objectives:\n\n1. Evaluate the available resources for conducting clinical research & develop research capacity and leadership.\n2. Quantify the incidence of musculoskeletal (MSK) injuries & define the healthcare resources currently available for MSK injury care.\n3. Assess MSK injury treatment pathways, clinical & quality of life outcomes, and economic impact.\n4. Implement a multi-centre feasibility study to inform a randomised control trial.\n\n \n ID: GB-GOV-10-GHRG_4_155974\nTitle: NIHR Global Health Research Group on Developing And Integrating mobile community mental health Services In Ukraine (DAISI Ukraine)\nDescription: Ukraine, like other eastern European countries, had started to move from inpatient-based to community mental health care before the outbreak of the war in February 2022. However, the war has changed the situation with increasing problems of mental distress, serious trauma, disruption to social support and context, and the destruction of the critical clinical infrastructure, with 6 psychiatric hospitals annihilated, over 10 million people displaced and healthcare and research workers increasingly leaving Ukraine.\n\nLittle is known about the best models of mental health care during wars. One model that shows considerable promise is Mobile Community Mental Health Teams (MCMHTs), which provide services to people with severe mental health problems at home. MCMHTs are currently being implemented in Ukraine using government funding. Eighty-eight MCMHTs are already in operation as a result of an unprecedented collaboration between the authors of this application and the World Health Organization (WHO). A total of around 200 MCMHTs are planned. The teams should comprise a range of mental health, social care and primary care specialists. MCMHTs should primarily work with service users (18 to 65 years) with severe psychiatric disorders, but could include 16 and 17 year old users. These teams could improve access to healthcare, although current evidence is limited. It is also possible that these teams could provide an alternative to inpatient treatment for those service users who would traditionally be referred for hospital treatment due to a significant worsening of their disorder, but this remains untested. Finally, there is an urgent need to train MCMHT professionals in overcoming the consequences of the war on the mental health of service users.\n\nThe current project, Developing And Integrating Mobile community mental health Services In Ukraine (DAISI Ukraine) will complement, enhance and inform the development of innovative community mental health care during and after the war in Ukraine, as well as informing appropriate mental health responses in other conflict areas. DAISI Ukraine will aim to evaluate, improve, fine-tune and embed MCMHTs in Ukraine culminating in the establishment of the national service standard for these teams. Specifically, DAISI Ukraine’s aims are to provide:\n\n1. Locally relevant evidence to underpin, guide and shape the implementation of MCMHTs. \n2. Improved local research capacity.\n3. A global network of researchers interested in community care. \n4. Appropriate training programmes for staff.\n5. Involvement of service users and their families in service development and research.\n\nService users and their families have been involved in the development of this proposal from day one. In DAISI Ukraine, they will be a part of the research team and core to its activities – they will be co-researchers and co-developers rather than simply being the objects of study. This process of engagement will change how service users feel about and manage their conditions. We will create a service users panel for research and engagement before the beginning of DAISI Ukraine. This will allow DAISI Ukraine service user researchers to support and mentor one another, giving them translational skills beneficial for employment and education. To our knowledge, DAISI Ukraine is the first example of co-developed and co-produced research in mental health services in Ukraine. The project will be implemented between 2024 and 2028.. The project has 5 objectives:\n\n1. Provide locally relevant evidence to underpin, guide and shape the implementation of Mobile Community Mental Health Teams (MCMHTs). \n2. Improve local research capacity. \n3. Create a global network of researchers interested in community care. \n4. Deliver appropriate training programmes for staff.\n5. The involvement of service users and their families in service development and research.\n \n ID: GB-GOV-10-GHRG_4_156011\nTitle: NIHR Global Health Research Group on Vaccines to Control Respiratory Pathogens & AMR across Africa (VacAMR)\nDescription: Globally, there are around 1.3 million deaths each year due to infections that are resistant to antibiotics (so-called AMR infections). Respiratory infections such as pneumonia account for ~15% of deaths in children under 5 years, many of these deaths are in sub-Saharan Africa (SSA), and most can be prevented with vaccines. Frequently and understandably, fear of bad outcomes leads to inappropriate antibiotic use which increases the threat of AMR. This is even when fever or respiratory infections are caused by viruses like influenza, respiratory syncytial virus (RSV) & COVID-19, which do not need antibiotics. As a result, Governments and the World Health Organization (WHO) have declared AMR a world threat.\n\nOver the next 4 years (2024-2028), we aim to achieve Africa-led transformation of the long-term impact of vaccines, targeting high burden respiratory infections & limiting AMR. We will bring together well-established research institutions in Kenya (KEMRI-Wellcome) and Malawi (Malawi-Liverpool-Wellcome Programme, Kamuzu University of Health Sciences), with less-well-resourced institutions in Ghana (Navrongo Health Research Centre) and Nigeria (Nigeria Centre for Disease Control and Nigerian Institute of Medical Research) in new South-South partnerships across Africa. \n\nWe will develop new interdisciplinary multimodal interventions, supported by improved diagnostics, and more robust measurement of immune protection. With communities and policymakers, we will identify target microbes within those prioritised by WHO; evaluate ways to control respiratory infections and AMR through evidence analysis & stakeholder consultation; and test the feasibility of a multimodal intervention package. We will improve the detection of infection and AMR through cutting-edge diagnostic technologies. By identifying better ways to measure immune protection, we will enhance the evaluation of interventions to control respiratory pathogens and AMR. This work will be underpinned by four cross-cutting themes: community engagement & involvement, understanding behaviour and risk perception, evidence to policy, and leadership development for Africa-based mic-career researchers. . This project has 6 objectives:\n\n1. Identify multimodal interventions to reduce AMR, developing the evidence base, co-creating interventions, modelling impact & prioritising methodologies. The intended outcomes of this objective are to produce an interdisciplinary intervention assessment platform; community of community engagement groups; and comprehensively trained Africa-based leadership. \n\n2. Accelerate implementation of diagnostic approaches to support AMR intervention evaluation. The intended outcomes of this objective are to target diagnostic platforms identified with Africa CDC; field test diagnostics to support intervention; host local training in Wole Genome Sequencing (WGS) analysis; and produce open-access protocols. \n\n3. Evaluate candidate immune markers of protection to support intervention & outcome evaluation. The intended outcomes of this objective are to select immunological tools; test protective immunity tools, and develop models; and produce open-access protocols. The intended impact is to have innovative intervention evaluation using immune biomarkers as secondary endpoints. \n\n4. Strengthen evidence-to-policy translation. The intended outcome of this objective is to support African leadership in the global AMR pandemic response, involving communities and policymakers.\n\n5. Engage communities to evaluate AMR risk & identify behaviour change interventions. The intended outcome of this objective is to create a community of engagement groups from across Africa with a focus on vaccines and AMR.\n\n6. Empower Africa-based leadership & innovation in AMR. The intended outcome of this objective is to support African leadership in the global AMR pandemic response, involving communities and policymakers.\n \n ID: GB-GOV-10-GHRG_4_156087\nTitle: NIHR Global Health Research Group on environmentally sustainable hospitals in low- and middle-income countries\nDescription: Climate change is an emergency and communities are worried about its impact on their health. World leaders are committed to reducing carbon emissions, including in healthcare, which contributes to 4.6% of global carbon emissions. The National Institute for Health and Social Care Research (NIHR) has identified this area as a research priority, which we will address. Our proposed Group will focus on reducing the carbon “footprint” of operating theatres in lower- and middle-income countries (LMICs) and then apply these lessons to other hospital areas. Starting with operating theatres is easier than changing the whole hospital at once, increasing the chances of success. Also, operating theatres produce the most carbon and waste compared to any other hospital area. This research project will run from July 2024 to August 2028. \n\nWe looked at published research, gathered initial data, consulted with lots of different stakeholders, and held two global community engagement workshops. Our proposal addresses 8 of 10 priorities identified by patients and stakeholders for “greener” operating theatres. We have prioritised three areas for testing:\n\n1. Reusable drapes and gowns in theatres: Instead of using disposable drapes and gowns that create a lot of waste, we want to test using ones that can be washed and reused multiple times. This will help reduce the amount of waste generated in the operating rooms, but we need to prove it will not increase the number of infections first.\n2. Reducing the use of harmful anaesthetic gases: Some of the gases used during surgery are harmful to the environment. We want to find ways to reduce the amount of these used or find alternatives that are more environmentally friendly.\n3. Improving what happens to recyclable waste: We want to make sure that recyclable waste, such as plastic packaging or containers used in the operating rooms, is managed properly and sent for recycling, instead of ending up in landfills or the ocean.\n\nWe aim to learn how to reduce carbon emissions from operating theatres across Ghana, India, Nigeria and Rwanda. Via experienced policymakers in Pakistan, we aim to put this research quickly into everyday practice and learn how to work with the World Health Organization (WHO). This Group will bring new senior leadership into the NIHR Global Health family, and train new junior researchers for the future.\n\n1. We will scope communities’ understanding of “Net Zero” and carbon-related concepts, to develop ways to communicate this in local, lay language.\n2. We will create a toolkit of resources that our teams can use to communicate Net Zero concepts and our research results to the community, including policymakers, media, and hospital managers in each country, and beyond.\n3. We will design, with input from the community, three research studies across our three prioritised topics, ranging from large and simple (e.g. 80 hospitals) to small and detailed (e.g 4 hospitals). The project on waste management will be spread across the whole hospital.\n4. We will train a new generation of scientific researchers to tackle environmentally sustainable healthcare in the future and organise community advocates for “greener” surgery.