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The Global Research Professorships programme funds research leaders, with a track-record of applied health research in low- and middle-income countries (LMICs), to promote effective translation of research and to strengthen research leadership at the highest academic levels. Funding of up to £2m over up to 5 years is awarded to Professors working in close partnership with a research institution in an LMIC.. By the end of the award, NIHR Global Research Professors will be expected to: \n\n1) Have demonstrated research leadership at a national and/or international level.\n2) Have been developed and protected by their institutions, including being relieved of administrative tasks.\n3) Enhance existing and establish new research collaborations in low- and middle-income countries (LMICs).\n4) Have supported training and capacity strengthening/mentorship within LMIC and UK (if applicable) institutions that enhances research capacity for future global health and care research.\n \n ID: GB-GOV-10-RP_04_301621\nTitle: NIHR GRP: Using participatory approaches to improve access to healthcare for disabled people in Uganda\nDescription: The NIHR Global Research Professorship scheme is open to all professions and Higher Education Institutions in England and the Devolved Administrations, to nominate health researchers and methodologists with an outstanding clinical and applied health research record and its effective translation for improved health. Global Research Professors are required to have existing strong links with partners in institutions in countries on the OECD DAC list and the award should plan to support training and capacity development in these partners. \nThere are one billion disabled people globally. Disabled people, on average, have higher healthcare needs than others, yet they face barriers in accessing it. As a result, they have worse health outcomes, including 2-3 times higher mortality rates across all ages. Policies and laws supporting the right to healthcare for disabled people are often not put into practice.\nEvidence is growing that interventions to improve healthcare led by communities are particularly effective. They are low-cost, scalable and address locally relevant concerns. One example is the Participatory Learning and Action (PLA) approach developed to prevent maternal and newborn deaths. In PLA, women’s community groups are established and meet monthly to: 1) identify problems, 2) identify solutions, 3) plan and implement solutions, and 4) evaluate their efforts. PLA significantly reduces maternal and newborn deaths, usually by at least 20%, and is endorsed by WHO.\nThe aim of this study is to assess whether the PLA for Disability (PLA-D) approach can reduce mortality and improve health of disabled people in Uganda. \nResearch will be undertaken by a consortium of UK and Uganda based partners. We will identify the problems facing disabled people in accessing healthcare in Uganda, through: 1) In-depth interviews with key informants (e.g. disabled people, health workers), 2) Analysis of existing numerical data, 3) Updating reviews on access to healthcare for disabled people.\nWe will then collaborate with disabled people and health professionals to use this information to adapt the PLA approach for disabled people. We will decide who should facilitate the groups, where they should meet, and how to adapt PLA delivery and materials. Five PLA-D groups will be established, each including about 20 disabled people. We will assess whether they are feasible to run or need further adaptations.\nWe will then undertake a trial to assess whether PLA-D is effective. We will identify 128 clusters (villages or city blocks) in Luuka district, and randomly assign them to be in the intervention or control group. In the control group, we will help to strengthen the health system, by undertaking an accessibility audit of health facilities and providing training on disability to healthcare workers. In the intervention group we will establish one PLA-D group per cluster, as well as the health system strengthening activities. We will interview all disabled people in the study about health and healthcare access at baseline and follow-up (1 year and 2 years), and record if any participants had died. The intervention and control groups will be compared to assess whether mortality rates were lower and health/healthcare access better in the intervention groups than among controls, and what the cost was for the outcomes achieved.\nCommunity engagement is at the heart of PLA as well as the Disability Movement with its ethos “Nothing about us, without us”. We will include disabled people as advisors at every stage, and as researchers wherever possible.\nWe will hold community meetings and with disabled people’s organisations. We will engage with policy and programme implementers, both in Uganda and internationally, by producing short documents of key findings and holding meetings. We will reach academics through publishing articles in journals and presenting at meetings and conferences.. Objectives:\nTo use an evidenced-based approach to co-create PLA-D.\nTo assess the feasibility of PLA-D implementation.\nTo undertake a cluster-based Randomised Controlled Trial (RCT) to assess the effectiveness/cost-effectiveness of PLA-D in reducing mortality.