\n5. We will build links to senior policymakers from the very start of this research, so they can influence its design, and act quickly upon the results. This includes learning how to work with the WHO on this topic.. This project has 4 objectives:\n\n1. Create a pool of community representatives, scope their understanding of Net Zero/carbon footprint, and identify their training needs.\n2. Build context-specific training toolkits, using suitable non-specialist language to create grassroot advocates.\n3. Involve communities in research design for projects in Workstreams 3 and 4.\n4. Use our large trial as a learning platform to test Community, Engagement and Involvement (CEI)-led dissemination to communities, media, and policymakers in each country.\n \n ID: GB-GOV-10-GHRG_4_156161\nTitle: NIHR Global Health Research Group on developing a learning health system to address the growing burden of non-communicable diseases in Thailand\nDescription: Long term conditions such as heart disease, diabetes and kidney disease are the leading causes of death in Thailand. It is estimated that reducing the number of people living with high blood pressure in Thailand can prevent 14,000 deaths, 27,000 strokes, and 18,000 heart attacks over the next five years. In Thailand, computerised medical records are used by the Ministry of Public Health to understand how whole regions deliver care. However, this information is not available to healthcare providers in a format that helps them identify people in need of earlier or more active management. Learning Health System approaches turn computerised medical data into information that allows healthcare teams to provide better health care and reduce inequalities.\n\nWe will work alongside healthcare providers, decision-makers, researchers, and the public to co-develop a data supported quality improvement approach for the management of diabetes, high blood pressure, and kidney disease in primary care settings. We will begin by hosting a series of workshops to identify challenges that healthcare teams face when managing individuals living with these long-term conditions and what kinds of data tools and ways of working might help address these challenges. Building on the recommendations made in the workshops, our team of computer scientists will develop computerized tools to support healthcare teams to better manage individuals with diabetes, high blood pressure, and kidney disease. These tools will be tested in two primary care units before being rolled out to all 16 primary care units participating in our study. The rollout of the computerised tools will be accompanied by training and ongoing support by our team of clinical nurse facilitators, clinical, and community champions who will support healthcare teams to incorporate the new computerised tools into their quality improvement activities. We will evaluate the intervention using formal statistical approaches which will measure improvements in control of blood pressure, diabetes, and kidney disease over time and compare our 16 intervention practices to other practices in the region. We will also conduct a realist evaluation which will involve interviews with the healthcare teams and observation of meetings and workflows to understand which components of the quality improvement intervention have worked, under what circumstances, and for which populations.\n\nThis project will run from July 2024 to July 2028 and is led by Queen Mary, University of London, and Chiang Mai University in partnership with the London School of Hygiene and Tropical Medicine and the Thai Ministry of Public Health.. The project has 5 objectives:\n\n1. Engage with healthcare providers, decision makers, researchers, and the public to co-design a Learning Health System, for the management of hypertension, diabetes, and kidney disease, and develop computerised data systems, decision support tools, and training materials in 16 randomly selected primary care units across two provinces in Thailand.\n\n2. Train multidisciplinary healthcare teams, data scientists, and researchers in the design, delivery, analysis, and evaluation of a Learning Health System, and establish a cohort of clinical and community champions to support the intervention.\n\n3. Pilot the delivery of a Learning Health System, for improving management and clinical outcomes of hypertension, diabetes, and kidney disease and generate robust new evidence around the acceptability and effectiveness of Learning Health System approaches and delivery of clinical care.\n\n4. Compare outcomes between intervention and control practices and conduct a health economic evaluation of the costs of implementing the Learning Health System versus routine care.\n\n5. Conduct a mixed-methods evaluations to identify provider and patient barriers and facilitators to implementing a Learning Health System to inform subsequent approaches to embedding quality improvement for hypertension, diabetes, and kidney disease care in Thai primary care settings and more widely across the region.\n \n ID: GB-GOV-10-GHRG_4_156179\nTitle: NIHR Global Health Research Group on reducing childhood mortality and morbidity from injuries in Tanzania and Zimbabwe\nDescription: Childhood injuries are a leading cause of death and disability, with 90% of injury burden reported in low- and middle-income countries. Being the leading cause of death for children aged 5 and above, injuries kill more than half a million children every year. Children with non-fatal injuries are frequently left with disabilities adversely impacting their development and quality of life. Childhood injuries contribute to a loss of economic productivity at individual, family, societal and national levels; they lead to catastrophic health expenditures, time off school and work, and impose a significant burden on healthcare systems. Sub-Saharan Africa has a high burden of childhood injury, which may be preventable through simple, cost-effective interventions instituted at family and community levels.\n\nThis proposal, co-led by the University of Oxford and University of Zimbabwe, aims to reduce the burden of disease from injuries among children aged 6 to 12 years in Tanzania and Zimbabwe. Addressing childhood injuries within community settings has been identified as a national priority by decision-makers in both countries, but policymakers in the two countries lack the necessary information for evidence-based resource allocations. The lack of published childhood injury data in the region prevents a comprehensive understanding of factors associated with childhood injuries, care processes, and outcomes; all of which would support the development of interventions to prevent injury occurrence, and improve post-injury care and long-term rehabilitation. This study, funded by the National Institute for Health and Care Research, seeks to fill this knowledge gap over four years, between 2024 and 2028. \n\nOur research programme will address the World Health Organization’s World Report on Child Injury Prevention recommendations:\n\n1) enhance the quality and quantity of data for child injury prevention.\n2) research on the causes, consequences, costs, and prevention of child injuries.\n3) implement specific actions to prevent and control child injuries.\n4) strengthen health systems to address child injuries.. The project has 4 objectives:\n\n1.1. Undertake a meso-level study of select locations within both nations to assess the trauma burden in children, including its drivers, care pathways, outcomes, and economic implications in Tanzania and Zimbabwe. \n1.2. Assess access to health services for injured children in Tanzania and Zimbabwe. \n1.3. Understand specific child road safety risks in Tanzania and Zimbabwe. \n\n2.1. Develop cost-effective strategies to reduce the burden of trauma experienced by children across Tanzania and Zimbabwe.\n2.2. Test the feasibility and acceptability of strategies developed to reduce the burden of childhood injuries. \n2.3. Inform policymaking regarding child injury prevention. \n\n3.1. Assess resource use, costs, and hospital-system efficiencies in the delivery of paediatric trauma care across networks of referral and district hospitals.\n3.2. Support value-based resource allocation for optimised delivery of paediatric trauma care in Tanzania and Zimbabwe. \n\n4.1. Develop a sustainable, community-led quality improvement initiative that introduces baseline standards for access and outcomes of paediatric trauma care (The Paediatric Trauma - Extension for Community Healthcare Outcomes: PT-ECHO) in Tanzania and Zimbabwe. \n4.2. Implement and evaluate the impact of the PT-ECHO initiative on improving access, quality, and outcomes of paediatric trauma care within the targeted communities.\n \n ID: GB-GOV-10-GHRG_4_156184\nTitle: NIHR Global Health Research Group on improving outcomes for people with type 2 diabetes in sub-Saharan Africa\nDescription: Over 20 million people live with type 2 diabetes (T2D) in sub-Saharan Africa (SSA). This number will increase by 134% by 2045, the largest expected increase of all regions in the world. A key challenge for managing T2D in SSA is the lack of local data to inform appropriate management. Increasing evidence shows that diabetes presents differently in SSA compared to high-income countries (HICs). One important difference is that those diagnosed with T2D in SSA are often young and lean, in stark contrast to its classical presentation in older and more obese individuals in high-income countries.\n\nThese observations raise important questions, such as:\n1. What is making lean individuals susceptible to diabetes, and do lifestyle factors play a role?\n2. What is the best way to identify people at risk of T2D in SSA, as most current risk scoring tools rely on age and obesity?\n3. Are the traditional approaches to prevention and treatment of T2D that focus on weight loss and/or metformin (to treat insulin resistance associated with obesity) as effective in this population where a high proportion (40-60%) of those living with T2D are lean?\n\nCollaborators from Uganda (Medical Research Council (MRC) / Uganda Virus Research Institute (UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Research Unit), Cameroon (University of Yaoundé 1), Malawi (Malawi Epidemiology and Intervention Research Unit, MEIRU), South Africa (University of Cape Town) and the UK (University of Exeter) aim to improve outcomes for people with T2D in SSA by addressing these questions. In a four-year project (July 2024 - 2028), the group will do this through three work packages using a combination of existing data and new research studies undertaken Uganda, Cameroon and Malawi. The group will also focus on developing leaders in diabetes research and building research capacity through studentships and training and capacity strengthening across clinical, laboratory, epidemiology, social and implementation science.. The project has 5 objectives:\n\n1. Determine whether lifestyle behaviours (diet and physical activity) contribute to lean type 2 diabetes (T2D) and explore whether current national guidelines for lifestyle change have the same effect in lean and obese individuals.\n2. Use data from our research in objective 1 and the literature to co-develop and pilot a new structured education intervention for T2D, incorporating appropriate lifestyle education including for those with the lean phenotype.\n3. Investigate whether commonly used low-cost T2D drugs work as well in lean patients as they do in individuals with obesity in sub-Saharan Africa (SSA).\n4. Use existing data from different countries to comprehensively identify the risk factors for lean T2D and integrate these into tools to improve identification of at-risk individuals who should be screened.\n5. Strengthen the capacity to undertake multidisciplinary diabetes research that leads to policy translation and practice in SSA.\n \n ID: GB-GOV-10-GHRG_4_156234\nTitle: NIHR Global Health Research Group on improving equity in respiratory disease outcomes in Africa using data-driven tools\nDescription: The improving equity in respiratory disease (RD) outcomes in Africa using data-driven tools (EQUI-RESP-AFRICA) Global Health Group aims to reduce the number of deaths, disabilities and wider health and societal impacts from respiratory diseases in the most disadvantaged populations across Africa. Combined, respiratory conditions including pneumonia, chronic obstructive pulmonary disease, influenza, asthma, tuberculosis, lung cancer and COVID-19 are the leading causes of death and disability both in Africa and globally. Despite this, knowledge and awareness of respiratory diseases are low, and they do not get the priority attention they need from health systems, policymakers and funding agencies. \n\nAn interdisciplinary group of academics, policymakers, representatives of non-governmental organisations (NGO), patients and civil society will implement a 4-year programme starting in Sept 2024 to address key respiratory diseases in five African countries where morbidity and mortality from respiratory diseases are very large: Nigeria, Kenya, Cameroon, Cote d’Ivoire, and South Africa. This is a collaboration co-led by the University of Edinburgh, UK and the University of Lagos, Nigeria, that is supported by a wide network of institutions and organisations in Africa and internationally.\n\nEQUI-RESP-AFRICA will build strong, equitable partnerships and develop capacity with research groups in African partner countries. It will focus on several lines of work based on local research priorities, which will be supported by cross-cutting platforms. These activities will generate new knowledge and use it to improve healthcare for the most underprivileged and support the development of appropriate health policies. The cross-cutting platforms will focus on knowledge exchange and capacity building in data science, digital health and innovation; then, on strong stakeholder and community engagement; and on data-driven formulation of health policies based on tools. It will prioritise the implementation of equitable interventions appropriate to each African context and tailored to patients’ needs. Strong community engagement and Involvement (CEI) strategies, and wide networks covering policy makers, local healthcare providers and NGOs will be developed to improve the relevance and impact of our research and reduce health inequity. We will focus on the problems of the poorest and underprivileged groups and on opportunities to improve gender equity in our network of partner countries.. This project has 6 objectives:\n\n1. Synthesise the existing knowledge to map the landscape of respiratory medicine in African partner countries. The focus will be on life-threatening respiratory infections, such as pneumonia and influenza, and also on chronic conditions silently present in many Africans: chronic obstructive pulmonary disease (COPD), asthma, and tuberculosis.\n2. Assess how much the health systems in African partner countries are prepared for dangerous emerging respiratory infections, such as COVID-19 and possible pandemic strains of influenza and other diseases. This line of work will study the factors that could undermine a decisive epidemic response and assess the capacity and security for providing oxygen treatment. It will then explore how local health workers adhere to internationally accepted guidelines for diagnosis and treatment.\n3. To conduct a study on the feasibility of introducing a programme of pulmonary rehabilitation and its effectiveness. This line of work will also evaluate the role of preventable risk factors for respiratory conditions, e.g. tobacco smoking and exposure to indoor and outdoor air pollution, which underlie millions of deaths globally each year.\n4. To build capacity in research methods, data science, digital health, AI and innovation among researchers in African partner countries.\n5. To engage relevant in-country stakeholders and community representatives and to raise awareness of respiratory health. \n6. To translate quality evidence to health policy using specific, evidence-based, data-driven tools to identify priorities and improve equity. \n\n \n ID: GB-GOV-10-GHRG_4_156261\nTitle: NIHR Global Health Research Group on COPD in primary care in South America (Breathe Well South America)\nDescription: This research programme addresses the problem of poor and inequitable access to quality primary healthcare for chronic obstructive pulmonary disease (COPD) patients in South America. COPD is the fourth leading cause of death in the continent, with a high hospital healthcare and societal burden, disproportionately affecting the poor. More than 75% of cases remain undiagnosed, therefore untreated.\n\nBuilding on a previous Global Health Research Group in Brazil, the aim of the programme is to develop primary care research capacity in South America (specifically Argentina, Brazil, and Peru) to improve earlier identification and management of COPD. It is co-led by the University of Birmingham (UoB) and the Universidad Cientifica del Sur (UCSUR) in partnership with CRONICAS Centre of Excellence in Chronic Diseases in Peru. The co-leads work in an equitable partnership with the Institute for Clinical Effectiveness and Health Policy (IECS) in Argentina and the University of São Paulo (USP) in Brazil. The three partner Institutions (‘hubs’) in South America will work with and build capacity amongst colleagues from 2-3 less-experienced institutions (‘spokes’), situated in contrasting geographical/economic areas which include the most disadvantaged populations. \n\nOver four years, starting in July 2024, Breathe Well partners will develop a set of COPD quality indicators, and an identification pathway for COPD patients in primary care. They will test the feasibility of these in different settings, and model the preliminary cost-effectiveness of the pathway and its potential impact on health inequalities. Based on the outcomes of the work, partners will then submit funding applications for full trials of the developed interventions.. The project has 8 objectives:\n\n1. Develop sustainable research infrastructure and research leaders, in order to deliver high quality COPD research in primary care in South America. This will involve training individuals on a range of generic, clinical and research skills and methods, and engaging with academic, clinical and funding institutions to sustain future research.\n\n2. Develop sustainable engagement with community members, clinical leaders and policy stakeholders, to ensure research is rooted in local, national and regional needs with clear pathways to impact on health and healthcare. The core project partners will provide training and mentoring for local teams to identify, engage, influence and work with relevant stakeholders, in order to ensure sustainability of impact. \n\n3. Assess the current quality of COPD primary care in Argentina, Brazil and Peru. This assessment will cover governance and the policy context, foundations, processes, quality and inequities, as well as the quality of electronic healthcare records (EHR). \n\n4. Develop a set of COPD quality indicators. These indicators will be used to monitor and improve the quality of care. \n\n5. Co-develop/adapt a pathway of identification and management of COPD patients in primary care, from early diagnosis through management and self-management. The pathway will be based on locally-appropriate, team-based, task-sharing implementation. \n\n6. Test feasibility of implementation. The pathway will be tested, including a comparison of different settings to evaluate its potential impact in different segments of society. \n\n7. Model preliminary cost-effectiveness of the pathway and potential impact on health inequalities. The pathway will be assessed using exploratory decision model-based health economic analyses from both healthcare and societal perspectives. \n\n8. Submit funding applications for full trials of the developed interventions.\n \n ID: GB-GOV-10-GHRG_4_156297\nTitle: NIHR Global Health Research Group on optimising antibiotic usage to mitigate antimicrobial resistance\nDescription: Antimicrobial resistance (AMR) is a global health security priority that is expected to severely impact health outcomes in low-income countries with inappropriate use of antibiotics being a key driver. Antibiotic prescribing and use (ABU) must be optimised to ensure patients with life-threatening illnesses receive appropriate medication while decreasing unnecessary prescriptions. This challenge is complicated by the lack of affordable, accurate and rapid diagnostics to support antibiotic stewardship by local health systems. Our focus is on community-based facilities where clinicians have limited time for therapeutic decision-making and where the emergence of AMR is a marker of failure of the health system to deliver quality care (QoC). \n\nOur Research Group comprises research institutions in the UK, Liverpool School of Tropical Medicine (LSTM), Uganda (Makerere University and doctors for Africa CUAMM (Collegio Universitario per Aspiranti Medici Missionari)), Zambia (Centre for Infectious Disease Research in Zambia - CIDRZ) and Malawi (Malawi Liverpool Wellcome Trust Centre). In Uganda, Zambia, and Malawi, we will rapidly assess the QoC for febrile children under 5-years of age to understand drivers of inappropriate ABU and support quality improvement at the health system level. To contribute to understanding drivers of AMR, we will develop a method for sentinel surveillance of key pathogens to identify regional differences in AMR prevalence and ABU in local health facilities and ABU in local communities. \n\nUsing community data at two time points we will assess and develop local solutions to address inappropriate ABU and prescribing practices. Our aim is to understand the AMR-ABU linkage and improve practices exacerbating AMR using a new surveillance system which can be locally sustained. Our project is located in three sub-districts in each country with assessments taking place at two time points to assess progress improving ABU and reducing AMR. The project will take place from August 2024 to July 2028.. This project has 4 objectives:\n\n1. Develop a surveillance system for tracking antibiotic use (ABU) and antimicrobial resistance (AMR) in three districts in Uganda, Malawi, and Zambia, assessing clinical care quality in lower-level health facilities for febrile illnesses.\n2. Investigate the relationship between quality of clinical care (QoC) in health facilities and AMR to key antibiotics by sampling febrile children to measure AMR prevalence and resistance patterns. \n3. Explore community-level drivers of ABU and AMR focusing on childhood febrile illnesses through surveys measuring caregivers' knowledge and practices, complemented by qualitative analysis for insights into health perceptions. \n4. Assess the risk of AMR development by analysing genomic traits from swab samples, detailing circulating resistance genes, and experimentally evolving bacterial isolates to evaluate potential resistance emergence.\n \n ID: GB-GOV-10-GHRG_4_156363\nTitle: NIHR Global Health Research Group on nurturing the resilience of mobile youth to navigate health and wellbeing crises in southern Africa\nDescription: A UK and low- and middle-income country (LMIC) research partnership to address the sexual and reproductive health rights (SRHR) of young migrants, by creating lasting interventions with young people to raise awareness of their eligibility for SRHR and promote the responsiveness of services in Zambia and South Africa. We aim to build resilient mobile adolescent and young people’s social networks that enhance visibility and solidarity, as well as inform policy and practice on building responsive SRHR services for mobile adolescent and young people in southern Africa.\n\nBetween 2024 and 2028, we will take a theory-based and systems perspective to synthesise two complementary concepts: candidacy and the framing of health systems’ responsiveness. This will place mobile adolescent and young people’s experiences of engaging with systems/services at the centre of addressing their needs, emphasising the importance of a deeper understanding of context at individual, community, institutional, and systems levels. Central to our approach is the involvement of mobile adolescent and young people in all stages, from problem identification, selection of interventions, approaches to delivery, monitoring and evaluation, results dissemination, and planning next steps.