\nTo undertake a process evaluation of PLA-D to understand mechanisms for impact and scale-up.\nTo strengthen capacity for informing disability policy and practice through the conduct of high-quality research.\n \n ID: GB-GOV-10-RP_04_301627\nTitle: NIHR GRP: Preventing Healthcare Associated Infection and Antimicrobial Resistance in Africa\nDescription: The NIHR Global Research Professorship scheme is open to all professions and Higher Education Institutions in England and the Devolved Administrations, to nominate health researchers and methodologists with an outstanding clinical and applied health research record and its effective translation for improved health. Global Research Professors are required to have existing strong links with partners in institutions in countries on the OECD DAC list and the award should plan to support training and capacity development in these partners.\nTo address Healthcare Associated Infection (HAI) in Africa, I will use cutting edge molecular microbiology and mathematical modelling to investigate the implementation of the WHO framework for Infection Prevention and Control (IPC) in Malawi. Key to this will be the development of equitable partnerships with the Ministry of Health and College of Medicine. I will use the data to develop effective, acceptable and scalable interventions to reduce HAI in Africa.\nHospitals are perceived as places of safety, however the concentration of vulnerable people, staff and visitors makes maintaining safety a major challenge that requires the involvement of multiple professional groups and patients, staff and visitors.\nInfections contracted because of admission to hospital, or exposure to other healthcare facilities are the most common adverse outcome associated with healthcare settings globally. Further, the germs, specifically bacteria, associated with HAI are increasingly resistant to antibiotics, making the treatment of HAI an increasing challenge. It is therefore best to prevent HAI.\nIPC is the term used to describe strategies to prevent HAI and the WHO has published a substantial body of work to support the implementation of IPC in low- and middle-income countries (LMIC). However, HAI and IPC are often not prioritised in LMIC due to lack of resources and multiple competing priorities.\nI will work in three government hospitals in Malawi. The project will be based at the Malawi Liverpool Wellcome Programme and will run in partnership with the College of Medicine, Ministry of Health and African Institute of Development Policy (AFIDEP). I will implement my project in 4 workstrands:\n1)\tImplementing IPC strategy: The priority will be to convene a national steering group to build an equitable partnership and reinvigorate existing ministry of health IPC teams. We will assess previous IPC strategies. I will conduct clinical and laboratory surveillance of HAI before implementing an IPC programme co-created with partners. Assessment of effectiveness of the implementation will be made and shared with policy makers.\n2)\tUsing mathematical modelling to understand the intervention: I will recruit cohorts of patients with different types of HAI and study them in-depth by capturing comprehensive patient and bacterial data before and after implementation for key HAI syndromes. I will use cutting edge microbiological tools and mathematical methods to analyse these data and iteratively improve the IPC programme.\n3)\tHealth economics: We will estimate the cost of HAI, and then evaluate cost effectiveness of interventions to enable policy makers to make recommendations about targeting efforts.\n4)\tPolicy: We will actively involve MoH and CoM throughout the project, co-creating nationally scalable IPC interventions.\nWe will involve patents and the public in co-producing IPC strategy and interventions and in doing so raise the profile of HAI, IPC and AMR in Malawi, in partnership with MLW’s community advisory group.\nOur findings will be shared with the WHO Infection Prevention team and more broadly to the academic community through presentation and peer-reviewed publication. We will engage with the public through MLW’s communications team, using radio, print and social media, and share information with hospitals through peer education meetings, and with the Ministry of Health through relevant technical advisory groups.. Objectives\n\nIn equitable partnership with a national-level IPC steering group, to reinvigorate local IPC teams in three hospitals in Southern Malawi;\nEstablish clinical and microbiological HAI surveillance, then implement, test and improve the WHO guidelines on IPC, investigating their effectiveness within an implementation science framework;\nAssess the efficacy of IPC implementation using descriptive epidemiology, high resolution molecular surveillance and causal inference;\nTo estimate the economic burden associated with HAI, and cost-effectiveness of IPC\nCo-create acceptable, sustainable, and nationally generalisable guidelines, policy and protocols to mitigate HAI in Malawi in partnership with College of Medicine and Public Health Institute of Malawi.