\n\nThis project will approach capacity strengthening in a comprehensive way, by nurturing the careers of early and mid-level researchers and ensuring community engagement and involvement throughout. This will contribute to enhancing and sustaining individual skills and expertise; relevant organisational systems and processes and group/network-level partnerships. By the end of the project, we will have developed interventions to improve mobile adolescent and young people’s access to SRHR services; co-created systems to monitor service responsiveness; supported identifiable youth-led approaches which enhance mobile adolescent and young people’s visibility; and established early/mid-career African researchers as research leaders.. The project has 5 objectives:\n\n1. Synthesise evidence that examines causation in youth-led health research to identify effective approaches and emergent processes that enhance health systems responsiveness and improve access to SRHR services for mobile adolescent and young people (mAYP) in southern Africa.\n\n2. Anchored by youth-led social mobilisation, to co-develop and implement interventions with young people that support mAYP to recognise their candidacy and access sexual and reproductive health services, working with health-care stakeholders to identify ways to make care more responsive to mAYP requirements.\n\n3. Co-produce and use a participatory monitoring and evaluation process in the piloting of the co-developed interventions, assessing their feasibility (including resource needs), acceptability, and equitable reach. \n\n4. Continuously engage and involve communities and other stakeholders to encourage and facilitate youth-led mobilisation to nurture their resilience and support facility/provider responsiveness to the health and well-being needs of mAYP.\n\n5. Consolidate and strengthen South African and Zambian researcher’ skills and agency to navigate the inequitable power dynamics in health research, promoting their visibility and shared intellectual leadership across Zambia, South Africa, and in the UK, to influence practice and policy in relation to the health and wellbeing needs of mAYP.\n \n ID: GB-GOV-10-GHRG_4_156365\nTitle: NIHR Global Health Research Group on Zoonotic Causes of Acute Febrile Illness (GHRG-ZAFI)\nDescription: Acute fever is a leading cause of child mortality in sub-Saharan Africa, responsible for 40% of child deaths (1.2 million fatalities) annually. Children presenting with acute fever are frequently assumed to have malaria or bacterial infections, leading to inappropriate treatments. A significant portion of these children likely suffer from zoonotic infections—diseases transmitted from animals to humans. Diagnosing these infections is challenging because healthcare professionals often lack training, and testing for zoonotic diseases is limited in much of Africa. \n\nOur Global Health Research Group aims to address this issue by:\n1.\tDetermining which zoonotic infections are most prevalent in the region.\n2.\tDeveloping effective, new diagnostic tests for these infections.\n3.\tEstablishing evidence-based guidelines to aid healthcare professionals in diagnosing and treating zoonotic infections.\n\nOur research group unites experts from the UK (University of Liverpool and Liverpool School of Tropical Medicine) and Africa (Kabale University and Makerere University in Uganda; University of Nairobi and the International Livestock Research Institute [ILRI] in Kenya; and Addis Ababa University and ILRI in Ethiopia). \nOur methodology includes:\n•\tConducting studies in rural and urban areas of Uganda, Kenya, and Ethiopia to understand the symptoms, causes, and risk factors of fever in children.\n•\tDeveloping and assessing new tests for zoonotic infections to determine their feasibility for use in clinical or research settings.\n•\tEngaging with communities and healthcare providers to understand their perceptions of the causes of fever and the challenges they face in treatment, as well as how healthcare is accessed by those who are sick.\n\nThrough these studies we aim to develop tools and guidelines for diagnosing and treating acute fever in children in our target countries. Additionally, we will focus investment and training to enhance the capabilities of our partner institutions in detecting zoonotic infections and nurturing future leaders in zoonotic disease research.\n\nDuring the project lifespan (July 2024 - June 2028), our group will improve the local capacity to diagnose zoonotic infections and introduce new diagnostic tests. In the medium to long term, better detection and reporting of zoonotic infections will lead to more accurate treatment of fever, thereby reducing childhood mortality and curbing the misuse of antimalarial and antibiotic treatments.. The project has 4 objectives:\n\n1. Determine the common zoonotic causes of acute febrile illness and associated factors in paediatric patients living in urban and rural areas of Uganda, Kenya and Ethiopia.\n1.1 Quantify the burden of non-malarial fever and identify the major zoonotic aetiologies.\n1.2 Identify risk factors for and clinical indicators of infection with specific zoonotic pathogens.\n\n2. Develop and test novel technologies and approaches for diagnosing zoonotic causes of acute febrile illness that are suitable for use in low- and middle-income countries and field settings.\n2.1 Evaluate point-of-care tests and pilot prototype molecular diagnostic platforms for key zoonotic pathogens.\n2.2 Determine the best sequence of tests to optimise diagnosis of fever.\n\n3. Involve communities and the health sector in Uganda, Kenya and Ethiopia in defining improved approaches to diagnosis and management of zoonotic causes of acute febrile illness.\n3.1 Identify community perceptions on the causes of acute febrile illness and care seeking behaviours for fever.\n3.2 Develop and validate a decision support tool for diagnosis and management of zoonotic causes of acute febrile illness in clinical settings.\n\n4. Strengthen capacity and capability for research on diagnosis and management of zoonotic diseases in Uganda, Kenya and Ethiopia. \n4.1 Develop and implement evidence-based capacity strengthening plans to ensure that all partner-affiliated laboratories have the capability to perform quality-assured molecular diagnostics research for zoonotic infections.\n4.2 Develop a cohort of clinical and laboratory scientists with expertise in zoonotic causes of acute febrile illness.\n \n ID: GB-GOV-10-GHRG_4_156442\nTitle: NIHR Global Health Research Group on community-based ear and hearing care\nDescription: Ear disease and hearing loss are common and under-recognised disorders, with 80% of the 1.6 billion people with hearing loss living in lower- and middle-income countries (LMICs). Hearing loss affects individuals, society, and the economy, through effects on health, education, employment, and community. Recent advances in developing a low-cost high-performance hearing aid could help many, but will fail to support two of the most disadvantaged groups: those with persistent or recurrent ear discharge due to a hole in the ear drum (a disorder called chronic suppurative otitis media, CSOM) and those who are born deaf.\n\nCSOM affects predominantly those in LMICs, and it is thought that 250 million people are affected. In CSOM, a hole in the ear drum leads not only to hearing loss, but also to intermittent or continuous discharge of pus that is stigmatising and precludes use of a conventional hearing aid. For those born deaf, hearing aids cannot help as the loss is too severe. In many LMIC communities, these children are erroneously assumed to lack intelligence, so denied access to education or means of communication.\n\nOur team has pioneered and undertaken feasibility studies for three novel solutions that enable community-led self-care for ear and hearing disorders in LMICs:\n1. Iodine antiseptic washout for active ear discharge in children and adults with CSOM. Iodine has the potential to treat infection, is widely available in LMICs, and is not toxic to the ear.\n2. Low-cost bone-conduction aids for hearing loss in children and adults with CSOM. Bone conduction sends sound through vibration of the skull and so circumvents the diseased ear drum.\n3. Web and app-based digital sign-language dictionaries to connect deaf children, their parents and communities, and empower the deaf community. This software has been developed and optimised over the past 8 years for Pakistani sign language by project partner Deaf Reach, and could be adapted to sign languages in other countries.\n\nAlmost all existing research partnerships in ear and hearing care are based in high-income countries, despite the large burden of disease in LMICs. This will be a four-year project from September 2024 to August 2028, to develop an international team to instigate and support these and other future trials in the field of ear and hearing care in LMICs, partnering with local clinical teams and universities. We will develop capacity in research, in ear and hearing care in three low-income countries: Zambia, Cambodia and Malawi.\n\nOur project is focused on developing community-based solutions, so it has and will continue to include community members in developing and steering the project. Our solutions, we hope will enable people to stop their ear discharge and/or recover functional hearing, leading to improvements in self-confidence, socialisation, education and employability, with advantages to community and society as well as individuals.. The project has 4 objectives:\n\n1. To evaluate the lived experience of individuals living with chronic suppurative otitis media (CSOM) and children who are deaf, and the attitudes knowledge and beliefs of their families, teachers and community, to ensure current and future interventions are sensitive to their needs.\n2. To evaluate the effectiveness and uptake of interventions for community-based ear and hearing care: topical iodine for ear discharge in people with CSOM, low-cost bone conduction headsets for people with CSOM, and digital sign-language dictionaries for empowering deaf culture.\n3. To train four PhD researchers in our partner countries (Malawi, Cambodia, Zambia) to become the academic leaders of the future in this field.\n4. To develop a global academic team that will lead future research in ear and hearing, focused on real world change, through impact on healthcare policy and practice.\n \n ID: GB-GOV-10-GHRG_4_156467\nTitle: NIHR Global Health Research Group on Virus Genomics for Outbreak Response (ViGOR) in Central and East Africa\nDescription: The application of genomics to the analysis and interpretation of virus outbreaks is now widely adopted in disease response, as was the case in the COVID-19 pandemic. However, the effective use of genomic science is contingent on having relevant technical capacity closely linked to national and local public health systems. These two components are often not established or indeed integrated. This project will produce optimised genomics analysis protocols for investigating past and future virus outbreaks in Central/East Africa and will strengthen links between technological developments, reference testing laboratories and public health authorities. The key aim is to develop more effective public health responses. The different data types/sources collected from outbreaks will be converged in new mathematical models to forecast the potential impact of various intervention scenarios. The project will closely link with health systems in each of the countries involved.\n\nThe lead institutes in this study are the University of Warwick, UK, and KEMRI-Wellcome Trust Research Programme, Kenya, for the mathematical modelling and genomics development/analysis, respectively. At its conclusion, we aim to have set up (a) critical sequencing/bioinformatics protocols in at least three regional reference laboratories (one in each of Kenya, Comoros and Democratic Republic of Congo), (b) enhanced local virus outbreak response expertise in genomics and modelling through purposive research mentorship opportunities and short courses on current cutting-edge approaches, and (c) relevant structures to support the rapid translation of genomics insights to outbreak responses. At all the key project implementation phases, we aim to adequately consult critical community and public health stakeholders to identify local priority infections and co-develop best practices in genomics/modelling evidence requirements and presentation for optimal intervention impact. The project will be implemented between 2024-2027.. This project has 7 objectives:\n\n1. Create a suite of optimised readily accessible and adaptable virus genome sequencing and bioinformatic protocols for priority outbreak pathogens in Central/East Africa - these will be made available for rapid deployment in reference labs for improved outbreak public health response.\n2. Transfer sustainable technical capacity in virus sequencing and bioinformatic analysis to three collaborating reference laboratories (in Kenya, Comoros and Democratic Republic of the Congo) - this will include mentorship of identified individuals in these labs to oversee future application of virus genomics in outbreak response of their labs.\n3. Investigate pathogen aetiology for select previous disease outbreaks with unknown aetiology by applying broad diagnostics/agnostic sequencing methods on samples archived in our partner labs - specific pathogen positive samples will be henceforth whole genome sequenced to provide data for elucidating the origins, dispersal patterns, and evolution of endemic and emerging viruses that have caused virus outbreaks in Central and East Africa.\n4. Through integrated epidemiological analysis of genomic and case data, we will advance understanding of the nature of past and prospective virus outbreaks during the project lifetime - we will develop and apply the mathematical models that converge these data types for improved insights and better public health response.\n5. Generate wider involvement in sequencing, genomics analysis and outbreak modelling within the Central/East Africa region by naturing local human resource capacity through targeted training, and mentorship of budding expertise - we will offer a competitive and closely mentored Research Fellowship scheme for growth of expertise in the region.\n6. Strengthen the collaborative link between the University of Warwick and KEMRI-Wellcome Trust Research Programme for enhanced synergy of their areas of strength, genomics and epidemiological modelling, respectively.\n7. Improve understanding, and potentially, uptake of genomics and mathematical modelling insights in outbreak response among key stakeholders in local/country level health systems. We will have an end-to-end involvement of relevant community stakeholders impacted by disease outbreaks in implementing the modern genomics/modelling advances.\n \n ID: GB-GOV-10-GHRG_4_156517\nTitle: NIHR Global Health Research Group on racism and social inequalities in mental health in Brazil\nDescription: This research is going to explore the questions of how racism and social disadvantage impact the mental health of Black Brazilians and how capacity can be built in research and healthcare around intersectional, anti-racist mental healthcare provision in Brazil.\n\nBrazil is a highly socio-racially unequal society where Black communities are characterised by extreme poverty, racial and social discrimination, and restricted access to health services. Brazil has high levels of unmet mental health problems in Black communities, leading to significant impact on quality of life, poor health outcomes and reduced educational/employment opportunities. There is a significant gap both in research and interventions on racism in mental health, notably from an intersectional approach. \n\nThe aims are to establish an urgently needed evidence base on racism and mental health in Brazil, and co-design effective, context-bespoke and culturally acceptable interventions to address mental health needs in underserved Black Brazilian communities. The objectives are to produce intersectional knowledge on racism and mental health; to conduct research with Black Brazilians; to co-develop community mental health interventions and training packages; to influence mental health policy in Brazil and the wider region; and to build sustainable research capacity. \n\nThis is a 4-year multidisciplinary mixed-methods study informed by a participatory action approach and underpinned by robust community engagement and involvement (CEI). Research through 4 case studies in quilombola and favela communities and mental healthcare services in the states of Bahia and São Paulo in Brazil. Completion: research by mid-2026; interventions and evaluation by early 2028; dissemination by mid-2028. \n\nThe strength of the project lies in the collaboration with 12 project partners from the health community, civil society, government, and international science community, which will aid rapid dissemination and achieve high impact. The project 'Mental Health Policy Network' will disseminate the new evidence on racial and social discrimination in mental health through presentations, open access publications, podcasts, videos, and a bilingual website. The project will establish a sustainable platform for future global mental health researcher-leaders and healthcare professionals. The project directly addresses the UN Sustainable Development Goals (SDGs) by promoting health and well-being for all.\n. The project has 6 objectives:\n\n1. To produce intersectional knowledge on the effects of racism on mental health in Brazil.\n2. To conduct socially engaged research with underserved Black communities in Brazil.\n3. To co-develop, with community members and stakeholders, community mental health interventions and training packages.\n4. To recommend and influence mental health policy at municipal, state and national levels in Brazil.\n5. To foster cross-cultural learning on racial and social inequalities in relation to mental health care in the Latin American and Caribbean (LAC) region.\n6. To build sustainable research capacity on inequalities in mental health through the group on racism and social inequalities (ORI) partnership.\n \n ID: GB-GOV-10-GHRG_4_156521\nTitle: NIHR Global Health Research Group on community health intervention through musical engagement for maternal mental health\nDescription: Pregnancy can be a particularly difficult time for women facing adversity or mental health issues. These challenges can affect the mother's well-being, employment, and community engagement. As the mother is at a higher risk of poor birth outcomes and postnatal depression, potentially impacting her ability to care for her child after birth. The child of a woman with antenatal depression, anxiety or stress during pregnancy is at twice the risk of cognitive, social, emotional, and behavioural problems. \nDelivering universal preventive interventions has the potential for broad impact and long-lasting consequences for mothers and their children, offering a scalable solution for improving maternal mental health without the need for screening, which is often unfeasible in resource-constrained settings.\n\nWorking with pregnant women and local women’s groups in The Gambia, we co-developed a music based intervention, CHIME (Community Health Intervention through Music Engagement) that involves pregnant women meeting for 6 weeks to make music together, drawing on community songs, adapting lyrics to give messages around maternal health and support, lifting mood and creating a supportive network. Building on outcomes from our published feasibility trial, researchers and academics from The Gambia, South Africa, Lesotho and UK will work with local communities, those with lived experience and other stakeholders to test effectiveness and cost-effectiveness in the Gambia via a full trial; test generalisability to an urban context in South Africa via a co-development process and feasibility trial and explore the potential uses of music for maternal mental health promotion in Lesotho, a rural context with rich culture around traditional and popular music, but where capacity around health promotion strategies is lacking. The project and research will be conducted over a 4 year period from September 2024 to August 2028. \n\nMeasures of effectiveness will focus on maternal mental health, wellbeing and functioning, as well as collected clinic data (antenatal care attendance, institutional delivery, birthweight, birth complications, breastfeeding success, vaccination uptake) and infant outcomes, via a parental self report. Through community and stakeholder partnership building, we will explore pathways for the CHIME intervention to be scaled and implemented. The primary target for impact is improvement in mental health and well-being of antenatal women, with cascading effects for their children, families, community and society.. The project has 8 objectives:\n\n1. Mentor, train and collaborate with researchers and non-academic partners across all sites to build capacity for research, both relevant to Community Health Intervention through Music Engagement (CHIME), and to advancing expertise and skills relating to maternal mental health, public mental health and community-based interventions.\n2. Engage with perinatal women, their families and communities as well as other stakeholders across all three sites to equip, engage and empower them to play a significant and sustainable role in the project.\n3. Comprehensively describe, through stakeholder input, how the CHIME intervention works in context, at both a cross-country and country-specific level, to inform intervention development, trial design, outcome measures and scenarios for implementation.\n4. Explore opportunities and develop partnerships for the future expansion of CHIME with a view to planning for its implementation in Lesotho.\n5. Adapt and conduct the CHIME intervention in Khayelitsha, South Africa in partnership with community members and service providers and test the feasibility of evaluating it through a cluster RCT.\n6. Test the effectiveness, cost effectiveness and asses the proposed mechanisms of action of CHIME in the Gambia.\n7. Co-develop plans for scaling CHIME and assess their budget impacts and return-on investment in the Gambia and South Africa.\n8. Utilise the knowledge generated through the CHIME research activities to influence policy and practice in the development and implementation of participatory-music based interventions for maternal mental health in the study countries and regions.