\n \n ID: GB-GOV-10-RP_04_301634\nTitle: NIHR GRP: Using innovations in intervention and evaluation to reduce sexual transmission of HIV \nDescription: The NIHR Global Research Professorship scheme is open to all professions and Higher Education Institutions in England and the Devolved Administrations, to nominate health researchers and methodologists with an outstanding clinical and applied health research record and its effective translation for improved health. Global Research Professors are required to have existing strong links with partners in institutions in countries on the OECD DAC list and the award should plan to support training and capacity development in these partners.\n\nMy goal is to bring the benefits of recent advances in HIV prevention to stem the HIV epidemic and its negative impact on young people in South Africa. I will do this through a peer-led community-based package of biomedical HIV prevention and psychosocial support that is tailored to young persons’ need. \nDespite huge advances in HIV treatment and prevention, HIV related ill-health and death remains a huge problem in South Africa. 7.7 million people are living with HIV and young people bear the brunt of both the health and socioeconomic impact of the HIV pandemic. The anticipated doubling in number of young people over the next twenty years underscores the urgency of developing scalable models of delivering HIV prevention alongside treatment. \nThe study will be conducted amongst men and women aged 16-30 living in a poor, rural area of KwaZulu-Natal: \nIn the first 18 months we will use participatory research to optimise Thetha Nami (a peer-navigator delivered HIV prevention intervention for young people). We will:\na) optimise the peer navigator needs assessment tool so that vulnerable and at risk individuals receive more support\nb) refine the social support and peer mentorship components of the intervention\nc) establish safe clinical pathways for delivery of sexual health self-care to young people\nd) identify ways to use routine service use data to identify groups that need increased support\nIn the second 30 months we will test this intervention in a randomised controlled trial. 3000 men and women aged 16-30 will be selected at random from the study area, ensuring gender and age balance. If they agree to participate they will be randomly offered one of four intervention combinations: a) usual care: clinic based HIV testing and treatment if positive and biomedical prevention if negative; b) the peer-led biosocial intervention c) the sexual health self-care kit and d) combination of the peer-led intervention and sexual health self-care kits. The participants will then be followed up after 24 months for an interviewer administered survey and a finger prick test for HIV. \nThe main outcome is the effect of the interventions on reducing sexually transmissible HIV. This is defined as participants remaining HIV negative, or, if living with HIV, starting antiretroviral therapy and having an undetectable HIV viral load. We will also measure the effect of the intervention/s on sexual and mental health and quality of life. \nWe involved patients and the public to iteratively co-create the peer-led intervention. We will engage young people throughout the study. This will include strengthening the youth advisory component of our community advisory board, delivery of interventions through peer-navigators, and involvement of youth on the project steering committee. I will use participatory dissemination workshops to understand enablers and ensure that these interventions are equitable in their reach. \nThe final output will be a well-defined and scalable implementation strategy to reduce the negative impact of HIV on youth in South Africa. It will comprise a feasible approach to identify those at risk, and then deliver an intervention to improve uptake and effective use of HIV prevention and care. By engaging our technical advisory group, which includes service users and providers and health policy makers, we are confident that we will generate the evidence needed to scale-up the interventions.. Aims and objectives: The goal of my fellowship is to stem the HIV epidemic and it’s negative impact on young people in SA through effective implementation of advances in HIV prevention. \nSpecific aim one: I will use community based participatory research to optimise risk-differentiated and tailored biosocial HIV prevention for young people in rural KZN\nOptimise the risk-differentiation (where more vulnerable and at risk individuals receive more support), and the psychosocial components of the intervention delivered by the peer navigators\nEstablish safe clinical pathways to support decentralised PrEP, ART, and sexual health selfcare\nUse routine service use data to identify groups that need increased support\nSpecific aims two: I will use a 4X2 factorial randomised controlled trial and process evaluation to evaluate the effectiveness and scalability of risk-differentiated and tailored biosocial HIV prevention delivered by peers to reduce the prevalence of sexually transmissible HIV among 16-30-year-old men and women\nEvaluate the effectiveness and cost effectiveness of the risk-differentiated and tailored biosocial HIV prevention delivered by peers to reduce the prevalence of transmissible HIV\nConduct a process evaluation of the acceptability, feasibility, and equitable reach of each component of the intervention\n", "_version_":1862221875076136960 }] } }