\n \n ID: GB-GOV-10-GHRG_4_156579\nTitle: NIHR Global Health Research Group on AI-assisted point-of-care ultrasound (AI-POCUS) for TB screening\nDescription: This Global Health Research Group (GHRG) aims to develop a simple, cheap imaging solution to screen for tuberculosis (TB). The World Health Organization strategy to \"End TB” by 2035 requires more people to be screened, diagnosed, and treated for TB. Current screening guidelines include chest x-ray, but this is inaccessible to many of the poorest people worldwide who are most in need of screening for TB. Ultrasound may be an alternative, as it is a simple and safe procedure that can be used for adults and children. Portable ultrasound probes (“Point-of-care” ultrasound, POCUS) that can connect to mobile phones could be placed at the lowest levels of the health care system in countries most affected by TB. Initial research is promising, but highly trained health workers able to interpret ultrasound images are not widely available. Therefore, artificial intelligence (AI) could provide a solution. This GHRG will bring together researchers from the London School of Hygiene and Tropical Medicine (LSHTM) and Imperial College in the UK with researchers from four high TB burden countries; Centro de Investigacao em Saude de Manica (CISM) in Mozambique, Zambart in Zambia, Prisma in Bolivia and Peru, alongside Delft Imaging to develop an AI-supported POCUS tool. \n\nThe project will conduct research over 4 years (2024-2028) to co-design an AI-POCUS tool. We will collect clinical, microbiological and imaging data to determine whether it is an effective tool for TB screening. To develop the AI reading, large numbers of images and data are needed, posing challenges with data privacy and ownership if data is transferred to a central source. The GHRG will therefore conduct research around the broader ethics of data privacy and transfer, and will pilot a “federated machine learning approach”, which involves all sites retaining full ownership of their data and concurrently training a general machine learning model on-site, before combining these models into a centralised one. Clinical performance and costs of a final version of an AI-supported POCUS product will then be assessed across the four sites in adults and children being investigated for TB. The GHRG will finally present the findings and discuss the roadmap to the further development of the product with communities affected by TB and policy makers. We will also produce a training package for health workers to facilitate adoption beyond the facilities and countries in this GHRG.. This project has 5 objectives:\n\n1. To create a network of multi-disciplinary researchers, clinicians, communities affected by TB, industry partners, and policy makers for integrated capacity strengthening, co-design and evaluation of an artificial intelligence-supported point-of-care ultrasound (AI-POCUS) for TB screening in children and adults. Using a model of equitable research partnerships the group will jointly make decisions on the best protocols to answer the research questions and evaluate the final product. We will include community-led research to understand the user perspective of AI-POCUS. We will build capacity in research and in the generation and ethics of artificial intelligence. \n\n2. To optimise different point-of-care ultrasound (POCUS) acquisition protocols and training methodologies in different epidemiological contexts. We will conduct formative studies, including qualitative research, in the four countries to assist in the design of the final AI-POCUS model. \n\n3. To automate the reading of point-of-care ultrasound by contextualizing the AI-POCUS approach at health facility level in low- and middle-income countries, broaden the understanding around the ethics of data sharing in artificial intelligence (AI) and pilot a distributed collaborative machine learning approach. We will establish a federated learning network with each country using its own data to train a machine-learning algorithm which will be shared across the network. Maximizing learning while minimizing the risks of data sharing. The outcome of objectives 2 and 3 will be a functional AI-POCUS model.\n\n4. To evaluate the clinical performance, acceptability and costs of implementing AI-POCUS. The AI-POCUS model developed from objectives 2 and 3 will be evaluated through a unified protocol in the 4 country sites.\n\n5. To disseminate research findings to maximise uptake of an AI-POCUS for TB.\nDissemination will involve local, national, and international dissemination and publication of main outcomes in scientific journals. We will develop a training kit for users and work with our industry partner to package and promote a successful AI-POCUS tool more widely.\n \n ID: GB-GOV-10-GHRG_4_156644\nTitle: NIHR Global Health Research Group on Post-TB CARE (Centre for Assessment and Research Excellence)\nDescription: Around 150 million people alive today have survived Tuberculosis (TB), but many will still suffer from the post-TB consequences. Almost all TB survivors live in countries where there is limited or no care available, which leads to much suffering. Our Post-TB Centre for Assessment and Research Excellence (CARE) project will help us to understand what care TB survivors need, and what care can be provided in places where options are very limited, but the needs are high.\n\nIn our Post-TB CARE project, we will first look at how TB survivors still suffer the consequences from TB after their medication is completed. Then we will ask TB survivors, doctors, and nurses what they think is the best way to provide post-TB care in their community. This information will help us to design studies to assess potential methods for improving the lives of TB survivors and their families. Finally, we are building a team and centre in South Africa to lead post-TB research. \n\nWe, at the London School of Hygiene & Tropical Medicine, Stellenbosch University, KHANA Center for Population Health Research and TB Proof are a group of researchers, doctors, care providers and TB survivors working together to make post-TB care better in the places where TB survivors live. We will be working with communities in South Africa and Cambodia with support from the United Kingdom. \n\nThe study will start in August 2024, and we hope to have completed our work in 4 years.. The project has 4 objectives:\n\n1. What is needed: Develop an operational multidimensional assessment tool, which can quantify impairment in TB survivors to accurately assess post-TB care needs. We will take a patient-centred approach by creating patient listening groups to determine the reported needs of TB survivors and inform scope of development of the operational and reference assessment tools, followed by recruitment of TB survivor cohorts in South Africa and Cambodia. The data will be used to inform the tests of post-TB impairment we will apply, and how we identify the operational assessment tool based on simple and low-cost diagnostics.\n\n2. How do we provide care: Design an effective, appropriate and sustainable post-TB care package for resource-limited settings, using good clinical governance. We will complete a pathway to understand preferences, combining qualitative and health economics methodology. We will conduct group discussions with TB survivors to identify care package components, followed by interviews with TB survivors and care providers in South Africa and Cambodia. These will inform attributes and levels for Discrete Choice Experiments (DCEs), where we can enumerate what patients and providers prefer in an effective, appropriate, and sustainable post-TB care package, evaluated with final interviews.\n\n3. Share what we know: Create a knowledge sharing and advocacy platform for post-TB in high-burden TB settings. We will build knowledge sharing networks both online and in-person, within and across geographical regions. TB survivor and post-TB care provider led, we will conduct stakeholder mapping in South Africa and Cambodia to identify relevant groups and existing networks, develop an online hub for activities and train a new cadre of TB champions.\n\n4. Future research leaders: Develop a multi-disciplinary centre of excellence for post-TB research, care and community engagement in South Africa to enable sustainable, collaborative south-south and north-south research partnerships in post-TB. We will develop a self-sustaining centre of post-TB excellence at Stellenbosch University (SU) through the work in Obj 1 to 3. TB survivor community perspective will be a leading voice, through an independent community advisory group. Financial sustainability of the centre will come via new funding applications, led by SU and Global South partners.\n \n ID: GB-GOV-10-GHRG_4_156700\nTitle: NIHR Global Health Research Group on working towards patient centred care by integrating TB and respiratory services in Africa\nDescription: An estimated 10.6 million people develop tuberculosis (TB) disease each year, with a quarter of cases occurring in Africa. TB is damaging to the lives and livelihoods of patients and their families, often causing increased poverty and poor long-term health outcomes even after treatment. There is a strong overlap between the symptoms, presentation, and needs of patients with chronic respiratory diseases and TB disease. Both groups experience cough and breathlessness, and their first point of contact with health services is often through TB services. Risk factors for respiratory diseases and TB are similar and include smoking, occupational exposures, and HIV. TB can directly cause lung damage, and similar interventions are used to care for patients with respiratory diseases and post-TB lung disease, including pulmonary rehabilitation and inhaled medications. \n\nDespite this overlap, TB and respiratory care in low-resource settings are delivered separately. TB care is provided via strong and well administered National TB Programmes (NTPs), but respiratory care is provided via less well defined and poorly resourced health systems. As a result, patients with TB do not receive good respiratory care, and those with lung diseases are either undiagnosed and untreated, or given un-necessary TB treatment and antibiotics for their symptoms. Our previous work with patients, health care workers, and policy makers in Africa has shown a wish to develop integrated TB-respiratory care to improve patient outcomes. However, there are no models of how this might be achieved, and this has prevented services from being implemented on the ground.\n\nIn this project we will develop a novel model of patient-centred integrated TB-respiratory care for implementation and evaluation in urban sites in three African countries: Nigeria, Kenya, and Tanzania. This work will be delivered by research partners in the UK (National Heart and Lung Institute at Imperial College London, University of Warwick), The Netherlands (Vrije Universiteit Amsterdam), Kenya (Centre for Respiratory Disease Research, Kenya Medical Research Institute), Tanzania (Kibong'oto Infectious Disease Hospital), and Nigeria (University of Lagos). The work will be completed together with local stakeholders and communities, to ensure that the services developed are suitable for local use. The project will run from July 2024 to July 2028.. The project has 7 objectives:\n\n1. To complete a literature review to understand potential models of integrated care, the impact of these, and approaches to evaluation. \n\n2. To describe the burden of non-TB respiratory disease amongst patients presenting to TB services, to inform a diagnostic pathway for lung conditions.\n\n3. To work with TB patients to understand the respiratory exposures they face, and how they address these, and to co-develop tools to empower them to improve their own respiratory health.\n\n4. To understand the changes which would be needed to health systems in order to deliver integrated TB- respiratory care, and what the challenges and impact of this might be. \n\n5. To understand the potential economic costs and benefits of integrated approaches to TB-respiratory care, and to develop a framework for formal economic evaluation of these models of care.\n\n6. To map and engage with stakeholders and community members with interest or influence in TB and respiratory care.\n\n7. To deliver sustainable research capacity strengthening in each site.\n \n ID: GB-GOV-10-GHRG_4_156746\nTitle: NIHR Global Health Research Group on optimising maternal and perinatal death surveillance and response to prevent future deaths\nDescription: Globally, there are high rates of death among pregnant women and newborn babies due to poor quality of care. Reviewing deaths of mothers and babies helps health workers, governments and community members identify and solve issues in access and quality of care. This process, known as Maternal and Perinatal Death Surveillance and Response (MPDSR), can reduce deaths by a third.\n\nHowever, in many countries, MPDSR has not had the expected impact due to weak health systems with poor leadership, exclusion of communities from the process, insufficient resources, and lack of training. Fear of blame and punishment discourages people from reporting deaths or providing complete information, so discussions do not address the main issues, and the necessary actions are not taken. A lack of change demotivates health workers and communities. More evidence is needed on how to build a cost-efficient, acceptable MPDSR process, adapted and integrated within local country health systems. \n\nThe project aims to improve reporting, review and response to deaths of mothers and babies in Ethiopia, Ghana and Uganda, and to evaluate the effect of doing this on death rates of babies.\n\nThis 4-year project will work with community members and stakeholders in Uganda, Ghana, and Ethiopia to study how deaths of mothers and babies are currently identified, reported and reviewed, and what changes are made in response. This project is led by the University of Southampton in collaboration with the University of Ghana School of Public Health (Ghana), Haramaya University (Ethiopia), Mbarara University of Science and Technology (Uganda), University of Cape Town (South Africa), the World Health Organization, Liverpool School of Tropical Medicine, and Leiden University (the Netherlands). \n\nDuring phase 1 and 2 of the research (2024-2025), we will conduct in-depth research on current MPDSR practices and develop tools to address the main barriers to MPDSR implementation. In phase 3 (2026-2028), each country will introduce an intervention package of the tools developed in phase 2 into 3 districts, starting at different times. We will count deaths of women and babies before and during implementation. We estimate that the number of babies dying can be reduced by 30%. If this approach reduces deaths, and is cost-effective, countries will be supported to scale it up. Our materials will be made available online. This will help to reduce preventable deaths and improve quality of care for women and their babies.. This project has 8 objectives:\n\n1. To build strong relationships between researchers and community members. The intended outcomes of this objective are to establish community advisory boards (CABs) in each country; to ensure that research plans are relevant and meaningful to the community by incorporating feedback from CABs; and to improve understanding of the motivations and influence of different stakeholders in the MPDSR process.\n\n2. To reduce fear of blame amongst for health workers, by improving laws and regulations. The intended outcomes of this objective are to make recommendations on changes to laws/regulations, so that information in MPDSR cannot be used as evidence against health workers; and to develop a complaints system that is separate from the MPDSR process. \n\n3. To develop standardised tools for reporting and collecting information on deaths of pregnant women and babies. The intended outcomes of this objective are to produce standard tools for reporting maternal and perinatal deaths, and for collecting information about them; to create a system for tracking implementation of recommendations; and to improve the quality of data from health facilities. \n\n4. To improve skills of health workers in conducting MPDSR. The intended outcome of this objective is to produce updated training packages that equip health workers and nursing/midwifery/medical students with the knowledge and skills needed to effectively implement MPDSR. \n\n5. To monitor how well MPDSR is being carried out, what the process costs, and develop sustainable ways of financing it. The intended outcomes of this objective are to produce a standardised form to monitor the implementation of MPDSR; to estimate the cost of implementing MPDSR; and to create a novel mechanism to fund recommendations from MPDSR.\n\n6. To empower communities to prevent the deaths of pregnant women and babies. The intended outcomes of this objective are to create a community death reporting system to provide comprehensive data on deaths in communities; produce standard simplified questionnaires on deaths for community health workers; create a community system for discussing deaths and making recommendations; and to create a training package for community health workers on bereavement counselling. \n\n7. To develop a customised “toolbox” in each country through consultation with stakeholders on each of the tools developed under objectives 2-6, to improve the implementation of MPDSR. \n\n8. To test the effectiveness of the “toolbox” by undertaking clinical trials in three districts in each country, with stagared start dates to allow for comparison. The intended outcome of this objective is to produce high-quality evidence on cost-effectiveness of the \"toolbox\" to improve the implementation of MPDSR.\n \n ID: GB-GOV-10-GHRG_4_156750\nTitle: NIHR Global Health Research Group on improving fitness to face arboviral outbreaks in West Africa\nDescription: Dengue and other viruses transmitted by the mosquito 'Aedes aegypti' are a growing problem in West Africa, with increasingly frequent outbreaks. Control of the mosquito is the most effective way to protect humans. This project, which will run from 2024 to 2028, is based in Ouagadougou, Burkina Faso, where regular dengue epidemics have occurred in recent years. To carry out the research project, we have formed a collaboration between Liverpool School of Tropical Medicine (LSTM, UK), Université Joseph Ki-Zerbo (Burkina Faso), Institut de Recherche en Sciences de la Santé – Direction Régionale de l'Ouest (Burkina Faso), Spanish National Research Council (Spain), Institut de Recherche pour le Développement (France), University of Glasgow (UK) and King's College London (UK). \n\nWe propose to develop a community-based approach for arbovirus outbreak prevention and response. We will collect data on the abundance and distribution of Aedes aegypti in different environments, their genetics and behaviour, human exposure to bites and circulating virus levels to model the forces governing dengue dynamics and to develop an improved index for virus transmission risk. Additional work will test the effectiveness of digital surveillance of mosquitoes using a mobile app to determine a potential role for citizen science. Trials will be conducted of different tools to control adult mosquitoes and immatures, including a large-scale community-embedded programme to determine the effectiveness of reducing mosquito breeding sources. Capacity building is embedded throughout, with the aim of developing skills in trial design and analysis, social science, community-based programme development and implementation, genetic diagnostics and genomics, serosurveillance, entomology and statistical modelling. Community engagement and involvement activities will play a crucial role throughout the project activities and have a dedicated work package supported by researchers based both in Burkina Faso and in Northern partner institutes. We believe that new evidence on arbovirus epidemiology in sub-Saharan Africa and a new generation of local specialists is urgently needed to fill the skills gaps from the bottom upwards and to equip African health systems with the experience, knowledge, and motivation to respond effectively to arbovirus outbreaks.. The project has 5 objectives:\n\n1. To develop improved indices for estimating arbovirus transmission risk through integrated modelling of adult Aedes aegypti abundance, distribution, and behavior, including factors such as genomic admixture, environmental covariables, human behavior, immunological biomarkers, and mosquito biting patterns.\n2. To implement community-based surveillance for immature mosquito development sites, adult occurrence, and perceptions of mosquito biting using the Mosquito Alert mobile app, while cross-validating data through entomological monitoring of adult mosquitoes and larval sites, as well as bite biomarkers.\n3. To conduct community-embedded interventions that include a large-scale cluster randomised controlled trial focused on larval source management and a phased suite of adult-targeted interventions tailored to local Aedes aegypti bionomics, culminating in a household-level randomised controlled trial of the most effective intervention strategies.\n4. To enhance the capacity of researchers from Burkina Faso and extend this capacity to the wider West African region by integrating PhD topics within all project activities, along with outreach initiatives aimed at the broader West African research and vector control community.\n5. To explore the interactions between human behaviour and mosquito biology, empowering citizens with knowledge and practical skills for mosquito control, thereby facilitating the successful implementation of relevant activities.\n \n ID: GB-GOV-10-GHRG_4_156801\nTitle: NIHR Global Health Research Group on the National Confidential Inquiry into suicide deaths, suicide attempts and suicide ideation for India\nDescription: We aim to set up the National Confidential Inquiry into suicide deaths, suicide ideation and suicide attempts for India (India Inquiry) by adapting the national confidential inquiry into suicide and safety in mental health (NCISH) from the UK to improve data capture and understanding of risk factors to inform suicide prevention and improve services for survivors in India. This research will focus on understanding of risk factors for suicide deaths from the administrative data at individual-level, and risk factors for suicide ideation and suicide attempt cases from the mental health services, identify gaps in this documentation, and will build consensus on a minimum data requirement and shared operational definitions for risk factors for these data to be utilised to plan, monitor and improve India’s response to suicide prevention.\n\nThe project is a collaboration between the University of Manchester (UK), Public Health Foundation of India (New Delhi, India), the All India Institute of Medical Sciences (New Delhi, India), the Jawaharlal Institute of Postgraduate Medical Education & Research (Puducherry, India) and the Sisters Living Works (Mumbai, India). Between July 2024 and June 2028, we will contextually adapt the NCISH as India Inquiry, pilot and refine the India Inquiry approach, test the India Inquiry model in two states, one each in the north and south of India, and then present an adaptable model for use across India.\n\nThis project aims to address the high burden of suicide deaths in India. An estimated 195,000 people died by suicide in 2019 in India, the highest number of suicide deaths globally. Furthermore, for every death by suicide in India, there are more than 200 people with suicidality and more than 15 suicide attempts. With the impulsive nature of suicide, and because hanging is increasingly the common method of suicide in India, there is an urgency to act upon suicide prevention. Suicide is the leading cause of death in the 15-39 age group in India, and the suicide death rate in Indian women is twice that of the global average for women. This research will contribute towards a comprehensive response to suicide prevention in India, which is to ensure that suicide does not continue to cost lives and adversely affect many millions through the loss of loved ones. This research is therefore anticipated to have substantial population health benefits.. This project has 4 objectives:\n\n1. To set-up India Inquiry by adapting the national confidential inquiry into suicide and safety in mental health (NCISH) in the UK for India to include suicide deaths captured in the police system and suicide ideation and suicide attempts in contact with mental health services.\n2. To test the India inquiry model to document and analyse the common factors associated with suicide deaths, suicide ideation, and suicide attempts through the confidential inquiry.\n3. To assess the validity of risk factors documented for suicide death cases in the police records at the time of filling report of suicide death with the police.\n4. To disseminate the findings of India inquiry, recommendations for capacity-building for improved documentation of common factors associated with suicide deaths, suicide ideation, and suicide attempts, and explore barriers and facilitators for broader adaptation of the India inquiry.\n \n ID: GB-GOV-10-GHRG_4_156820\nTitle: NIHR Global Health Research Group on addressing the commercial determinants of health in sub-Saharan Africa \nDescription: Non-communicable diseases (NCDs) and the climate crisis jointly pose unequal burdens on the health of citizens, with implications for economies and sustainable development. Most of the premature death and disease from these causes happens in low- and middle-income countries (LMICs) and falls most heavily on the poorest and most vulnerable communities within them. Among the key drivers of these harms are global industries that manufacture and distribute unhealthy products, including tobacco, alcohol, unhealthy food and drink products and fossil fuels. Their diverse impacts on health and their activities in shaping policies to protect and advance their interests constitute “the commercial determinants of health”. The substantial evidence-base about these impacts and about how to regulate such industries to promote health is largely confined to high-income countries.\n\nIn sub-Saharan Africa (SSA), the relationship between such commercial actors and public health is not well understood. The entire region is strategically important to commercial actors both as a source of raw materials and as key markets for future growth. The region confronts particular challenges in seeking to regulate business impacts on health, including resource constraints, competing priorities, the influence of donors and international organisations, and the power of global corporate actors. In an ambitious programme of research in South Africa, Ghana and Kenya, our team will undertake research to inform policies to address these challenges, focusing on the alcohol, unhealthy food and fossil fuel industries.\n\nThis Group brings together leading researchers from the University of the Witwatersrand, South Africa; Kwame Nkrumah University of Science and Technology, Ghana; African Population Health Research Centre, Kenya; and the University of Edinburgh, UK. Working across diverse disciplines, via partnerships and with key stakeholders, this research will address national priorities, strengthen research capacity, and promote South learning. Based on high quality academic outputs and by engaging with communities, advocacy organisations, government ministries and international organisations, we will promote positive impacts on health and development and produce accessible learning materials, good practice guidance and model policies. The project will be implemented between 2024 and 2028.. The project has 4 objectives:\n\n1. To map the health impacts of commercial actors and show how strategic links between alcohol, food and fossil fuel industries influence policies to advance their interests.\n2. To use economic modelling and evaluation to inform policies to effectively regulate unhealthy commodity industries.\n3. To examine how health policy processes can be strengthened to manage conflicts between health goals and the interests of these three industries.\n4. To explore how such research can inform efforts to tackle inequalities in health and in power distribution, working in collaboration with communities and civil society.\n \n ID: GB-GOV-10-GHRG_4_156828\nTitle: NIHR Global Health Research Group on Preterm pre-eclampsiA: PlAcental Growth factor testing for reduction of Adverse Outcomes (PAPAGAIO)\nDescription: The number of women and babies dying due to pre-eclampsia in lower- and middle-income countries (LMICs) compared to the UK is one of the starkest, avoidable health injustices in the world. Although prompt detection and appropriate management of pre-eclampsia were highlighted in the Sustainable Development Goals (SDGs), progress has been inadequate. Globally, 30,000 women and 500,000 babies die every year due to pre-eclampsia. A woman in Sierra Leone is over 2000 times more likely to die from pre-eclampsia than in the UK.\n\nPre-eclampsia is diagnosed by high blood pressure (BP), with one of: the presence of protein in the urine, problems with liver, kidney or clotting function, eclampsia (fits) in the mother, or growth problems for the baby. It is challenging to diagnose and difficult to predict life-threatening complications, especially in resource-poor settings where BP monitors, blood/urine tests, and ultrasound scans may be scarce. The only definitive treatment is delivery of the baby and premature birth is often necessary.\n\nRecently, a new blood test for pre-eclampsia has been developed, called placental growth factor (PlGF). This test is better at diagnosing pre-eclampsia than all other commonly used tests combined. It accurately predicts which women and babies are likely to become seriously unwell and need premature birth, and which women can be safely reassured and continue their pregnancy. A large trial in the UK demonstrated that PlGF helps doctors diagnose pre-eclampsia faster and reduces severe complications, including eclampsia and stroke. PlGF is now recommended in national guidance in the UK. This new test needs to reach locations where it is most needed, where stillbirth, maternal death and severe complications are at least 100 times greater, and resources are limited.\n\nWe have recently shown that, in pre-eclampsia between 34 and 37 weeks of pregnancy, early birth reduces stillbirth by 75%. However, given the challenges associated with limited resources, it is critical to get the diagnosis right to justify early delivery. Premature delivery in the absence of pre-eclampsia would cause harm, especially in LMICs where neonatal care may be limited. PlGF will enable accurate diagnosis to ensure that the correct babies are delivered early to save lives.\n\nWe propose an extensive investigation of the impact of PlGF on making a diagnosis of pre-eclampsia and timing birth, through a cross-continent research group in Sierra Leone, Zambia, India and Brazil.\n\n• Workstream 1 will be an observational study of existing care pathways and management strategies for pre-eclampsia, including cost implications.\n\n• Workstream 2 will be a randomised controlled trial investigating the impact of PlGF on clinical outcomes, including diagnosis, timing of birth and complications.\n\n• Workstream 3 will be a randomised controlled trial of planned early birth, compared to watchful waiting, in women with pre-eclampsia between 34 and 37 weeks of pregnancy, with diagnosis informed by PlGF. The primary outcome for this trial will be stillbirth or early neonatal death.\n\nThroughout all phases, we will build local research capacity and run a training programme to develop research leaders of the future and promote education on the management of pre-eclampsia. Our group has a wealth of experience and proven track record. We are well placed to conduct this important and necessary research, to save lives and improve clinical outcomes for women and their babies where it is vitally needed. This project will run from July 2024 to June 2027.. This project has 4 objectives:\n\n1. Describe care pathways for preterm pre-eclampsia, identify barriers to, and facilitators of placental growth factor (PlGF) testing in lower- and middle-income countries (LMICs).\n2. Assess clinical and cost effectiveness of PlGF testing in suspected preterm pre-eclampsia.\n3. Evaluate clinical and cost effectiveness of planned early delivery in late preterm pre-eclampsia with diagnosis incorporating PlGF testing. \n4. Sustainably build local research capacity at individual and institutional levels. \n \n ID: GB-GOV-10-GHRG_4_156915\nTitle: NIHR Global Health Research Group on Violence Against Women and Violence Against Children\nDescription: Violence against women and children (VAW/C) are human rights violations that affect many women (one in three) and children (around one billion) worldwide. There aren't many other violations that affect such a large part of the global population and have such devastating effects on people's well-being and lives. To address VAW/C, there's a group called the Lancet Commission on VAW/C, of which the applicants are members. The group is made up of policy makers, researchers, and individuals who have experienced violence themselves, many of whom are from low- and middle-income countries (LMICs). As part of our work, we have seen that there is a lot of information about preventing VAW/C in high income countries, but not as much in LMICs. This is a problem because it's important to understand the country specific context to effectively address the issue. We have identified five anchor countries who are engaged to address these concerns and provide recommendations to support other Southern Hemisphere nations.\n\nThe aim of the project is to work across South Africa (University of Cape Town), Mexico (Instituto Tecnológico y de Estudios Superiores de Monterrey), Peru (Universidad Peruana Cayetano Heredia), Brazil (Universidade Federal de Pelotas) and Sri Lanka (University of Jaffna) to co-produce (with survivors of VAW/C) research using a trauma informed framework which will help us understand the effects of violence across different contexts, provide recommendations to prevent violence and build local research capacity.\n\nThe research will include developing diverse, representative, and inclusive survivor panels; describing the economic cost of inaction; finding out what works to prevent violence and developing novel solutions; knowledge exchange; and impact and dissemination activities across five streams of work or work packages (WP).\n\nWP1 on development of the survivor panels including focus groups and evaluation will be completed by February 2028. WP2 on the healthcare burden and impact of VAW/C will be completed by September 2026. WP3 will focus on the economic impact and social burden and will be done by November 2027. The subsequent work around identification and evaluation of interventions and policies to prevent VAC/W will form part of WP4 and will be completed by May 2028. The final work package (WP5) focusing on capacity building and knowledge exchange will run in parallel to the other work packages and will be completed by the end of the project.. The project has 5 objectives: \n\n1. Engage with the affected community and develop working groups (panels) of diverse survivors that are linked into local healthcare networks, and assess impact of this approach. The intended outcome of this objective is to empower those affected by violence by integrating their voice into local healthcare systems and sharing best practices for other countries to learn from.\n\n2. Map country level data and carry out epidemiological studies to describe the burden of harm particularly in marginalised and underserved communities. The intended outcomes of this objective are to produce an openly accessible data directory to facilitate further research; to discover new undocumented harms associated with violence; and to produce novel survey data describing the intersection between experiences of violence and subsequent ill health.\n\n3. Identify the economic impacts and social burden associated with VAW/C. The intended outcome of this objective is to produce an economic toolkit summarising the economic harms of violence, including those previously undocumented, as well as a total cost of inaction.\n\n4. Optimise approaches to finding out what works to prevent VAW/C in LMICs. The intended outcomes of this objective are to produce a policy toolkit summarising effective and promising population based interventions and policies which can be implemented to prevent harm, and to directly benefit residents in Sri Lanka who will be part of a pilot trial of a primary prevention service.\n\n5. Build research capacity in the LMICs and an open-access knowledge exchange and training programme. The intended outcome of this objective is to generate sustainable and well-trained communities of researchers, students (through 10 PhD/Master’s level degree sponsorships) and survivors who will be able to further independently expand this field of research, particularly to help their local communities.\n", "_version_":1865393003471831040 }] } }